1
|
Bousquet J, Sousa-Pinto B, Anto JM, Bedbrook A, Fonseca JA, Zuberbier T. MASK-air: An OECD (Organisation for Economic Co-operation and Development) Best Practice for Public Health on Integrated Care for Chronic Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2010-2016.e7. [PMID: 38521122 DOI: 10.1016/j.jaip.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/17/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]
Abstract
In the recent report of the Organisation for Economic Co-operation and Development (OECD) on Best Practices (BPs) for Integrating Care to Prevent and Manage Chronic Diseases, an app on rhinitis and asthma (MASK-air [Mobile Airways Sentinel networK for airway diseases]) has been listed. The OECD is a reliable source of evidence-based policy analysis and economic data largely used by governments. It has published several BPs on public health. On May 10, 2023, the OECD published 13 BPs for Integrating Care to Prevent and Manage Chronic Diseases in the European Union. The report did not cover all models of integrated care; rather, it "focuse(d) on those that are of key strategic interest to policy makers." New MASK-air studies (not published in the report) include equity, usability of the app in old-age adults, economic impact, quality of life, and allergen immunotherapy. MASK-air is freely available on iOS and Android in 30 countries and has been recently introduced in the United States. The MASK-air OECD BP represents a model of digitally enabled, patient-centered care for chronic diseases using a holistic approach of shared decision making.
Collapse
Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; MASK-air, Montpellier, France; ARIA, Montpellier, France.
| | - Bernardo Sousa-Pinto
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Anna Bedbrook
- MASK-air, Montpellier, France; ARIA, Montpellier, France
| | - Joao A Fonseca
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| |
Collapse
|
2
|
Tempels-Pavlica Ž, Aarts MCJ, Welsing PMJ, van der Meer AN, van der Zwan LP, Uss E, Knulst AC. House dust mite sublingual allergen immunotherapy tablet is safe and well-tolerated in Dutch clinical practice. FRONTIERS IN ALLERGY 2024; 5:1355324. [PMID: 38487467 PMCID: PMC10937523 DOI: 10.3389/falgy.2024.1355324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/16/2024] [Indexed: 03/17/2024] Open
Abstract
Background Half (49%) of clinically diagnosed allergic rhinitis (AR) patients are sensitized to house dust mite (HDM). If allergen avoidance and symptomatic medication fail, allergen immunotherapy may be indicated. Objective We investigated safety and tolerability of HDM-sublingual immunotherapy by HDM-SLIT tablets in Dutch daily clinical practice. Methods Daily intake of 12 SQ-HDM SLIT-tablet was investigated in a prospective, multicenter, observational study (EUPAS43753). It comprised 4 consultations in 1 year. Data on safety, tolerability, treatment satisfaction, symptomatic medication, compliance, and clinical effectiveness (Control of Allergic Rhinitis and Asthma Test; CARAT) were collected. Descriptive and longitudinal regression data analysis were performed. Results Adult patients (n = 415), mean (SD) age 36.6 (12.2) years, 61.4% female and 36% asthmatic were included. The preponderance (65.1%) experienced adverse events (AEs). These, mostly mild (67%), AEs comprised: oral allergic reactions (58.6%), respiratory (12.4%) and gastrointestinal symptoms (9.4%). Sixty (14.5%) patients stopped due to AEs and 76 (18.3%) for non-AE reasons. CARAT scores improved clinically significant by 6 points and symptomatic medication use decreased from 96.1% to 77.4%. Most patients (74.5%) tolerated the treatment and were compliant (>86.5%). The majority of patients (62.4%) and investigators (69.4%) were satisfied with treatment. Conclusions HDM SLIT-tablet is a safe and well-tolerated AR treatment. AEs occur often but are mostly mild and decreasing during the first year. CARAT scores improved and symptomatic medication use decreased suggesting better control of AR with treatment. Compliance, tolerability, and treatment satisfaction are good. However, patient follow-up and compliance remain important points of attention when initiating treatment.
Collapse
Affiliation(s)
| | - Mark C. J. Aarts
- Department of Otorhinolaryngology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, Netherlands
| | - Paco M. J. Welsing
- Department of Rheumatology & Clinical Immunology, University Medical Centre Utrecht, Utrecht, Netherlands
| | | | | | - Elena Uss
- Medical Department, ALK-Abelló BV, Almere, Netherlands
| | - André C. Knulst
- Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
3
|
Matricardi PM, Sousa-Pinto B, Dramburg S, Bousquet J. Beyond ARIA: Will e-diaries replace retrospective questionnaires in measuring the severity of allergic rhinitis in clinical research and daily practice? Clin Exp Allergy 2023; 53:1004-1010. [PMID: 37488953 DOI: 10.1111/cea.14372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/12/2023] [Accepted: 06/05/2023] [Indexed: 07/26/2023]
Abstract
Retrospective questionnaires are used since decades to assess the severity and/or control of allergic diseases. Applications on smartphones have recently facilitated the use of prospective clinical diaries, based on questionnaires filled every day by the patient. Once limited to clinical trials, these e-diaries, based on validated disease control scores and visual analogue scales, permit a quantitative day-by-day measure free of recall bias. Given the advantages of this procedure, its use could be extended to the daily clinical practice. E-diaries may facilitate (1) a more precise identification of the culprit allergen in the diagnostic work-up of poly-sensitized patients, (2) the stratification of patients for treatment, (3) the follow-up of the patients under treatment for optimized shared decision-making, and (4) a careful assessment of preventive therapies. While a few apps are being used in scientific studies, consensus on their use in daily practice should be reached and guidelines for specialists should be elaborated by scientific associations.
Collapse
Affiliation(s)
- Paolo M Matricardi
- Department of Pediatric Respiratory Care, Immunology, and Intensive Care Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Stephanie Dramburg
- Department of Pediatric Respiratory Care, Immunology, and Intensive Care Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- University Hospital Montpellier, Montpellier, France
| |
Collapse
|
4
|
Alnahas S, Abouammoh N, Althagafi W, Abd-Ellatif EE. Prevalence, severity, and risk factors of allergic rhinitis among schoolchildren in Saudi Arabia: A national cross-sectional study, 2019. World Allergy Organ J 2023; 16:100824. [PMID: 37859757 PMCID: PMC10582485 DOI: 10.1016/j.waojou.2023.100824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 10/21/2023] Open
Abstract
Background Allergic rhinitis is a significant public health concern worldwide, affecting both developed and developing countries, with prevalence rates ranging between 10% and 30% in adults and over 40% in children. However, there are limited studies on allergic rhinitis prevalence in Saudi Arabia. Objective To explore allergic rhinitis among schoolchildren in Saudi Arabia in terms of prevalence, severity, and risk factors. Methods This study was conducted between March and April 2019, covering 20 regions. The study employed a multistage, stratified cluster sampling approach and selected 137 primary and 140 intermediate schools. The research utilized the methodology and questionnaires recommended by the Global Asthma Network (GAN). Data analysis was carried out using IBM SPSS Statistics (Version 23). Results The completed questionnaires in the analysis comprised 3614 children aged 6-7 years old and 4068 adolescents aged 13-14 years old. The study found that 5.6% of children and 14.0% of adolescents reported current rhinoconjunctivitis, with 0.5% of children and 1.3% of adolescents experiencing severe symptoms. Several risk factors were significantly associated with rhinoconjunctivitis. In children 6-7 years old, eating cooked vegetables was inversely associated with rhinoconjunctivitis, while prematurity, wheezing in infancy, and a history of pneumonia were positively associated with the condition. In adolescents, vigorous physical activity, current exposure to cats, and frequent use of paracetamol were found to be the main risk factors associated with rhinoconjunctivitis, while high consumption of pulses and eggs was found to have a protective effect. Conclusion In Saudi Arabia, the prevalence of rhinoconjunctivitis in children is lower than average globally, but among adolescents, it is within the global average range. However, the prevalence of severe rhinoconjunctivitis among adolescents is twice the global average. Further research is required to examine regional differences, track trends over time, and explore risk factors that contribute to allergic rhinitis.
Collapse
Affiliation(s)
- Sawsan Alnahas
- Field Epidemiology Training Program, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Public Health Protection, Dubai Health Authority, Dubai, United Arab Emirates
| | - Noura Abouammoh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Wael Althagafi
- General Directorate of Health Programs and Chronic Diseases, Ministry of Health, Riyadh, Saudi Arabia
| | - Eman Elsayed Abd-Ellatif
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| |
Collapse
|
5
|
Peterson AM, Miller B, Ioerger P, Hentati F, Doering MM, Kallogjeri D, Piccirillo JF. Most-Cited Patient-Reported Outcome Measures Within Otolaryngology-Revisiting the Minimal Clinically Important Difference: A Review. JAMA Otolaryngol Head Neck Surg 2023; 149:261-276. [PMID: 36729451 PMCID: PMC10729312 DOI: 10.1001/jamaoto.2022.4703] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance Patient-reported outcome measures (PROMs) allow clinicians and researchers to assess health-related information from a patient's perspective. These measures have been used more frequently over the last several decades, but an associated minimal clinically important difference (MCID) is needed to optimize their utility. This narrative review identified the top 100 most-cited otolaryngology-related PROM development and validation publications and assessed the presence and characteristics of the PROMs' associated MCID. Observations In this narrative review, a literature search in Scopus and Web of Science was conducted on June 29, 2022, using keywords related to PROM development and validation studies in otolaryngology and reference lists. Studies that met the definition of a PROM and assessed an otolaryngologic disorder or study population were included for full-text review. After full-text review of 188 articles, the top 100 most-cited PROM development and validation publications, resulting in 106 total PROMs, were chosen for review. A total of 39 (37%) of the identified PROMs had an associated MCID. Of those reporting an MCID, 14 (35.9%) used an anchor-based method, 12 (30.8%) used a distribution-based method, 10 (25.6%) used both, and 3 (7.7%) did not specify or used neither method. Rhinology had the greatest number of PROMs with an associated MCID (16 of 24, 66%), and pediatrics had the fewest (1 of 13, 7.7%). The median number of citations of PROMs with an MCID was higher than those without an MCID. Conclusions and Relevance The majority of the most-cited PROMs in otolaryngology lack an associated MCID. These data indicated that there are a multitude of PROMs that have been cited hundreds of times and used for decades without the ability to identify whether a particular change in score on the instrument is clinically meaningful. There is a need to determine and validate MCIDs for commonly used PROMs to aid clinical research and trial interpretation.
Collapse
Affiliation(s)
- Andrew M. Peterson
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Brevin Miller
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Patrick Ioerger
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- University of Kansas Medical Center, Kansas City, Kansas
| | - Firas Hentati
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Case Western Reserve University, Cleveland, Ohio
| | - Michelle M. Doering
- Becker Medical Library, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| |
Collapse
|
6
|
Moitra S, Simoni M, Baldacci S, Maio S, Angino A, Silvi P, Viegi G, La Grutta S, Ruggiero F, Bedini G, Natali F, Cecchi L, Berger U, Prentovic M, Gamil A, Baïz N, Thibaudon M, Monnier S, Caimmi D, Tanno LK, Demoly P, Orlandini S, Annesi‐Maesano I. Symptom control and health-related quality of life in allergic rhinitis with and without comorbid asthma: A multicentre European study. Clin Transl Allergy 2023; 13:e12209. [PMID: 36825519 PMCID: PMC9893887 DOI: 10.1002/clt2.12209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/26/2022] [Accepted: 09/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Allergic rhinitis (AR) is a major non-communicable disease that affects the health-related quality of life (HRQoL) of patients. However, data on HRQoL and symptom control in AR patients with comorbid asthma (AR + asthma) are lacking. METHODS In this multicentre, cross-sectional study, patients with AR were screened and administered questionnaires of demographic characteristics and health conditions (symptoms/diagnosis of AR and asthma, disease severity level, and allergic conditions). HRQoL was assessed using a modified version of the RHINASTHMA questionnaire (30, 'not at all bothered' - 150 'very much bothered') and symptom control was evaluated by a modified version of the Control of Allergic Rhinitis/Asthma Test (CARAT) (0, 'no control' - 30, 'very high control'). RESULTS Out of 643 patients with AR, 500 (78%) had asthma as a comorbidity, and 54% had moderate-severe intermittent AR, followed by moderate-severe persistent AR (34%). Compared to the patients with AR alone, patients with AR + asthma had significantly higher RHINASTHMA (e.g., median RHINASTHMA-total score 48.5 vs. 84, respectively) and a significantly lower CARAT score (median CARAT-total score 23 vs. 16.5, respectively). Upon stratifying asthma based on severity, AR patients with severe persistent asthma had worse HRQoL and control than those with mild persistent asthma. The association was significantly higher among non-obese participants compared to obese ones, with RHINASTHMA-upper symptoms score but not with CARAT. CONCLUSIONS Our observation of poorer HRQoL and symptoms control in AR patients with comorbid asthma supports the importance of a comprehensive approach for the management of AR in case of a comorbid allergic condition.
Collapse
Affiliation(s)
- Subhabrata Moitra
- Division of Pulmonary Medicine & Alberta Respiratory CentreDepartment of MedicineUniversity of AlbertaEdmontonAlbertaCanada
| | - Marzia Simoni
- Pulmonary Environmental Epidemiology UnitCNR Institute of Clinical Physiology (IFC)PisaItaly
| | - Sandra Baldacci
- Pulmonary Environmental Epidemiology UnitCNR Institute of Clinical Physiology (IFC)PisaItaly
| | - Sara Maio
- Pulmonary Environmental Epidemiology UnitCNR Institute of Clinical Physiology (IFC)PisaItaly
| | - Anna Angino
- Pulmonary Environmental Epidemiology UnitCNR Institute of Clinical Physiology (IFC)PisaItaly
| | - Patrizia Silvi
- Pulmonary Environmental Epidemiology UnitCNR Institute of Clinical Physiology (IFC)PisaItaly
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology UnitCNR Institute of Clinical Physiology (IFC)PisaItaly
| | | | | | | | - Francesca Natali
- Department of Agrifood Production and Environmental SciencesUniversity of FlorenceFlorenceItaly
| | - Lorenzo Cecchi
- Centre of BioclimatologyUniversity of FlorenceFlorenceItaly
| | - Uwe Berger
- Research Unit Aerobiology and Pollen InformationDepartment of Oto‐Rhino‐LaryngologyMedical University of ViennaViennaAustria
| | - Maria Prentovic
- Research Unit Aerobiology and Pollen InformationDepartment of Oto‐Rhino‐LaryngologyMedical University of ViennaViennaAustria
| | - Amir Gamil
- Institut Desbrest of Epidemiology and Santé Publique INSERM & Montpellier UniversityMontpellierFrance
| | - Nour Baïz
- Institut Desbrest of Epidemiology and Santé Publique INSERM & Montpellier UniversityMontpellierFrance
| | - Michel Thibaudon
- Reseau National de Surveillance Aerobiologique (RNSA)BrussieuFrance
| | - Samuel Monnier
- Reseau National de Surveillance Aerobiologique (RNSA)BrussieuFrance
| | - Davide Caimmi
- Institut Desbrest of Epidemiology and Santé Publique INSERM & Montpellier UniversityMontpellierFrance
| | - Luciana K. Tanno
- Institut Desbrest of Epidemiology and Santé Publique INSERM & Montpellier UniversityMontpellierFrance
| | - Pascal Demoly
- Institut Desbrest of Epidemiology and Santé Publique INSERM & Montpellier UniversityMontpellierFrance
| | - Simone Orlandini
- Department of Agrifood Production and Environmental SciencesUniversity of FlorenceFlorenceItaly
| | - Isabella Annesi‐Maesano
- Institut Desbrest of Epidemiology and Santé Publique INSERM & Montpellier UniversityMontpellierFrance
| |
Collapse
|
7
|
Pedersen CK, Haase C, Aanaes K, von Buchwald C, Backer V. An update on patient reported outcomes in type 2 inflammation airway disease. Curr Opin Allergy Clin Immunol 2023; 23:1-8. [PMID: 36378110 DOI: 10.1097/aci.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE OF REVIEW Patient reported outcome measures (PROMs) play an important role in assessing so-called global airway disease caused by type-2 inflammation, not only in terms of patients' perspective on symptoms and treatment/side-effect, but they can also serve as a measure of disease control, and not least as an indicator of possible coexisting comorbidity otherwise unrecognized. The objective of this review was to investigate any newly developed PROMs for global airway disease and to give an overview of the most commonly used PROMs in the management of global airway disease. RECENT FINDINGS The Standard Tests for Asthma, Allergic Rhinitis and Rhinosinusitis (STARR-15) is a recently developed PROM aimed to raise clinicians' awareness of coexisting type-2 inflammation disease. Strengths of the STARR-15 is that is quick and symptom-centered, i.e. items are not specifically aimed at a disease the patients might not be aware they have. The STARR-15 has, however, not yet been validated, so details of responsiveness and reproducibility are yet to be determined. SUMMARY PROMs are a quick and cheap way to assess patient perspectives in global airway disease, and can play an important role in unveiling otherwise overlooked co-existing double disease.
Collapse
Affiliation(s)
- Christian Korsgaard Pedersen
- Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Copenhagen University Hospital Rigshospitalet, Denmark
| | | | | | | | | |
Collapse
|
8
|
Bousquet J, Anto JM, Sousa‐Pinto B, Czarlewski W, Bedbrook A, Haahtela T, Klimek L, Pfaar O, Kuna P, Kupczyk M, Regateiro FS, Samolinski B, Valiulis A, Yorgancioglu A, Arnavielhe S, Basagaña X, Bergmann KC, Bosnic‐Anticevich S, Brussino L, Canonica GW, Cardona V, Cecchi L, Chaves‐Loureiro C, Costa E, Cruz AA, Gemicioglu B, Fokkens WJ, Ivancevich JC, Kraxner H, Kvedariene V, Larenas‐Linnemann DE, Laune D, Louis R, Makris M, Maurer M, Melén E, Micheli Y, Morais‐Almeida M, Mullol J, Niedoszytko M, Okamoto Y, Papadopoulos NG, Patella V, Pham‐Thi N, Rouadi PW, Sastre J, Scichilone N, Sheikh A, Sofiev M, Taborda‐Barata L, Toppila‐Salmi S, Tsiligianni I, Valovirta E, Ventura MT, Vieira RJ, Zidarn M, Amaral R, Ansotegui IJ, Bédard A, Benveniste S, Bewick M, Bindslev‐Jensen C, Blain H, Bonini M, Bourret R, Braido F, Carreiro‐Martins P, Charpin D, Cherrez‐Ojeda I, Chivato T, Chu DK, Cingi C, Del Giacco S, de Blay F, Devillier P, De Vries G, Doulaptsi M, Doyen V, Dray G, Fontaine J, Gomez RM, Hagemann J, Heffler E, Hofmann M, Jassem E, Jutel M, Keil T, Kritikos V, Kull I, Kulus M, Lourenço O, Mathieu‐Dupas E, Menditto E, Mösges R, Murray R, Nadif R, Neffen H, Nicola S, O’Hehir R, Olze H, Palamarchuk Y, Pépin J, Pétré B, Picard R, Pitsios C, Puggioni F, Quirce S, Raciborski F, Reitsma S, Roche N, Rodriguez‐Gonzalez M, Romantowski J, Sá‐Sousa A, Serpa FS, Savouré M, Shamji MH, Sova M, Sperl A, Stellato C, Todo‐Bom A, Tomazic PV, Vandenplas O, Van Eerd M, Vasankari T, Viart F, Waserman S, Fonseca JA, Zuberbier T. Digitally-enabled, patient-centred care in rhinitis and asthma multimorbidity: The ARIA-MASK-air ® approach. Clin Transl Allergy 2023; 13:e12215. [PMID: 36705508 PMCID: PMC9823305 DOI: 10.1002/clt2.12215] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/19/2022] [Indexed: 01/09/2023] Open
Abstract
MASK-air® , a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air® is a Good Practice of DG Santé on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air® results should lead to change management in rhinitis and asthma.
Collapse
Affiliation(s)
- Jean Bousquet
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany,University Hospital MontpellierMontpellierFrance,InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
| | - Josep M. Anto
- ISGlobalBarcelona Institute for Global HealthBarcelonaSpain,IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain,Universitat Pompeu Fabra (UPF)BarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)BarcelonaSpain
| | - Bernardo Sousa‐Pinto
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | | | | | - Tari Haahtela
- Skin and Allergy HospitalHelsinki University HospitalUniversity of HelsinkiHelsinkiFinland
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck SurgeryUniversitätsmedizin MainzMainzGermany,Center for Rhinology and AllergologyWiesbadenGermany
| | - Oliver Pfaar
- Section of Rhinology and AllergyDepartment of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital MarburgPhilipps‐Universität MarburgMarburgGermany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and AllergyBarlicki University HospitalMedical University of LodzLodzPoland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and AllergyBarlicki University HospitalMedical University of LodzLodzPoland
| | - Frederico S. Regateiro
- Allergy and Clinical Immunology UnitCentro Hospitalar e Universitário de CoimbraCoimbraPortugal,ICBR, Coimbra Institute for Clinical and Biomedical Research, CIBBFaculty of MedicineUniversity of CoimbraCoimbraPortugal,Institute of ImmunologyFaculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarsawPoland
| | - Arunas Valiulis
- Institute of Clinical Medicine and Institute of Health SciencesVilniusLithuania,Medical Faculty of Vilnius UniversityVilniusLithuania
| | - Arzu Yorgancioglu
- Department of Pulmonary DiseasesCelal Bayar University, Faculty of MedicineManisaTurkey
| | | | - Xavier Basagaña
- ISGlobalBarcelona Institute for Global HealthBarcelonaSpain,IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain,Universitat Pompeu Fabra (UPF)BarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)BarcelonaSpain
| | - Karl C. Bergmann
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany
| | - Sinthia Bosnic‐Anticevich
- Quality Use of Respiratory Medicine GroupWoolcock Institute of Medical ResearchThe University of SydneySydneyNSWAustralia,Sydney Local Health DistrictSydneyNSWAustralia
| | - Luisa Brussino
- Department of Medical SciencesAllergy and Clinical Immunology UnitUniversity of TorinoTorinoItaly,Mauriziano HospitalTorinoItaly
| | - G. Walter Canonica
- Department of Biomedical SciencesHumanitas University, Pieve EmanueleMilanItaly,Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Center IRCCSRozzanoItaly
| | - Victoria Cardona
- Allergy SectionDepartment of Internal MedicineHospital Vall d'HebronBarcelonaSpain,ARADyAL Research NetworkBarcelonaSpain
| | - Lorenzo Cecchi
- SOS Allergology and Clinical ImmunologyUSL Toscana CentroPratoItaly
| | - Claudia Chaves‐Loureiro
- Pneumology UnitHospitais da Universidade de CoimbraCentro Hospitalar e Universitário de CoimbraCoimbraPortugal
| | - Elisio Costa
- UCIBIO, REQUINTEFaculty of Pharmacy and Competence Center on Active and Healthy AgeingUniversity of Porto (Porto4Ageing)PortoPortugal
| | - Alvaro A. Cruz
- Fundaçao ProARFederal University of Bahia and GARD/WHO Planning GroupSalvadorBahiaBrazil
| | - Bilun Gemicioglu
- Cerrahpasa Faculty of MedicineDepartment of Pulmonary DiseasesIstanbul University‐CerrahpasaIstanbulTurkey
| | - Wytske J. Fokkens
- Department of OtorhinolaryngologyAmsterdam University Medical Centres, location AMCAmsterdamthe Netherlands
| | | | - Helga Kraxner
- Department of Otorhinolaryngology, Head and Neck SurgerySemmelweis UniversityBudapestHungary
| | - Violeta Kvedariene
- Faculty of MedicineInstitute of Clinical MedicineClinic of Chest Diseases and AllergologyVilnius UniversityVilniusLithuania,Faculty of MedicineDepartment of PathologyInstitute of Biomedical SciencesVilnius UniversityVilniusLithuania
| | | | | | - Renaud Louis
- Department of Pulmonary MedicineCHU LiegeLiègeBelgium,GIGA I3 Research GroupUniversity of LiegeLiègeBelgium
| | - Michael Makris
- Allergy Unit “D Kalogeromitros”2nd Department of Dermatology and VenereologyNational & Kapodistrian University of Athens“Attikon” University HospitalAthensGreece
| | - Marcus Maurer
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany
| | - Erik Melén
- Sach's Children and Youth HospitalSödersjukhusetStockholmSweden,Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
| | | | | | - Joaquim Mullol
- Rhinology Unit & Smell ClinicENT DepartmentHospital ClínicBarcelonaSpain,Clinical & Experimental Respiratory ImmunoallergyIDIBAPS, CIBERESUniversity of BarcelonaBarcelonaSpain
| | | | | | | | - Vincenzo Patella
- Division of Allergy and Clinical ImmunologyDepartment of Medicine“Santa Maria della Speranza” Hospital, BattipagliaSalernoItaly,Agency of Health ASLSalernoItaly
| | - Nhân Pham‐Thi
- Ecole Polytechnique PalaiseauIRBA (Institut de Recherche Bio‐Médicale des Armées)BretignyFrance
| | - Philip W. Rouadi
- Department of Otolaryngology, Head and Neck SurgeryEye and Ear University HospitalBeirutLebanon,Department of Otorhinolaryngology, Head and Neck SurgeryDar Al Shifa HospitalSalmiyaKuwait
| | - Joaquin Sastre
- Fundacion Jimenez Diaz, CIBERESFaculty of MedicineAutonoma University of MadridMadridSpain
| | | | - Aziz Sheikh
- Usher InstituteThe University of EdinburghEdinburghUK
| | | | - Luis Taborda‐Barata
- Department of ImmunoallergologyCova da Beira University Hospital CentreCovilhãPortugal,UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
| | - Sanna Toppila‐Salmi
- Skin and Allergy HospitalHelsinki University HospitalUniversity of HelsinkiHelsinkiFinland
| | - Ioanna Tsiligianni
- International Primary Care Respiratory Group IPCRGAberdeenScotland,Health Planning UnitFaculty of MedicineDepartment of Social MedicineUniversity of CreteCreteGreece
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical ImmunologyUniversity of TurkuTurkuFinland,Terveystalo Allergy ClinicTurkuFinland
| | | | - Rafael José Vieira
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic DiseasesGolnikSlovenia,Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Rita Amaral
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | | | - Annabelle Bédard
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance,Université Paris‐Saclay, UVSQUniversity Paris‐SudVillejuifFrance
| | - Samuel Benveniste
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO)Broca HospitalParisFrance,Mines ParisTech CRI ‐ PSL Research UniversityFontainebleauFrance
| | - Michael Bewick
- University of Central Lancashire Medical SchoolPrestonUK
| | - Carsten Bindslev‐Jensen
- Odense Research Center for Anaphylaxis (ORCA)OdenseDenmark,Department of Dermatology and Allergy CentreOdense University HospitalOdenseFinland
| | - Hubert Blain
- Department of GeriatricsMontpellier University Hospital, MUSEMontpellierFrance
| | - Matteo Bonini
- Department of Clinical and Surgical SciencesFondazione Policlinico Universitario A Gemelli IRCCSRomeItaly,National Heart and Lung InstituteRoyal Brompton Hospital & Imperial College LondonLondonUK
| | | | - Fulvio Braido
- Department of Internal Medicine (DiMI)University of GenoaGenovaItaly,IRCCS Ospedale Policlinico San MartinoGenovaItaly
| | - Pedro Carreiro‐Martins
- NOVA Medical School/Comprehensive Health Research Centre (CHRC)LisbonPortugal,Serviço de ImunoalergologiaHospital de Dona EstefâniaCentro Hospitalar Universitário de Lisboa CentralLisbonPortugal
| | - Denis Charpin
- Clinique des BronchesAllergie et SommeilHôpital NordMarseilleFrance
| | - Ivan Cherrez‐Ojeda
- Universidad Espíritu SantoSamborondónEcuador,Respiralab Research GroupGuayaquil, GuayasEcuador
| | - Tomas Chivato
- School of MedicineUniversity CEU San PabloMadridSpain
| | - Derek K. Chu
- Department of Health Research Methods, Evidence, and Impact & Department of MedicineMcMaster UniversityHamiltonONCanada
| | - Cemal Cingi
- Medical FacultyENT DepartmentEskisehir Osmangazi UniversityEskisehirTurkey
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical ImmunologyUniversity Hospital “Duilio Casula”University of CagliariCagliariItaly
| | - Frédéric de Blay
- Allergy DivisionChest Disease DepartmentUniversity Hospital of StrasbourgStrasbourgFrance,Federation of Translational MedicineUniversity of StrasbourgStrasbourgFrance
| | - Philippe Devillier
- VIM Suresnes, UMR 0892Pôle des Maladies des Voies RespiratoiresHôpital FochUniversité Paris‐SaclaySuresnesFrance
| | | | - Maria Doulaptsi
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of CreteHeraklion, CreteGreece
| | - Virginie Doyen
- Department of Chest MedicineCentre Hospitalier Universitaire UCL NamurNamurBelgique,Université Catholique de LouvainYvoirBelgium
| | | | | | | | - Jan Hagemann
- Department of Otolaryngology, Head and Neck SurgeryUniversitätsmedizin MainzMainzGermany,Center for Rhinology and AllergologyWiesbadenGermany
| | - Enrico Heffler
- Department of Biomedical SciencesHumanitas University, Pieve EmanueleMilanItaly,Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Center IRCCSRozzanoItaly
| | - Maja Hofmann
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Berlin Institute of HealthBerlinGermany
| | - Ewa Jassem
- Department of PneumologyMedical University of GdańskGdańskPoland
| | - Marek Jutel
- Department of Clinical ImmunologyWrocław Medical UniversityWrocławPoland,ALL‐MED Medical Research InstituteWroclawPoland
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health EconomicsCharité ‐ Universitätsmedizin BerlinBerlinGermany,Institute for Clinical Epidemiology and BiometryUniversity of WuerzburgWuerzburgGermany,State Institute of Health, Bavarian Health and Food Safety AuthorityErlangenGermany
| | - Vicky Kritikos
- Quality Use of Respiratory Medicine GroupWoolcock Institute of Medical ResearchThe University of SydneySydneyNSWAustralia
| | - Inger Kull
- Sach's Children and Youth HospitalSödersjukhusetStockholmSweden,Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
| | - Marek Kulus
- Department of Pediatric Respiratory Diseases and AllergologyMedical University of WarsawWarsawPoland
| | - Olga Lourenço
- Faculty of Health Sciences and CICS – UBIHealth Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
| | | | - Enrica Menditto
- CIRFFDepartment of PharmacyUniversity of Naples Federico IINaplesItaly
| | - Ralph Mösges
- CRI‐Clinical Research International‐LtdHamburgGermany
| | - Ruth Murray
- Medical Communication ConsultantMedscript Ltd, DundalkIreland and WellingtonNew Zealand,Research FellowOPCCambridgeUK
| | - Rachel Nadif
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance,Université Paris‐Saclay, UVSQUniversity Paris‐SudVillejuifFrance
| | - Hugo Neffen
- Center of Allergy, Immunology and Respiratory DiseasesSanta FeArgentina
| | - Stefania Nicola
- Department of Medical SciencesAllergy and Clinical Immunology UnitUniversity of TorinoTorinoItaly
| | - Robyn O’Hehir
- Department of Allergy, Immunology and Respiratory MedicineAlfred Hospital and Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Heidi Olze
- Berlin Institute of HealthBerlinGermany,Department of OtorhinolaryngologyCharité‐Universitätsmedizin BerlinBerlinGermany
| | | | - Jean‐Louis Pépin
- Université Grenoble AlpesLaboratoire HP2GrenobleFrance,INSERMU1042VillejuifFrance
| | | | - Robert Picard
- Conseil Général de l'Economie Ministère de l'Economiede l'Industrie et du NumériqueParisFrance
| | | | - Francesca Puggioni
- Department of Biomedical SciencesHumanitas University, Pieve EmanueleMilanItaly,Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Center IRCCSRozzanoItaly
| | - Santiago Quirce
- Department of AllergyHospital La Paz Institute for Health Research (IdiPAZ)MadridSpain
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarsawPoland
| | - Sietze Reitsma
- Department of OtorhinolaryngologyAmsterdam University Medical Centres, AMCAmsterdamthe Netherlands
| | - Nicolas Roche
- PneumologieAP‐HP Centre Université de Paris CitéHôpital CochinParisFrance,UMR 1016Institut CochinParisFrance
| | | | - Jan Romantowski
- Department of AllergologyMedical University of GdańskGdanskPoland
| | - Ana Sá‐Sousa
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | - Faradiba S. Serpa
- Asthma Reference Center ‐ School of Medicine of Santa Casa de Misericórdia of VitóriaVitoria, Espirito SantoBrazil
| | - Marine Savouré
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance,Université Paris‐Saclay, UVSQUniversity Paris‐SudVillejuifFrance
| | - Mohamed H. Shamji
- National Heart and Lung InstituteImperial CollegeLondonUK,NIHR Imperial Biomedical Research CentreLondonUK
| | - Milan Sova
- Department of Respiratory Medicine and TuberculosisUniversity HospitalBrnoCzech Republic
| | - Annette Sperl
- Center for Rhinology and AllergologyWiesbadenGermany
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoSalernoItaly
| | - Ana Todo‐Bom
- ImunoalergologiaCentro Hospitalar Universitário de CoimbraFaculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Peter Valentin Tomazic
- Department of General ORLH&NSMedical University of GrazENT‐University Hospital GrazGrazSteiermarkAustria
| | - Olivier Vandenplas
- Department of Chest MedicineCentre Hospitalier Universitaire UCL NamurNamurBelgique,Université Catholique de LouvainYvoirBelgium
| | | | - Tuula Vasankari
- Fihla, Finnish Lung AssociationHelsinkiFinland,University of TurkuTurkuFinland
| | | | - Susan Waserman
- Department of Medicine, Clinical Immunology and AllergyMcMaster UniversityHamiltonOntarioCanada
| | - Joao A. Fonseca
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | - Torsten Zuberbier
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany
| |
Collapse
|
9
|
Validation of the Spanish language version of the control of allergic rhinitis and asthma test. NPJ Prim Care Respir Med 2022; 32:47. [PMID: 36309520 PMCID: PMC9617860 DOI: 10.1038/s41533-022-00313-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/11/2022] [Indexed: 11/08/2022] Open
Abstract
Allergic rhinitis and asthma are common diseases that frequently coexist, referred to as unified airway disease. There is currently no validated scale in Spanish, which allows simultaneous evaluation of both conditions. A translation from Portuguese to Spanish was therefore performed. It was administered to 120 patients aged between 18 and 70 years whose native language was Spanish and presented a diagnosis of allergic rhinitis and asthma. The reliability, validity and sensitivity to instrument change validations were carried out, as well as the values of minimally relevant clinical differences. Reliability was evaluated using Cronbach´s alpha test on CARAT-global: 0.83 [IC 95% 0.79–0.88]; test and retest evaluation was done with Pearson´s correlation coefficient: 0.6 [IC 95% 0.32–0.77] and the standard error of measurement 3.5 (p < 0.005). A confirmatory factor analysis was performed corroborating two factors. Correlation coefficients were not high in the longitudinal validation. Concurrent validity showed an acceptable correlation between CARAT10 asthma ACQ5 and low between allergic rhinitis-VAS. There was a milestone of the controlled disease in the discriminant validity of CARAT10 rhinitis ≥ 8 mean an adequate control, CARAT10-asthma > 16 In this case, CARAT10-asthma value < 16 are interpreted as an inadequate or partial control and values ≥ 16 mean an adequate control and CARAT10-global ≥ 18, patients evaluated with CARAT10 with a result ≥ 18, which would be a patient with both conditions controlled. The minimally relevant clinically important average difference found in the CARAT10 scale was 3.25 (SD 3.77). The CARAT10 scale in Spanish is a standardised, reliable and valid evaluation method on patients with unified airway disease.
Collapse
|
10
|
Vieira RJ, Sousa-Pinto B, Cardoso-Fernandes A, Jácome C, Portela D, Amaral R, Sá-Sousa A, Pereira AM, Bousquet J, Fonseca JA. Control of Allergic Rhinitis and Asthma Test: A systematic review of measurement properties and COSMIN analysis. Clin Transl Allergy 2022; 12:e12194. [PMID: 36178185 PMCID: PMC9510765 DOI: 10.1002/clt2.12194] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 11/09/2022] Open
Abstract
The Control of Allergic Rhinitis and Asthma Test (CARAT) is a patient-reported outcome measurement (PROM) assessing the control of asthma and allergic rhinitis (AR) at a 4 week interval. This systematic review aimed to evaluate the measurement properties of CARAT. Following PRISMA and COSMIN guidelines, we searched five bibliographic databases and retrieved studies concerning the development, assessment of properties, validation, and/or cultural adaption of CARAT. The studies' methodological quality, the quality of measurement properties, and the overall quality of evidence were assessed. We performed meta-analysis of CARAT measurement properties. We included 16 studies. Control of Allergic Rhinitis and Asthma Test displayed sufficient content validity and very good consistency (meta-analytical Cronbach alpha = 0.83; 95% CI = 0.80-0.86;I2 = 62.6%). Control of allergic rhinitis and Asthma Test meta-analytical intraclass correlation coefficient was 0.91 (95% CI = 0.64-0.98;I2 = 93.7%). It presented good construct validity, especially for correlations with Patient-reported outcome measures assessing asthma (absolute Spearman correlation coefficients range = 0.67-0.73; moderate quality of evidence), and good responsiveness. Its minimal important difference is 3.5. Overall, CARAT has good internal consistency, reliability, construct validity and responsiveness, despite the heterogeneous quality of evidence. Control of Allergic Rhinitis and Asthma Test can be used to assess the control of asthma and AR. As first of its kind, this meta-analysis of CARAT measurement properties sets a stronger level of evidence for asthma and/or AR control questionnaires.
Collapse
Affiliation(s)
- Rafael José Vieira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Bernardo Sousa-Pinto
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - António Cardoso-Fernandes
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Cristina Jácome
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Diana Portela
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Rita Amaral
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal.,School of Health, Polytechnic of Porto, Porto, Portugal.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ana Sá-Sousa
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Ana Margarida Pereira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Allergy Unit, CUF Porto Hospital & Institute, Porto, Portugal
| | - Jean Bousquet
- Institute for Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.,University Hospital, Montpellier, France.,ARIA, Montpellier, France
| | - João Almeida Fonseca
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal.,Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Porto, Portugal.,Allergy Unit, CUF Porto Hospital & Institute, Porto, Portugal
| |
Collapse
|
11
|
Sousa‐Pinto B, Azevedo LF, Jutel M, Agache I, Canonica GW, Czarlewski W, Papadopoulos NG, Bergmann K, Devillier P, Laune D, Klimek L, Anto A, Anto JM, Eklund P, Almeida R, Bedbrook A, Bosnic‐Anticevich S, Brough HA, Brussino L, Cardona V, Casale T, Cecchi L, Charpin D, Chivato T, Costa EM, Cruz AA, Dramburg S, Durham SR, De Feo G, Gerth van Wijk R, Fokkens WJ, Gemicioglu B, Haahtela T, Illario M, Ivancevich JC, Kvedariene V, Kuna P, Larenas‐Linnemann DE, Makris M, Mathieu‐Dupas E, Melén E, Morais‐Almeida M, Mösges R, Mullol J, Nadeau KC, Pham‐Thi N, O’Hehir R, Regateiro FS, Reitsma S, Samolinski B, Sheikh A, Stellato C, Todo‐Bom A, Tomazic PV, Toppila‐Salmi S, Valero A, Valiulis A, Ventura MT, Wallace D, Waserman S, Yorgancioglu A, Vries G, Eerd M, Zieglmayer P, Zuberbier T, Pfaar O, Almeida Fonseca J, Bousquet J. Development and validation of combined symptom-medication scores for allergic rhinitis. Allergy 2021; 77:2147-2162. [PMID: 34932829 DOI: 10.1111/all.15199] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/22/2021] [Accepted: 12/04/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Validated combined symptom-medication scores (CSMSs) are needed to investigate the effects of allergic rhinitis treatments. This study aimed to use real-life data from the MASK-air® app to generate and validate hypothesis- and data-driven CSMSs. METHODS We used MASK-air® data to assess the concurrent validity, test-retest reliability and responsiveness of one hypothesis-driven CSMS (modified CSMS: mCSMS), one mixed hypothesis- and data-driven score (mixed score), and several data-driven CSMSs. The latter were generated with MASK-air® data following cluster analysis and regression models or factor analysis. These CSMSs were compared with scales measuring (i) the impact of rhinitis on work productivity (visual analogue scale [VAS] of work of MASK-air® , and Work Productivity and Activity Impairment: Allergy Specific [WPAI-AS]), (ii) quality-of-life (EQ-5D VAS) and (iii) control of allergic diseases (Control of Allergic Rhinitis and Asthma Test [CARAT]). RESULTS We assessed 317,176 days of MASK-air® use from 17,780 users aged 16-90 years, in 25 countries. The mCSMS and the factor analyses-based CSMSs displayed poorer validity and responsiveness compared to the remaining CSMSs. The latter displayed moderate-to-strong correlations with the tested comparators, high test-retest reliability and moderate-to-large responsiveness. Among data-driven CSMSs, a better performance was observed for cluster analyses-based CSMSs. High accuracy (capacity of discriminating different levels of rhinitis control) was observed for the latter (AUC-ROC = 0.904) and for the mixed CSMS (AUC-ROC = 0.820). CONCLUSION The mixed CSMS and the cluster-based CSMSs presented medium-high validity, reliability and accuracy, rendering them as candidates for primary endpoints in future rhinitis trials.
Collapse
Affiliation(s)
- Bernardo Sousa‐Pinto
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine University of Porto Porto Portugal
- CINTESIS ‐ Center for Health Technology and Services Research University of Porto Porto Portugal
| | - Luís Filipe Azevedo
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine University of Porto Porto Portugal
- CINTESIS ‐ Center for Health Technology and Services Research University of Porto Porto Portugal
| | - Marek Jutel
- Department of Clinical Immunology Wrocław Medical University Wroclaw Poland
- ALL‐MED Medical Research Institute Wroclaw Poland
| | - Ioana Agache
- Faculty of Medicine Transylvania University Brasov Romania
| | - G. Walter Canonica
- Department of Biomedical Sciences Humanitas University Milan Italy
- Personalized Medicine Asthma & Allergy ‐Humanitas Clinical & Research Centre IRCCS Rozzano Italy
| | | | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital “P&A Kyriakou” University of Athens Athens Greece
| | - Karl‐Christian Bergmann
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
- Institute for Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany
| | - Philippe Devillier
- UPRES EA220 Pôle des Maladies des Voies Respiratoires Hôpital Foch Université Paris‐Saclay Suresnes France
| | | | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany
- Center for Rhinology and Allergology Wiesbaden Germany
| | | | - Josep M. Anto
- ISGlobAL Barcelona Institute for Global Health Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Patrik Eklund
- Computing Science Department Umeå University Umeå Finland
| | - Rute Almeida
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine University of Porto Porto Portugal
- CINTESIS ‐ Center for Health Technology and Services Research University of Porto Porto Portugal
| | | | - Sinthia Bosnic‐Anticevich
- Quality Use of Respiratory Medicine Group Woolcock Institute of Medical Research The University of Sydney Sydney New South Wales Australia
- Sydney Local Health District Sydney New South Wales Australia
| | - Helen A. Brough
- Division of Allergy/Immunology University of South Florida Tampa Florida USA
| | - Luisa Brussino
- Department of Medical Sciences Allergy and Clinical Immunology Unit University of Torino & Mauriziano Hospital Torino Italy
| | - Victoria Cardona
- Allergy Section Department of Internal Medicine Hospital Vall d'Hebron & ARADyAL Research Network Barcelona Spain
| | - Thomas Casale
- Division of Allergy/Immunology University of South Florida Tampa Florida USA
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology USL Toscana Centro Prato Italy
| | - Denis Charpin
- Clinique des Bronches Allergie et Sommeil Hôpital Nord Marseille France
| | - Tomás Chivato
- School of Medicine University CEU San Pablo Madrid Spain
| | - Elisio M. Costa
- Faculty of Pharmacy and Competence Center on Active and Healthy Ageing University of Porto (Porto4Ageing) UCIBIOREQUINTE Porto Portugal
| | - Alvaro A. Cruz
- Fundaçao ProAR Federal University of Bahia and GARD/WHO Planning Group Salvador Brazil
| | - Stephanie Dramburg
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine Charité Medical University Berlin Germany
| | - Stephen R. Durham
- Allergy and Clinical Immunology National Heart and Lung Institute Imperial College London London UK
| | - Giulia De Feo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana” University of Salerno Salerno Italy
| | - Roy Gerth van Wijk
- Section of Allergology Department of Internal Medicine Erasmus MC Rotterdam The Netherlands
| | - Wystke J. Fokkens
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam The Netherlands
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases Cerrahpasa Faculty of Medicine Istanbul University‐Cerrahpasa Istanbul Turkey
| | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
| | - Maddalena Illario
- Department of Public Health and Research and Development Unit Federico II University and Hospital Naples Italy
| | | | - Violeta Kvedariene
- Department of Pathology Faculty of Medicine Institute of Biomedical Sciences Vilnius University Vilnius Lithuania
- Faculty of Medicine Institute of Clinical Medicine Clinic of Chest Diseases and Allergology Vilnius University Vilnius Lithuania
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Poland
| | | | - Michael Makris
- Allergy Unit “D Kalogeromitros” 2nd Department of Dermatology and Venereology National & Kapodistrian University of Athens, “Attikon” University Hospital Athens Greece
| | | | - Erik Melén
- Sachs’ Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | | | - Ralph Mösges
- CRI‐Clinical Research International‐Ltd Hamburg Germany
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic ENT Department Hospital Clínic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy IDIBAPSCIBERESUniversity of Barcelona Barcelona Spain
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research Stanford University School of Medicine Stanford California USA
| | - Nhân Pham‐Thi
- IRBA (Institut de Recherche bio‐Médicale des Armées) Ecole Polytechnique Palaiseau Bretigny France
| | - Robyn O’Hehir
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University and Alfred Health Melbourne Victoria Australia
| | - Frederico S. Regateiro
- Allergy and Clinical Immunology Unit Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
- Institute of Immunology Faculty of Medicine University of Coimbra Portugal
- ICBR ‐ Coimbra Institute for Clinical and Biomedical Research CIBB Coimbra Portugal
| | - Sietze Reitsma
- Department of Otorhinolaryngology Amsterdam University Medical CentresAMC Amsterdam The Netherlands
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology Medical University of Warsaw Warsaw Poland
| | - Aziz Sheikh
- Usher Institute The University of Edinburgh Edinburgh UK
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana” University of Salerno Salerno Italy
| | - Ana Todo‐Bom
- Imunoalergologia Centro Hospitalar Universitário de Coimbra and Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Peter Valentin Tomazic
- Department of General ORL, H&NS Medical University of GrazENT‐University Hospital Graz Austria
| | - Sanna Toppila‐Salmi
- Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Antonio Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy IDIBAPSUniversity of Barcelona Spain
| | - Arunas Valiulis
- Faculty of Medicine Institute of Clinical Medicine & Institute of Health Sciences Vilnius University Vilnius Lithuania
- European Academy of Paediatrics (EAP/UEMS‐SP) Brussels Belgium
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology University of Bari Medical School Bari Italy
| | - Dana Wallace
- Nova Southeastern University Fort Lauderdale Florida USA
| | - Susan Waserman
- Department of Medicine Clinical Immunology and Allergy McMaster University Hamilton Ontario Canada
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases Faculty of Medicine Celal Bayar University Manisa Turkey
| | | | | | - Petra Zieglmayer
- Vienna Challenge Chamber Vienna Austria
- Competence Center for Allergology and Immunology Karl Landsteiner University Krems Austria
| | - Torsten Zuberbier
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
- Institute for Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany
| | - Oliver Pfaar
- Section of Rhinology and Allergy Department of Otorhinolaryngology, Head and Neck Surgery University Hospital MarburgPhilipps‐Universität Marburg Marburg Germany
| | - João Almeida Fonseca
- Departamento Medicina da Comunidade Informaçao e Decisao em Saude (MEDCIDS) Faculdada de Medicina da Universidade do Porto Porto Portugal
- Medicina, EDucaçao, I&D e Avaliaçao Lda (MEDIDA) Porto Portugal
- Imunoalergologia CUF Porto Portugal
| | - Jean Bousquet
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology Berlin Germany
- Institute for Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany
- MACVIA‐France Montpellier France
- University Hospital Montpellier Montpellier France
| |
Collapse
|
12
|
Sousa-Pinto B, Eklund P, Pfaar O, Klimek L, Zuberbier T, Czarlewski W, Bédard A, Bindslev-Jensen C, Bedbrook A, Bosnic-Anticevich S, Brussino L, Cardona V, Cruz AA, de Vries G, Devillier P, Fokkens WJ, Fuentes-Pérez JM, Gemicioğlu B, Haahtela T, Huerta-Villalobos YR, Ivancevich JC, Kull I, Kuna P, Kvedariene V, Larenas Linnemann DE, Laune D, Makris M, Melén E, Morais-Almeida M, Mösges R, Mullol J, O'Hehir RE, Papadopoulos NG, Pereira AM, Prokopakis EP, Psarros F, Regateiro FS, Reitsma S, Samolinski B, Scichilone N, da Silva J, Stellato C, Todo-Bom A, Tomazic PV, Salmi ST, Valero A, Valiulis A, Valovirta E, van Eerd M, Ventura MT, Yorgancioglu A, Basagaña X, Antó JM, Bousquet J, Fonseca JA. Validity, reliability, and responsiveness of daily monitoring visual analog scales in MASK-air®. Clin Transl Allergy 2021; 11:e12062. [PMID: 34567526 PMCID: PMC8449952 DOI: 10.1002/clt2.12062] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/07/2021] [Accepted: 08/02/2021] [Indexed: 01/10/2023] Open
Abstract
Background MASK-air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales (VASs). We aimed to assess the concurrent validity, reliability, and responsiveness of these daily VASs. Methods Daily monitoring VAS data were assessed in MASK-air® users with allergic rhinitis. Concurrent validity was assessed by correlating daily VAS values with those of the EuroQol-5 Dimensions (EQ-5D) VAS, the Control of Allergic Rhinitis and Asthma Test (CARAT) score, and the Work Productivity and Activity Impairment Allergic Specific (WPAI-AS) Questionnaire (work and activity impairment scores). Intra-rater reliability was assessed in users providing multiple daily VASs within the same day. Test-retest reliability was tested in clinically stable users, as defined by the EQ-5D VAS, CARAT, or "VAS Work" (i.e., VAS assessing the impact of allergy on work). Responsiveness was determined in users with two consecutive measurements of EQ-5D-VAS or "VAS Work" indicating clinical change. Results A total of 17,780 MASK-air® users, with 317,176 VAS days, were assessed. Concurrent validity was moderate-high (Spearman correlation coefficient range: 0.437-0.716). Intra-rater reliability intraclass correlation coefficients (ICCs) ranged between 0.870 (VAS assessing global allergy symptoms) and 0.937 (VAS assessing allergy symptoms on sleep). Test-retest reliability ICCs ranged between 0.604 and 0.878-"VAS Work" and "VAS asthma" presented the highest ICCs. Moderate/large responsiveness effect sizes were observed-the sleep VAS was associated with lower responsiveness, while the global allergy symptoms VAS demonstrated higher responsiveness. Conclusion In MASK-air®, daily monitoring VASs have high intra-rater reliability and moderate-high validity, reliability, and responsiveness, pointing to a reliable measure of symptom loads.
Collapse
Affiliation(s)
- Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine, University of Porto Porto Portugal.,CINTESIS - Center for Health Technology and Services Research University of Porto Porto Portugal.,RISE - Health Research Network University of Porto Porto Portugal
| | - Patrik Eklund
- Department of Computing Science Umeå University Umeå Sweden
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps Universität Marburg Marburg Germany
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany.,Center for Rhinology and Allergology Wiesbaden Germany
| | - Torsten Zuberbier
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Universitätsmedizin Berlin Humboldt-Universität zu Berlin Berlin Germany
| | - Wienczyslawa Czarlewski
- MASK-air Montpellier France.,Medical Consulting Czarlewski Levallois France.,MACVIA-France Montpellier France
| | - Annabelle Bédard
- ISGlobAL Universitat Pompeu Fabra (UPF) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,Equipe d'Epidémiologie Respiratoire Intégrative Université Paris-Saclay UVSQ Université Paris-Sud INSERM CESP Villejuif France
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Anna Bedbrook
- MASK-air Montpellier France.,MACVIA-France Montpellier France
| | - Sinthia Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group Woolcock Institute of Medical Research The University of Sydney Sydney New South Wales Australia.,Sydney Local Health District Glebe New South Wales Australia
| | - Luisa Brussino
- Department of Medical Sciences Allergy and Clinical Immunology Unit University of Torino & Mauriziano Hospital Torino Italy
| | - Victoria Cardona
- Allergy Section Department of Internal Medicine Hospital Vall d'Hebron & ARADyAL research network Barcelona Spain
| | - Alvaro A Cruz
- Fundação ProAR - Federal University of Bahia Salvador Brazil.,WHO GARD Planning Group Salvador Brazil
| | | | - Philippe Devillier
- Laboratoire de Pharmacologie UPRES EA220 Pôle des Maladies des Voies Respiratoires Hôpital Foch Université Paris-Saclay Suresnes France
| | - Wytske J Fokkens
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam the Netherlands
| | - José Miguel Fuentes-Pérez
- Hospital General Regional IMSS General Regional Hospital 1 Dr. Carlos Mac Gregor Sanchez Navarro Mexico City Mexico
| | - Bilun Gemicioğlu
- Department of Pulmonary Diseases Istanbul University-Cerrahpaşa Cerrahpasa Faculty of Medicine Istanbul Turkey
| | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | | | | | - Inger Kull
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Poland
| | - Violeta Kvedariene
- Department of Pathology Faculty of Medicine Institute of Biomedical Sciences Vilnius University Vilnius Lithuania.,Clinic of Chest Diseases and Allergology Faculty of Medicine Institute of Clinical Medicine Vilnius University Vilnius Lithuania
| | | | | | - Michael Makris
- Allergy Unit "D Kalogeromitros" 2nd Dpt of Dermatology and Venereology National & Kapodistrian University of Athens "Attikon" University Hospital Athens Greece
| | - Erik Melén
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden.,Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | | | - Ralph Mösges
- Medical Faculty Institute of Medical Statistics, and Computational Biology University of Cologne Cologne Germany.,CRI-Clinical Research International-Ltd Hamburg Germany
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic ENT Department Hospital Clínic Clinical & Experimental Respiratory Immunoallergy IDIBAPS University of Barcelona CIBERES Barcelona Spain
| | - Robyn E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University Melbourne Victoria Australia.,Alfred Health Melbourne Victoria Australia
| | - Nikolaos G Papadopoulos
- Center for Pediatrics and Child Health Institute of Human Development Royal Manchester Children's Hospital University of Manchester Manchester UK.,Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital "P&A Kyriakou" University of Athens Athens Greece
| | - Ana Margarida Pereira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine, University of Porto Porto Portugal.,CINTESIS - Center for Health Technology and Services Research University of Porto Porto Portugal.,RISE - Health Research Network University of Porto Porto Portugal
| | - Emmanuel P Prokopakis
- Department of Otorhinolaryngology University of Crete School of Medicine Heraklion Greece
| | - Fotis Psarros
- Allergy Department Athens Naval Hospital Athens Greece
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit Institute of Immunology Faculty of Medicine Centro Hospitalar e Universitário de Coimbra University of Coimbra Coimbra Portugal.,Faculty of Medicine ICBR - Coimbra Institute for Clinical and Biomedical Research CIBB University of Coimbra Coimbra Portugal
| | - Sietze Reitsma
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam the Netherlands
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology Medical University of Warsaw Warsaw Poland
| | | | - Jane da Silva
- Allergy Service Internal Medicine Department University Hospital of Federal University of Santa Catarina (HU-UFSC) Florianópolis Brazil
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Salerno Italy
| | - Ana Todo-Bom
- Allergy and Clinical Immunology Unit Institute of Immunology Faculty of Medicine Centro Hospitalar e Universitário de Coimbra University of Coimbra Coimbra Portugal.,Faculty of Medicine ICBR - Coimbra Institute for Clinical and Biomedical Research CIBB University of Coimbra Coimbra Portugal
| | | | | | - Antonio Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy IDIBAPS University of Barcelona Spain
| | - Arunas Valiulis
- Department of Public Health Vilnius University Institute of Clinical Medicine Clinic of Children's Diseases Institute of Health Sciences Vilnius Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP) Brussels Belgium
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology University of Turku Turku Finland.,Terveystalo Allergy Clinic Turku Finland
| | | | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology University of Bari Medical School Bari Italy
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases Faculty of Medicine Celal Bayar University Manisa Turkey
| | - Xavier Basagaña
- ISGlobAL Universitat Pompeu Fabra (UPF) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,Universitat Pompeu Fabra (UPF) Barcelona Spain.,CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Josep M Antó
- ISGlobAL Universitat Pompeu Fabra (UPF) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,Universitat Pompeu Fabra (UPF) Barcelona Spain.,CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,IMIM (Hospital del Mar Research Institute) Barcelona Spain
| | - Jean Bousquet
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Universitätsmedizin Berlin Humboldt-Universität zu Berlin Berlin Germany.,MACVIA-France Montpellier France.,Centre Hospitalier Universitaire Montpellier France
| | - João Almeida Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine, University of Porto Porto Portugal.,CINTESIS - Center for Health Technology and Services Research University of Porto Porto Portugal.,RISE - Health Research Network University of Porto Porto Portugal
| |
Collapse
|
13
|
Amaral R, Jácome C, Almeida R, Pereira AM, Alves-Correia M, Mendes S, Rodrigues JCC, Carvalho J, Araújo L, Costa A, Silva A, Teixeira MF, Ferreira-Magalhães M, Alves RR, Moreira AS, Fernandes RM, Ferreira R, Pinto PL, Neuparth N, Bordalo D, Bom AT, Cálix MJ, Ferreira T, Gomes J, Vidal C, Mendes A, Vasconcelos MJ, Silva PM, Ferraz J, Morête A, Pinto CS, Santos N, Loureiro CC, Arrobas A, Marques ML, Lozoya C, Lopes C, Cardia F, Loureiro CC, Câmara R, Vieira I, da Silva S, Silva E, Rodrigues N, Fonseca JA. Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031015. [PMID: 33498858 PMCID: PMC7908090 DOI: 10.3390/ijerph18031015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 02/07/2023]
Abstract
We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13–17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
Collapse
Affiliation(s)
- Rita Amaral
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (C.J.); (R.A.); (A.M.P.); (S.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, 4200-072 Porto, Portugal
- Department of Women’s and Children’s Health, Paediatric Research, Uppsala University, SE-751 05 Uppsala, Sweden
- Correspondence: ; Tel.: +351-917-006-669
| | - Cristina Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (C.J.); (R.A.); (A.M.P.); (S.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Rute Almeida
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (C.J.); (R.A.); (A.M.P.); (S.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Ana Margarida Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (C.J.); (R.A.); (A.M.P.); (S.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal; (M.A.-C.); (L.A.)
| | - Magna Alves-Correia
- Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal; (M.A.-C.); (L.A.)
| | - Sandra Mendes
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (C.J.); (R.A.); (A.M.P.); (S.M.); (J.A.F.)
| | - José Carlos Cidrais Rodrigues
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, 4464-513 Matosinhos, Portugal; (J.C.C.R.); (J.C.); (C.L.)
| | - Joana Carvalho
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, 4464-513 Matosinhos, Portugal; (J.C.C.R.); (J.C.); (C.L.)
| | - Luís Araújo
- Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal; (M.A.-C.); (L.A.)
| | - Alberto Costa
- Serviço de Pediatria, Hospital Senhora da Oliveira, 4835-044 Guimarães, Portugal; (A.C.); (A.S.)
| | - Armandina Silva
- Serviço de Pediatria, Hospital Senhora da Oliveira, 4835-044 Guimarães, Portugal; (A.C.); (A.S.)
| | - Maria Fernanda Teixeira
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, 4099-001 Porto, Portugal;
| | - Manuel Ferreira-Magalhães
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, 4099-001 Porto, Portugal;
| | - Rodrigo Rodrigues Alves
- Serviço de Imunoalergologia, Hospital do Divino Espírito Santo, 9500-370 Ponta Delgada, Portugal;
| | - Ana Sofia Moreira
- Unidade de Imunoalergologia, Hospital do Divino Espírito Santo, 9500-370 Ponta Delgada, Portugal;
| | - Ricardo M. Fernandes
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal; (R.M.F.); (R.F.); (A.M.)
| | - Rosário Ferreira
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal; (R.M.F.); (R.F.); (A.M.)
| | - Paula Leiria Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, 1150-199 Lisboa, Portugal; (P.L.P.); (N.N.)
| | - Nuno Neuparth
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, 1150-199 Lisboa, Portugal; (P.L.P.); (N.N.)
- Pathophysiology, CHRC/CEDOC, High Burden and High Mortality Diseases Thematic Line Coordinator, Nova Medical School, 1150-190 Lisboa, Portugal
| | - Diana Bordalo
- Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, 4780-371 Vila Nova de Famalicão, Portugal;
| | - Ana Todo Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal;
| | - Maria José Cálix
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela–Viseu, 3504-509 Viseu, Portugal;
| | - Tânia Ferreira
- Unidade de Saúde Familiar Progresso e Saúde, ACeS Baixo Mondego, 3060-716 Tocha, Portugal;
| | - Joana Gomes
- Serviço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal;
| | - Carmen Vidal
- Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, 15706 Santiago De Compostela, Spain;
| | - Ana Mendes
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, 1649-035 Lisboa, Portugal; (R.M.F.); (R.F.); (A.M.)
| | - Maria João Vasconcelos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, 4200–319 Porto, Portugal;
| | | | - José Ferraz
- Imunoalergologia, Hospital Privado de Alfena, Trofa Saúde, 4445-243 Alfena, Portugal;
| | - Ana Morête
- Serviço de Imunoalergologia, Hospital Infante D. Pedro, Centro Hospitalar Baixo Vouga, 3814-501 Aveiro, Portugal;
| | - Claúdia Sofia Pinto
- Serviço de Pneumologia, Hospital São Pedro de Vila Real, Centro Hospitalar De Trás-Os-Montes E Alto Douro, 5000-508 Vila Real, Portugal;
| | - Natacha Santos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, 8000-386 Portimão, Portugal;
| | | | - Ana Arrobas
- Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal;
| | - Maria Luís Marques
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Porto, 4099-001 Porto, Portugal;
| | - Carlos Lozoya
- Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, 6000-085 Castelo Branco, Portugal;
| | - Cristina Lopes
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, 4464-513 Matosinhos, Portugal; (J.C.C.R.); (J.C.); (C.L.)
- Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Francisca Cardia
- Unidade de Saúde Familiar Terras de Azurara, ACES Dão Lafões, 3530-113 Mangualde, Portugal;
| | - Carla Chaves Loureiro
- Departamento de Pediatria, Serviço de Pediatria Ambulatória, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal;
| | - Raquel Câmara
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, 2834-003 Barreiro, Portugal;
| | - Inês Vieira
- UCSP Dr. Arnaldo Sampaio, ACES Pinhal Litoral, 2419-014 Leiria, Portugal;
| | - Sofia da Silva
- USF Cuidarte, Unidade Local de Saúde do Alto Minho, 4925-083 Portuzelo, Portugal;
| | - Eurico Silva
- Unidade de Saúde Familiar João Semana, ACeS Baixo Vouga, 3880-225 Ovar, Portugal;
| | - Natalina Rodrigues
- Unidade de Saúde Familiar Mondego, ACES Baixo Mondego, 3045-059 Coimbra, Portugal;
| | - João A. Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (C.J.); (R.A.); (A.M.P.); (S.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Allergy Unit, CUF Porto Hospital and Institute, 4100-180 Porto, Portugal; (M.A.-C.); (L.A.)
| |
Collapse
|
14
|
Bousquet J, Anto JM, Bachert C, Haahtela T, Zuberbier T, Czarlewski W, Bedbrook A, Bosnic-Anticevich S, Walter Canonica G, Cardona V, Costa E, Cruz AA, Erhola M, Fokkens WJ, Fonseca JA, Illario M, Ivancevich JC, Jutel M, Klimek L, Kuna P, Kvedariene V, Le L, Larenas-Linnemann DE, Laune D, Lourenço OM, Melén E, Mullol J, Niedoszytko M, Odemyr M, Okamoto Y, Papadopoulos NG, Patella V, Pfaar O, Pham-Thi N, Rolland C, Samolinski B, Sheikh A, Sofiev M, Suppli Ulrik C, Todo-Bom A, Tomazic PV, Toppila-Salmi S, Tsiligianni I, Valiulis A, Valovirta E, Ventura MT, Walker S, Williams S, Yorgancioglu A, Agache I, Akdis CA, Almeida R, Ansotegui IJ, Annesi-Maesano I, Arnavielhe S, Basagaña X, D Bateman E, Bédard A, Bedolla-Barajas M, Becker S, Bennoor KS, Benveniste S, Bergmann KC, Bewick M, Bialek S, E Billo N, Bindslev-Jensen C, Bjermer L, Blain H, Bonini M, Bonniaud P, Bosse I, Bouchard J, Boulet LP, Bourret R, Boussery K, Braido F, Briedis V, Briggs A, Brightling CE, Brozek J, Brusselle G, Brussino L, Buhl R, Buonaiuto R, Calderon MA, Camargos P, Camuzat T, Caraballo L, Carriazo AM, Carr W, Cartier C, Casale T, Cecchi L, Cepeda Sarabia AM, H Chavannes N, Chkhartishvili E, Chu DK, Cingi C, Correia de Sousa J, Costa DJ, Courbis AL, Custovic A, Cvetkosvki B, D'Amato G, da Silva J, Dantas C, Dokic D, Dauvilliers Y, De Feo G, De Vries G, Devillier P, Di Capua S, Dray G, Dubakiene R, Durham SR, Dykewicz M, Ebisawa M, Gaga M, El-Gamal Y, Heffler E, Emuzyte R, Farrell J, Fauquert JL, Fiocchi A, Fink-Wagner A, Fontaine JF, Fuentes Perez JM, Gemicioğlu B, Gamkrelidze A, Garcia-Aymerich J, Gevaert P, Gomez RM, González Diaz S, Gotua M, Guldemond NA, Guzmán MA, Hajjam J, Huerta Villalobos YR, Humbert M, Iaccarino G, Ierodiakonou D, Iinuma T, Jassem E, Joos G, Jung KS, Kaidashev I, Kalayci O, Kardas P, Keil T, Khaitov M, Khaltaev N, Kleine-Tebbe J, Kouznetsov R, Kowalski ML, Kritikos V, Kull I, La Grutta S, Leonardini L, Ljungberg H, Lieberman P, Lipworth B, Lodrup Carlsen KC, Lopes-Pereira C, Loureiro CC, Louis R, Mair A, Mahboub B, Makris M, Malva J, Manning P, Marshall GD, Masjedi MR, Maspero JF, Carreiro-Martins P, Makela M, Mathieu-Dupas E, Maurer M, De Manuel Keenoy E, Melo-Gomes E, Meltzer EO, Menditto E, Mercier J, Micheli Y, Miculinic N, Mihaltan F, Milenkovic B, Mitsias DI, Moda G, Mogica-Martinez MD, Mohammad Y, Montefort S, Monti R, Morais-Almeida M, Mösges R, Münter L, Muraro A, Murray R, Naclerio R, Napoli L, Namazova-Baranova L, Neffen H, Nekam K, Neou A, Nordlund B, Novellino E, Nyembue D, O'Hehir R, Ohta K, Okubo K, Onorato GL, Orlando V, Ouedraogo S, Palamarchuk J, Pali-Schöll I, Panzner P, Park HS, Passalacqua G, Pépin JL, Paulino E, Pawankar R, Phillips J, Picard R, Pinnock H, Plavec D, Popov TA, Portejoie F, Price D, Prokopakis EP, Psarros F, Pugin B, Puggioni F, Quinones-Delgado P, Raciborski F, Rajabian-Söderlund R, Regateiro FS, Reitsma S, Rivero-Yeverino D, Roberts G, Roche N, Rodriguez-Zagal E, Rolland C, Roller-Wirnsberger RE, Rosario N, Romano A, Rottem M, Ryan D, Salimäki J, Sanchez-Borges MM, Sastre J, Scadding GK, Scheire S, Schmid-Grendelmeier P, Schünemann HJ, Sarquis Serpa F, Shamji M, Sisul JC, Sofiev M, Solé D, Somekh D, Sooronbaev T, Sova M, Spertini F, Spranger O, Stellato C, Stelmach R, Thibaudon M, To T, Toumi M, Usmani O, Valero AA, Valenta R, Valentin-Rostan M, Pereira MU, van der Kleij R, Van Eerd M, Vandenplas O, Vasankari T, Vaz Carneiro A, Vezzani G, Viart F, Viegi G, Wallace D, Wagenmann M, Wang DY, Waserman S, Wickman M, Williams DM, Wong G, Wroczynski P, Yiallouros PK, Yusuf OM, Zar HJ, Zeng S, Zernotti ME, Zhang L, Shan Zhong N, Zidarn M. ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice. Allergy 2020; 76:168-190. [PMID: 32512619 DOI: 10.1111/all.14422] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/04/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
Collapse
Affiliation(s)
- Jean Bousquet
- MACVIA-France and CHU, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France, and Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - Josep M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Claus Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium and Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital Guangzou, China, and Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Torsten Zuberbier
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | | | | | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia
| | - G Walter Canonica
- Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain
| | - Elisio Costa
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - Alvaro A Cruz
- ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Planning Group, Brazil
| | - Marina Erhola
- National Insitute for Health and Welfare, Helsinki, Finland
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centres, AMC, Amsterdam, the Netherlands, and Euforea, Brussels, Belgium
| | - Joao A Fonseca
- CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto; and Medida, Lda Porto, Portugal
| | - Maddalena Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | | | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University and ALL-MED Medical Research Institute, Warsaw, Poland
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University and Institute of Clinical Medicine, Clinic of Chest diseases and Allergology, Faculty of Medicine, Vilnius, Lithuania
| | - Ltt Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - Désirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | | | - Olga M Lourenço
- Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Erik Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Spain
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Mikaëla Odemyr
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Yoshitaka Okamoto
- Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - Nikos G Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - Vincenzo Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Salerno, Italy
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Nhân Pham-Thi
- Ecole polytechnique, Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées, Bretigny), France
| | | | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Aziz Sheikh
- The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre Hospital & University of Copenhagen, Copenhagen, Denmark
| | - Ana Todo-Bom
- Allergy and Clinical Immunology Unit, Institute of Immunology, Faculty of Medicine, University of Coimbra, ICBR - Coimbra Institute for Clinical and Biomedical Research, CIBB, Coimbra, Portugal
| | | | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Ioanna Tsiligianni
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece and International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - Arunas Valiulis
- Vilnius University Faculty of Medicine, Institute of Clinical Medicine & Institute of Health Sciences, Vilnius, Lithuania
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
| | - Maria-Teresa Ventura
- University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy
| | | | - Sian Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Rute Almeida
- CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto; and Medida, Lda Porto, Portugal
| | - Ignacio J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Universités, Medical School Saint Antoine, Paris, France
| | | | - Xavier Basagaña
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Eric D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Annabelle Bédard
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Sven Becker
- Department of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
| | - Kazi S Bennoor
- Dept of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Samuel Benveniste
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France.,Mines ParisTech CRI-PSL Research University, Fontainebleau, France
| | - Karl C Bergmann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | | | - Slawomir Bialek
- Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland
| | | | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - Hubert Blain
- Department of Geriatrics, Montpellier University hospital, Montpellier, France.,EA 2991, Euromov, University Montpellier, Montpellier, France
| | - Matteo Bonini
- UOC Pneumologia, Istituto di Medicina Interna, F Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy, and National Heart and Lung Institute, Royal Brompton Hospital & Imperial College London, London, UK
| | | | | | | | | | | | - Koen Boussery
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Fluvio Braido
- University of Genoa, Department of Internal Medicine (DiMI) and IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Vitalis Briedis
- Department of Clinical Pharmacy of Lithuanian, University of Health, Kaunas, Lithuania
| | - Andrew Briggs
- Health Economics and Health Technology Assessment, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Christopher E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Jan Brozek
- Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Guy Brusselle
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Luisa Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - Roland Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | - Moises A Calderon
- Imperial College London-National Heart and Lung Institute, London, UK
| | - Paulo Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thierry Camuzat
- Assitant Director General, Montpellier, Région Occitanie, Montpellier, France
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer Piso, Cartagena, Colombia, and Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia
| | | | - Warner Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA
| | | | - Thomas Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL, USA
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Alfonso M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia and SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Branquilla, Colombia
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Ekaterine Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - Derek K Chu
- Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Cemal Cingi
- ENT Department, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimaraes, Portugal
| | | | | | - Adnan Custovic
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, UK
| | - Biljana Cvetkosvki
- Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia
| | - Gennaro D'Amato
- Division of Respiratory and Allergic Diseases, Department of Respiratory Diseases, High Specialty Hospital ACardarelli, Napoli, Italy
| | - Jane da Silva
- Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São, Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis-SC, Brazil
| | - Carina Dantas
- Cáritas Diocesana de Coimbra, Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - Dejan Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic of Macedonia
| | - Yves Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061, Montpellier, France
| | - Giulia De Feo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | | | - Philippe Devillier
- UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - Gerard Dray
- IMT Mines Ales, Université Montpellier, Montpellier, France
| | - Ruta Dubakiene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - Stephen R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Mark Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Mina Gaga
- ERS President 2017-2018, Athens Chest Hospital, 7th Resp Med Dept and Asthma Center, Athens, Greece
| | - Yehia El-Gamal
- Pediatric Allergy and Immunology Unit, Children's hospital, Ain Shams University, Cairo, Egypt
| | - Enrico Heffler
- Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Regina Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - John Farrell
- Department of Health, Social Services and Public Safety, Northern Ireland Belfast, UK
| | - Jean-Luc Fauquert
- CHU Clermont-Ferrand, Unité d'allergologie de l'enfant, pôle pédiatrique, Hôpital Estaing, Clermont-Ferrand, France
| | - Alessandro Fiocchi
- Division of Allergy, Department of Pediatric Medicine-The Bambino Gesù Children's Research Hospital Holy See, Rome, Italy
| | | | | | - José M Fuentes Perez
- Hospital General Regional 1 "Dr Carlos Mc Gregor Sanchez Navarro" IMSS, Mexico City, Mexico
| | - Bilun Gemicioğlu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Amiran Gamkrelidze
- Gamkrelidze National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | | | - Philippe Gevaert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium and Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital Guangzou, China, and Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Maia Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - Nick A Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | - Maria-Antonieta Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - Jawad Hajjam
- Centich: Centre d'Expertise National des Technologies de l'Information et de la communication pour l'autonomie, Groupe VyV, Conseil Régional des Pays de la Loire, Centre d'expertise PartenariatEuropéen d'Innovation pour un vieillissement actif et en bonne santé, Nantes, France
| | | | - Marc Humbert
- Université Paris-Sud; Service de Pneumologie, Hôpital Bicêtre; Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, Federico II University, Napoli, Italy
| | - Despo Ierodiakonou
- Department of Social Medicine, Faculty of Medicine, University of Crete, and International Primary Care Respiratory Group, Crete, Greece
| | - Tomohisa Iinuma
- Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - Ewa Jassem
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Guy Joos
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Ki-Suck Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
| | - Igor Kaidashev
- Ukrainina Medical Stomatological Academy, Poltava, Ukraine
| | - Omer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Przemyslaw Kardas
- First Department of Family Medicine, Medical University of Lodz, Poland
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, and Institute of Health Resort Medicine and Health Promotion, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Musa Khaitov
- National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russian Federation
| | | | | | | | - Marek L Kowalski
- Department of Immunology and Allergy, Healthy Ageing Research Center, Medical University of Lodz, Lodz, Poland
| | - Vicky Kritikos
- Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, and Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Stefania La Grutta
- Institute for Research and Biomedical Innovation (IRIB), National Research Council (CNR), Palermo, Italy
| | - Lisa Leonardini
- Veneto Region, Mattone Internazionale Program, Venise, Italy
| | - Henrik Ljungberg
- Lung-Allergy Department at Astrid Lindgren Children's Hospital, Karolinska University Hospital, & Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Philip Lieberman
- Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, TN, USA
| | - Brian Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - Karin C Lodrup Carlsen
- Oslo University Hospital, Department of Paediatrics, Oslo, and University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | | | - Claudia C Loureiro
- Pneumology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium
| | - Alpana Mair
- DG for Health and Social Care, Scottish Government, Edinburgh, UK
| | - Bassam Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - Michaël Makris
- Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Chaidari, Greece
| | - Joao Malva
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra; Coimbra, and Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - Patrick Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | - Gailen D Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Mohamed R Masjedi
- Tobacco Control Research Centre; Iranian Anti Tobacco Association, Tehran, Iran
| | - Jorge F Maspero
- Argentine Association of Allergy and Clinical Immunology, Buenos Aires, Argentina
| | - Pedro Carreiro-Martins
- Serviço de Immunologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal and Nova Medical School/Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | | | - Marcus Maurer
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | | | - Elisabete Melo-Gomes
- PNDR, Portuguese National Programme for Respiratory Diseases, Faculdade de Medicina de Lisboa, Lisbon, Portugal
| | - Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA, USA
| | | | - Jacques Mercier
- Department of Physiology, CHRU, University Montpellier, Vice President for Research, PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | | | | | - Florin Mihaltan
- National Institute of Pneumology M Nasta, Bucharest, Romania
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Dimitirios I Mitsias
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | | | | | - Yousser Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, and Syrian Private University-Damascus, Damascus, Syria
| | - Steve Montefort
- Lead Respiratory Physician Mater Dei Hospital Malta, Academic Head of Department and Professor of Medicine, University of Malta, Deputy Dean Faculty of Medicine and Surgery, University of Medicine, La Valette, Malta
| | - Ricardo Monti
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | | | - Ralph Mösges
- CRI-Clinical Research International-Ltd, Hamburg, Germany
| | - Lars Münter
- Danish Committee for Health Education, Copenhagen East, Denmark
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Ruth Murray
- Research Fellow, OPC, Cambridge, UK and Director Medscript, Paraparaumu, New Zealand
| | | | - Luigi Napoli
- Director, Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - Leyla Namazova-Baranova
- Scientific Centre of Children's Health under the PoH, Russian National Research Medical University named Pirogov, Moscow, Russia
| | - Hugo Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Center for Allergy and Immunology, Santa Fe, Argentina
| | - Kristoff Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - Angelo Neou
- Die Hautambulanz and Rothhaar study center, Berlin, Germany
| | - Björn Nordlund
- Lung-Allergy Department at Astrid Lindgren Children's Hospital, Karolinska University Hospital, & Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ettore Novellino
- Director of Department of Pharmacy of University of Naples Federico II, Naples, Italy
| | | | - Robyn O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia; Department of Immunology, Monash University, Melbourne, Vic., Australia
| | - Ken Ohta
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - Kimi Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | | | - Valentina Orlando
- Director of Department of Pharmacy of University of Naples Federico II, Naples, Italy
| | - Solange Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | | | - Isabella Pali-Schöll
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine and Medical University, Vienna, Austria
| | - Peter Panzner
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - Gianni Passalacqua
- Allergy and Respiratory Diseases, Ospedale Policlino San Martino-University of Genoa, Genoa, Italy
| | - Jean-Louis Pépin
- Université Grenoble Alpes, Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, Grenoble, France
| | | | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Jim Phillips
- Centre for Empowering Patients and Communities, Faulkland, UK
| | - Robert Picard
- Conseil Général de l'Economie Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - Hilary Pinnock
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Davor Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University JJ Strossmayer, Osijek, Croatia
| | - Todor A Popov
- University Hospital "Sv Ivan Rilski", Sofia, Bulgaria
| | | | - David Price
- Observational and Pragmatic Research Institute Singapore, Singapore City, Singapore
| | - Emmanuel P Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - Fotis Psarros
- Allergy Department, Athens Naval Hospital, Athens, Greece
| | - Benoit Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Francesca Puggioni
- Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Pablo Quinones-Delgado
- Agency for Social Services and Dependency, Regional Government for Equality, Social Policies and Conciliation of Andalucia, Seville, Spain
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | | | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Institute of Immunology, Faculty of Medicine, University of Coimbra, ICBR - Coimbra Institute for Clinical and Biomedical Research, CIBB, Coimbra, Portugal
| | - Sietze Reitsma
- Department of Otorhinolaryngology, Academic Medical Centres, AMC, Amsterdam, the Netherlands, and Euforea, Brussels, Belgium
| | | | - Graham Roberts
- David Hide Centre, St Mary's Hospital, Isle of Wight and University of Southampton, Southampton, UK
| | - Nicolas Roche
- Pneumologie et Soins Intensifs Respiratoires, Centre Hôpital Cochin, Hôpitaux Universitaires Paris, Paris, France
| | | | | | | | - Nelson Rosario
- Hospital de Clinicas, University of Parana, Parana, Brazil
| | - Antonino Romano
- Allergy Unit, Presidio Columbus, Rome, Catholic University of Sacred Heart, Rome and IRCCS Oasi Maria SS, Troina, Italy
| | - Menachem Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - Dermot Ryan
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | | | - Mario M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, Caracas, Venezuela
| | - Joaquin Sastre
- Faculty of Medicine, Autnonous University of Madrid, Madrid, Spain
| | | | - Sophie Scheire
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | | | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Faradiba Sarquis Serpa
- Asthma Reference Center, School of Medicine of Santa Casa de Misericordia of Vitoria-Esperito Santo, Vitoria, Brazil
| | - Mohamed Shamji
- Immunomodulation and Tolerance Group, Imperial College London, and Allergy and Clinical Immunology, Imperial College London, London, UK
| | | | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, Sao Paulo, Brazil
| | - David Somekh
- European Health Futures Forum (EHFF), Dromahair, UK
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - Milan Sova
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - François Spertini
- Service Immunologie et Allergie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Otto Spranger
- Global Allergy and Airways Patient Platform GAAPP, Vienna, Austria
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Michel Thibaudon
- RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France
| | - Teresa To
- Sidkkids Hospitala and Institute of Health Policy, Management and Evaluation, Toronto, Canada
| | - Mondher Toumi
- Public Health, Aix-marseille University, Marseille, France
| | - Omar Usmani
- National Heart and Lung Institute (NHLI), Imperial College London & Royal Brompton Hospital, Airways Disease Section, London, UK
| | - Antonio A Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Rudolph Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,NRC Institute of Immunology FMBA of Russia, Moscow, Russia and Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | - Rianne van der Kleij
- Department of Public Health & Primary Care, Leiden University Medical Center (LUMC), Leiden, The Netherlands, Erasmus MC, Department of Obstetrics and Gynaecology, University Medical Center, Rotterdam, The Netherlands
| | | | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Tuula Vasankari
- FILHA, Finnish Lung Association, Helsinki, and Turku University, Turku, Finland
| | - Antonio Vaz Carneiro
- Instituto de Medicina Preventiva e Saude Publica, Instituto de Saude Ambiental, Centro de Estudos de Medicina Baseada na Evidência, Cochrane, Portugal
| | - Giorgio Vezzani
- Pulmonary Unit, Department of Medical Specialties, Arcispedale SMaria Nuova/IRCCS, AUSL di Reggio Emilia, Reggio Emilia, Italy
| | | | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy; and CNR Institute of Biomedicine and Molecular Immunology "A Monroy", Palermo, Italy
| | - Dana Wallace
- Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Martin Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Magnus Wickman
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Dennis M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Gary Wong
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Piotr Wroczynski
- Department of Physical Pharmacy and Bioanalysis, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Panayiotis K Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Pediatrics, Hospital "Archbishop Makarios III", Nicosia, Cyprus
| | | | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | | | | | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
| | - Nan Shan Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| |
Collapse
|
15
|
Serhal S, Saini B, Bosnic-Anticevich S, Krass I, Wilson F, Armour C. Medication Adherence in a Community Population with Uncontrolled Asthma. PHARMACY 2020; 8:pharmacy8040183. [PMID: 33036454 PMCID: PMC7711630 DOI: 10.3390/pharmacy8040183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 12/12/2022] Open
Abstract
It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management in those most at risk—a population with clinically uncontrolled asthma. Participants (n = 363) were recruited from Australian community pharmacies, and a dispensed medication history report for the previous 12 months was collected to examine medication adherence and factors affecting adherence. Information was also collected regarding participant asthma control and asthma/allergic rhinitis (if applicable) management. The participants’ mean asthma control score was 2.49 (± 0.89 SD, IQR = 1.20) (score ≥ 1.5 indicative of poorly controlled asthma), and 72% were either non-adherent or yet to initiate preventer therapy. Almost half had been prescribed high doses of inhaled corticosteroid and 24% reported use of oral corticosteroids. Only 22% of participants with concomitant allergic rhinitis were using first line treatment. A logistic regression model highlighted that participant health care concession status and hospital admissions were associated with better adherence. Suboptimal medication management is evident in this at-risk population.
Collapse
Affiliation(s)
- Sarah Serhal
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- Correspondence: ; Tel.: +61-4-1495-9883
| | - Bandana Saini
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Ines Krass
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Frances Wilson
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
| | - Carol Armour
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
| |
Collapse
|
16
|
Dierick BJH, van der Molen T, Flokstra-de Blok BMJ, Muraro A, Postma MJ, Kocks JWH, van Boven JFM. Burden and socioeconomics of asthma, allergic rhinitis, atopic dermatitis and food allergy. Expert Rev Pharmacoecon Outcomes Res 2020; 20:437-453. [PMID: 32902346 DOI: 10.1080/14737167.2020.1819793] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Asthma, allergic rhinitis, atopic dermatitis, and food allergy affect approximately 20% of the global population. Few studies describe the burden of the totality of these diseases and only a handful studies provide a comprehensive overview of the socioeconomic impact of these diseases. AREAS COVERED For this narrative review, we searched Pubmed using selected keywords and inspected relevant references using a snowballing process. We provide an overview of the socioeconomic burden of allergic diseases (in particular, asthma, allergic rhinitis, atopic dermatitis, and food allergy). The focus of this review is on their epidemiology (incidence, prevalence), burden (disability-adjusted life years, quality of life), and direct and indirect costs (absenteeism and presenteeism). We have put special emphasis on differences between countries. EXPERT COMMENTARY Both the prevalence and the burden of allergic diseases are considerable with prevalence varying between 1% and 20%. We identified a plethora of studies on asthma, but studies were generally difficult to compare due to the heterogeneity in measures used. There were only few studies on the burden of food allergy; therefore, more studies on this allergy are required. For future studies, we recommend standardizing epidemiologic, socioeconomic impact, and quality of life measures of allergic diseases.
Collapse
Affiliation(s)
- Boudewijn J H Dierick
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen , Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC) , Groningen, The Netherlands
| | - Thys van der Molen
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen , Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC) , Groningen, The Netherlands
| | - Bertine M J Flokstra-de Blok
- Groningen Research Institute for Asthma and COPD (GRIAC) , Groningen, The Netherlands.,General Practitioners Research Institute , Groningen, The Netherlands
| | - Antonella Muraro
- Food Allergy Centre, Department of Woman and Child Health, Padua University Hospital , Padua, Italy
| | - Maarten J Postma
- Department of Health Sciences, Unit of Global Health Economics, University of Groningen, University Medical Center Groningen , Groningen, The Netherlands
| | - Janwillem W H Kocks
- Groningen Research Institute for Asthma and COPD (GRIAC) , Groningen, The Netherlands.,General Practitioners Research Institute , Groningen, The Netherlands
| | - Job F M van Boven
- Groningen Research Institute for Asthma and COPD (GRIAC) , Groningen, The Netherlands.,Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center Groningen , Groningen, The Netherlands
| |
Collapse
|
17
|
Pfaar O, Gerth van Wijk R, Klimek L, Bousquet J, Creticos PS. Clinical trials in allergen immunotherapy in the age group of children and adolescents: current concepts and future needs. Clin Transl Allergy 2020; 10:11. [PMID: 32346471 PMCID: PMC7181492 DOI: 10.1186/s13601-020-00314-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/19/2020] [Indexed: 12/12/2022] Open
Abstract
Allergen immunotherapy (AIT) is the only treatment option available for allergic patients with disease-modifying intention. Both efficacy and safety has been demonstrated for multiple trials in children, adolescents and adults. Though regulatory requirements for marketing authorization have been clearly outlined and an increasing number of high quality trials has been initiated, multiple concepts and details in study design may be further elaborated, harmonized and improved. An international group of experts in the field of AIT has thoroughly reviewed and discussed current concepts and provided an outlook on further improvement especially in the age group of children and adolescents. Emphasis of the group's discussion as a basis for this article was put on (i) the regulatory background of marketing authorization of AIT products including the 'Pediatric Investigational Plan', (ii) patient reported outcomes and endpoints in AIT trials, (iii) considerations regarding the 'minimal clinically important difference', (iv) the role of placebo effects in AIT clinical trials and clinical routine and (v) the potential of mobile Health for future development of AIT. Current concepts in AIT have been optimized throughout the recent decades, but there remains room for improvement e.g., in the topics outlined in this article.
Collapse
Affiliation(s)
- O Pfaar
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - R Gerth van Wijk
- 2Section of Allergology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - J Bousquet
- MACVIA-France, Contre les Maladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,5INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France, Universite Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - P S Creticos
- 6Division of Allergy & Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, MD 21224 USA.,Creticos Research Group, Crownsville, MD 21032 USA
| |
Collapse
|
18
|
Effect of nasal irrigation on allergic rhinitis control in children; complementarity between CARAT and MASK outcomes. Clin Transl Allergy 2020; 10:9. [PMID: 32190296 PMCID: PMC7068957 DOI: 10.1186/s13601-020-00313-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background Nasal irrigations (NI) are increasingly used as an over-the-counter adjunctive treatment for allergic rhinitis (AR), but clinical studies on their effectiveness are limited. Methods An open-label, controlled, non-randomized, real-life study was conducted to evaluate the effectiveness of NI with a new hypertonic solution as add-on treatment for AR. Children and adolescents with AR were prescribed symptomatic treatment. The active group also received an additional sea-water NI solution supplemented with algae extracts. The primary endpoint was symptom control, assessed by the control of allergic rhinitis and asthma test (CARAT) questionnaires. Moreover, the MASK/Allergy Diary was used to track symptoms and daily medication use that were combined in a novel total symptom/medication score (TSMS). Results We assessed 76 patients. Overall, there was a significant improvement of CARAT results (median Z-score change of 1.1 in the active/NI group vs. 0.4 in the control group; p = 0.035). Among patients > 12 years old (n = 51), there was a significant improvement in CARAT10 results among participants receiving NI (21.0 to 25.5; p < 0.001), but not in the regular treatment group (21.5 to 24.0; p = 0.100). For children < 12 years old (n = 25), the ΝΙ group had significantly improved symptom control (CARATKids results: 5.0 to 2.0; p = 0.002), in contrast to the control group (4.0 to 2.5; p = 0.057). MASK data on allergic symptoms were comparable between groups. However, the NI group had lower TSMS, more days with < 20% symptoms and fewer days using symptomatic treatment (26.9% vs. 43.5%; p = 0.005). Conclusion Addition of NI with a sea-water solution to regular treatment improved AR symptom control. CARAT questionnaires and MASK application can be useful outcome tools in real-life studies.
Collapse
|
19
|
Gravbrot N, Kelly DF, Milligan J, Griffiths CF, Barkhoudarian G, Jahnke H, White WL, Little AS. The Minimal Clinically Important Difference of the Anterior Skull Base Nasal Inventory-12. Neurosurgery 2019; 83:277-280. [PMID: 28973679 DOI: 10.1093/neuros/nyx401] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/19/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The minimal clinically important difference (MCID) is defined as the smallest change in health-related quality of life (QOL) that patients consider meaningful. The MCID is essential for determining clinically significant changes, rather than simply statistically significant changes, in QOL scores. The Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12), a site-specific sinonasal QOL instrument, has emerged as a standard instrument for assessing QOL in patients who have undergone endonasal transsphenoidal surgery. OBJECTIVE To determine the MCID for the ASK Nasal-12. METHODS Distribution- and anchor-based methods were used to determine the MCID for the ASK Nasal-12 based on raw data from a multicenter prospective QOL study of 218 patients. RESULTS Two distribution-based statistical methods, the one-half standard deviation method and the effect-size method, both yielded MCIDs of 0.37 (medium effect). The first anchor-based method, using the 2-wk postoperative overall nasal functioning item as the anchor, yielded an MCID of 0.31. The second anchor-based method, using the 2-wk postoperative Short Form Health Survey 8 bodily pain item as the anchor, yielded an MCID of 0.29. CONCLUSION The largest MCID obtained for the ASK Nasal-12 using 4 statistical methods 2 wk postoperatively was 0.37. This information provides clinicians with an essential context for determining the clinical significance of changes in QOL scores after interventions. Our results will help clinicians better interpret QOL scores and design future studies that are powered to detect meaningful QOL changes.
Collapse
Affiliation(s)
- Nicholas Gravbrot
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hos-pital and Medical Center, Phoenix, Ari-zona
| | - Daniel F Kelly
- Pacific Pituitary Disorders Center, John Wayne Cancer Institute, Saint John's Health Center, Santa Monica, California
| | - John Milligan
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hos-pital and Medical Center, Phoenix, Ari-zona
| | - Chester F Griffiths
- Pacific Pituitary Disorders Center, John Wayne Cancer Institute, Saint John's Health Center, Santa Monica, California
| | - Garni Barkhoudarian
- Pacific Pituitary Disorders Center, John Wayne Cancer Institute, Saint John's Health Center, Santa Monica, California
| | - Heidi Jahnke
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hos-pital and Medical Center, Phoenix, Ari-zona
| | - William L White
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hos-pital and Medical Center, Phoenix, Ari-zona
| | - Andrew S Little
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hos-pital and Medical Center, Phoenix, Ari-zona
| |
Collapse
|
20
|
Bosnic‐Anticevich S, Costa E, Menditto E, Lourenço O, Novellino E, Bialek S, Briedis V, Buonaiuto R, Chrystyn H, Cvetkovski B, Di Capua S, Kritikos V, Mair A, Orlando V, Paulino E, Salimäki J, Söderlund R, Tan R, Williams DM, Wroczynski P, Agache I, Ansotegui IJ, Anto JM, Bedbrook A, Bachert C, Bewick M, Bindslev‐Jensen C, Brozek JL, Canonica GW, Cardona V, Carr W, Casale TB, Chavannes NH, Correia de Sousa J, Cruz AA, Czarlewski W, De Carlo G, Demoly P, Devillier P, Dykewicz MS, Gaga M, El‐Gamal Y, Fonseca J, Fokkens WJ, Guzmán MA, Haahtela T, Hellings PW, Illario M, Ivancevich JC, Just J, Kaidashev I, Khaitov M, Khaltaev N, Keil T, Klimek L, Kowalski ML, Kuna P, Kvedariene V, Larenas‐Linnemann DE, Laune D, Le LTT, Lodrup Carlsen KC, Mahboub B, Maier D, Malva J, Manning PJ, Morais‐Almeida M, Mösges R, Mullol J, Münter L, Murray R, Naclerio R, Namazova‐Baranova L, Nekam K, Nyembue TD, Okubo K, O'Hehir RE, Ohta K, Okamoto Y, Onorato GL, Palkonen S, Panzner P, Papadopoulos NG, Park H, Pawankar R, Pfaar O, Phillips J, Plavec D, Popov TA, Potter PC, Prokopakis EP, Roller‐Wirnsberger RE, Rottem M, Ryan D, Samolinski B, Sanchez‐Borges M, Schunemann HJ, Sheikh A, Sisul JC, Somekh D, Stellato C, To T, Todo‐Bom AM, Tomazic PV, Toppila‐Salmi S, Valero A, Valiulis A, Valovirta E, Ventura MT, Wagenmann M, Wallace D, Waserman S, Wickman M, Yiallouros PK, Yorgancioglu A, Yusuf OM, Zar HJ, Zernotti ME, Zhang L, Zidarn M, Zuberbier T, Bousquet J. ARIA pharmacy 2018 "Allergic rhinitis care pathways for community pharmacy": AIRWAYS ICPs initiative (European Innovation Partnership on Active and Healthy Ageing, DG CONNECT and DG Santé) POLLAR (Impact of Air POLLution on Asthma and Rhinitis) GARD Demonstration project. Allergy 2019; 74:1219-1236. [PMID: 30565275 DOI: 10.1111/all.13701] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/22/2018] [Accepted: 10/11/2018] [Indexed: 12/16/2022]
Abstract
Pharmacists are trusted health care professionals. Many patients use over-the-counter (OTC) medications and are seen by pharmacists who are the initial point of contact for allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies and provides tools intended to help pharmacists provide optimal advice/interventions/strategies to patients with rhinitis. The Allergic Rhinitis and its Impact on Asthma (ARIA)-pharmacy ICP includes a diagnostic questionnaire specifically focusing attention on key symptoms and markers of the disease, a systematic Diagnosis Guide (including differential diagnoses), and a simple flowchart with proposed treatment for rhinitis and asthma multimorbidity. Key prompts for referral within the ICP are included. The use of technology is critical to enhance the management of allergic rhinitis. However, the ARIA-pharmacy ICP should be adapted to local healthcare environments/situations as regional (national) differences exist in pharmacy care.
Collapse
Affiliation(s)
- Sinthia Bosnic‐Anticevich
- Woolcock Institute of Medical Research University of Sydney and Sydney Local Health District Glebe New South Wales Australia
| | - Elisio Costa
- UCIBIO REQUIMTE Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork) University of Porto Porto Portugal
| | | | - Olga Lourenço
- Faculty of Health Sciences and CICS – UBI Health Sciences Research Centre University of Beira Interior Covilhã Portugal
| | - Ettore Novellino
- Department of Pharmacy of University of Naples Federico II Naples Italy
| | - Slawomir Bialek
- Department of Biochemistry and Clinical Chemistry Faculty of Pharmacy with the Division of Laboratory Medicine Warsaw Medical University Warsaw Poland
| | - Vitalis Briedis
- Department of Clinical Pharmacy of Lithuanian University of Health Sciences Kaunas Lithuania
| | | | | | - Biljana Cvetkovski
- Woolcock Institute of Medical Research University of Sydney and Sydney Local Health District Glebe New South Wales Australia
| | | | - Vicky Kritikos
- Woolcock Institute of Medical Research University of Sydney and Sydney Local Health District Glebe New South Wales Australia
| | - Alpana Mair
- DG for Health and Social Care Scottish Government Edinburgh UK
| | | | | | | | - Rojin Söderlund
- Department of Nephrology and Endocrinology Karolinska University Hospital Stockholm Sweden
| | - Rachel Tan
- Woolcock Institute of Medical Research University of Sydney and Sydney Local Health District Glebe New South Wales Australia
| | - Dennis M. Williams
- Eshelman School of Pharmacy University of North Carolina Chapel Hill North Carolina
| | - Piotr Wroczynski
- Department of Biochemistry and Clinical Chemistry Faculty of Pharmacy with the Division of Laboratory Medicine Warsaw Medical University Warsaw Poland
| | | | | | - Josep M. Anto
- ISGlobAL Centre for Research in Environmental Epidemiology (CREAL) Barcelona Spain
- IMIM (Hospital del Mar Research Institute) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - Anna Bedbrook
- MACVIA‐France Fondation Partenariale FMC VIA‐LR Montpellier France
| | - Claus Bachert
- Upper Airways Research Laboratory ENT Department Ghent University Hospital Ghent Belgium
| | | | - Carsten Bindslev‐Jensen
- Department of Dermatology and Allergy Centre Odense University Hospital Odense Research Center for Anaphylaxis (ORCA) Odense Denmark
| | - Jan L. Brozek
- Department of Health Research Methods, Evidence, and Impact Division of Immunology and Allergy Department of Medicine McMaster University Hamilton Ontario Canada
| | - Giorgio Walter Canonica
- Personalized Medicine Clinic Asthma & Allergy Humanitas Research Hospital Humanitas University Rozzano, Milan Italy
| | - Victoria Cardona
- Allergy Section Department of Internal Medicine Hospital Vall ‘dHebron & ARADyAL Research Network Barcelona Spain
| | - Warner Carr
- Allergy and Asthma Associates of Southern California Mission Viejo California
| | - Thomas B. Casale
- Division of Allergy/Immunology University of South Florida Tampa Florida
| | - Niels H. Chavannes
- Department of Public Health and Primary Care Leiden University Medical Center Leiden The Netherlands
| | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute (ICVS) School of Medicine University of Minho Braga Portugal
- ICVS/3B's PT Government Associate Laboratory Braga/Guimarães Portugal
| | - Alvaro A. Cruz
- ProAR – Nucleo de Excelencia em Asma Federal University of Bahia Bahia Brazil
- WHO GARD Planning Group Brasilia Brazil
| | | | - Giuseppe De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations Brussels Belgium
| | - Pascal Demoly
- Department of Respiratory Diseases Montpellier University Hospital Montpellier France
- Epidemiology of Allergic and Respiratory Diseases Department Institute Pierre Louis of Epidemiology and Public Health Medical School Saint Antoine INSERM and UPMC Sorbonne Université Paris France
| | - Philippe Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220 Hôpital Foch Suresnes Université Versailles Saint‐Quentin Université Paris Saclay Saclay France
| | - Mark S. Dykewicz
- Section of Allergy and Immunology Saint Louis University School of Medicine Saint Louis Missouri
| | - Mina Gaga
- ERS President 2017‐2018 Athens Chest Hospital 7th Resp Med Department and Asthma Center Athens Greece
| | - Yehia El‐Gamal
- Pediatric Allergy and Immunology Unit Children's Hospital Ain Shams University Cairo Egypt
| | - João Fonseca
- CINTESIS Center for Research in Health Technologies and Information Systems Faculdade de Medicina da Universidade do Porto Porto Portugal
- MEDIDA, Lda Porto Portugal
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Academic Medical Centre Amsterdam The Netherlands
| | | | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
- University of Helsinki Helsinki Finland
| | - Peter W. Hellings
- Laboratory of Clinical Immunology Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | - Maddalena Illario
- Division for Health Innovation Campania Region and Federico II University Hospital Naples (R&D and DISMET) Naples Italy
| | | | - Jocelyne Just
- Allergology Department Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand‐Trousseau (APHP) Sorbonne Universités UPMC Univ Paris 06 UMR_S 1136 Institut Pierre Louis d'Epidémiologie et de Santé Publique Equipe EPAR Paris France
| | - Igor Kaidashev
- Ukrainian Medical Stomatological Academy Poltava Ukraine
| | - Musa Khaitov
- National Research Center Institute of Immunology Federal Medicobiological Agency Laboratory of Molecular immunology Moscow Russian Federation
| | | | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics Charité ‐ Universitätsmedizin Berlin Berlin Germany
- Institute for Clinical Epidemiology and Biometry University of Wuerzburg Wuerzburg Germany
| | - Ludger Klimek
- Center for Rhinology and Allergology Wiesbaden Germany
| | - Marek L. Kowalski
- Department of Immunology and Allergy Healthy Ageing Research Center Medical University of Lodz Lodz Poland
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Lodz Poland
| | | | | | | | - Lan T. T. Le
- University of Medicine and Pharmacy Hochiminh City Vietnam
| | - Karin C. Lodrup Carlsen
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Faculty of Medicine Institute of Clinical MedicineUniversity of Oslo Oslo Norway
| | - Bassam Mahboub
- Department of Pulmonary Medicine Rashid Hospital Dubai UAE
| | | | - Joao Malva
- Faculty of Medicine Coimbra Institute for Clinical and Biomedical Research (iCBR) University of Coimbra Coimbra Portugal
- Ageing@Coimbra EIP‐AHA Reference Site Coimbra Portugal
| | - Patrick J. Manning
- Department of Medicine (RCSI) Bon Secours Hospital Glasnevin, Dublin Ireland
| | | | - Ralph Mösges
- Institute of Medical Statistics, and Computational Biology Medical Faculty University of Cologne Cologne Germany
- CRI‐Clinical Research International‐Ltd Hamburg Germany
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic ENT Department Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy IDIBAPS CIBERES University of Barcelona Barcelona Spain
| | - Lars Münter
- Danish Committee for Health Education Copenhagen East Denmark
| | | | | | - Leyla Namazova‐Baranova
- Scientific Centre of Children's Health under the MoH, Russia, Russian National Research Medical University named Pirogov Moscow Russia
| | - Kristof Nekam
- Hospital of the Hospitaller Brothers in Buda Budapest Hungary
| | | | - Kimi Okubo
- Department of Otolaryngology Nippon Medical School Tokyo Japan
| | - Robyn E. O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine Alfred Hospital and Central Clinical School Monash University Melbourne Victoria Australia
- Department of Immunology Monash University Melbourne Victoria Australia
| | - Ken Ohta
- National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology Chiba University Hospital Chiba Japan
| | | | - Susanna Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations Brussels Belgium
| | - Petr Panzner
- Department of Immunology and Allergology Faculty of Medicine and Faculty Hospital in Pilsen Charles University in Prague Pilsen Czech Republic
| | - Nikolaos G. Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK
- Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital “P&A Kyriakou” University of Athens Athens Greece
| | - Hae‐Sim Park
- Department of Allergy and Clinical Immunology Ajou University School of Medicine Suwon South Korea
| | - Ruby Pawankar
- Department of Pediatrics Nippon Medical School Tokyo Japan
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section for Rhinology and Allergy University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | - Jim Phillips
- Centre for Empowering Patients and Communities Faulkland, Somerset UK
| | - Davor Plavec
- Children's Hospital Srebrnjak Zagreb, School of Medicine University J.J. Strossmayer Osijek Croatia
| | | | - Paul C. Potter
- Allergy Diagnostic and Clinical Research Unit University of Cape Town Lung Institute Cape Town South Africa
| | - Emmanuel P. Prokopakis
- Department of Otorhinolaryngology University of Crete School of Medicine Heraklion Greece
| | | | - Menachem Rottem
- Division of Allergy Asthma and Clinical Immunology Emek Medical Center Afula Israel
| | - Dermot Ryan
- Honorary Clinical Research Fellow Allergy and Respiratory Research Group The University of Edinburgh Past President SLAAI FACAAI Edinburgh UK
| | - Bolesław Samolinski
- Department of Prevention of Environmental Hazards and Allergology Medical University of Warsaw Warsaw Poland
| | - Mario Sanchez‐Borges
- Allergy and Clinical Immunology Department Centro Médico‐Docente la Trinidad Caracas Trinidad
- Clínica El Avila Altamira, Caracas Venezuela
| | - Holger J. Schunemann
- Department of Health Research Methods, Evidence, and Impact Division of Immunology and Allergy Department of Medicine McMaster University Hamilton Ontario Canada
| | - Aziz Sheikh
- The Usher Institute of Population Health Sciences and Informatics The University of Edinburgh Edinburgh UK
| | | | - David Somekh
- European Health Futures Forum (EHFF) Isle of Wright UK
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana” University of Salerno Salerno Italy
| | - Teresa To
- The Hospital for Sick Children Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
| | - Ana Maria Todo‐Bom
- Imunoalergologia Centro Hospitalar Universitário de Coimbra Coimbra Portugal
- Faculty of Medicine University of Coimbra Coimbra Portugal
| | | | - Sanna Toppila‐Salmi
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
- University of Helsinki Helsinki Finland
| | - Antonio Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy IDIBAPS University of Barcelona Barcelona Spain
| | - Arunas Valiulis
- Clinic of Children's Diseases and Institute of Health Sciences Department of Public Health Vilnius University Institute of Clinical Medicine Vilnius Lithuania
- European Academy of Paediatrics (EAP/UEMS‐SP) Brussels Belgium
| | - Errka Valovirta
- Department of Lung Diseases and Clinical Immunology University of Turku and Terveystalo allergy clinic Turku Finland
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology University of Bari Medical School Bari Italy
| | - Martin Wagenmann
- Department of Otorhinolaryngology Universitätsklinikum Düsseldorf Dusseldorf Germany
| | - Dana Wallace
- Nova Southeastern University Fort Lauderdale Florida
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy McMaster University Hamilton Ontario Canada
| | - Magnus Wickman
- Centre for Clinical Research Sörmland Uppsala University Eskilstuna Sweden
| | - Panayiotis K. Yiallouros
- Cyprus International Institute for Environmenta & Public Health in Association with Harvard School of Public Health Cyprus University of Technology Limassol Cyprus
- Department of Pediatrics Hospital “Archbishop Makarios III” Nicosia Cyprus
| | | | | | - Heather J. Zar
- Department of Paediatrics and Child Health Red Cross Children's, Hospital, and MRC Unit on Child & Adolescent Health University of Cape Town Cape Town South Africa
| | | | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Beijing Institute of Otolaryngology Beijing China
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases Golnik Slovenia
| | - Torsten Zuberbier
- Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin Berlin Institute of Health Comprehensive Allergy Center A member of GALEN Berlin Germany
| | - Jean Bousquet
- MACVIA‐France Fondation Partenariale FMC VIA‐LR Montpellier France
- Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin Berlin Institute of Health Comprehensive Allergy Center A member of GALEN Berlin Germany
- University Hospital Montpellier France
- INSERM U 1168 VIMA: Ageing and chronic diseases Epidemiological and public health approaches Villejuif France
- Université Versailles St‐Quentin‐en‐Yvelines UMR‐S 1168 Montigny le Bretonneux France
| |
Collapse
|
21
|
Calderón MA, Casale TB, Demoly P. Validation of Patient-Reported Outcomes for Clinical Trials in Allergic Rhinitis: A Systematic Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 7:1450-1461.e6. [PMID: 30797777 DOI: 10.1016/j.jaip.2019.01.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 01/07/2023]
Abstract
Although regulatory authorities have recently recommended the use of a combined symptom-medication score as a primary efficacy end point, none has been psychometrically validated. Here, we sought to determine to what extent allergic rhinitis (AR)-related patient-reported outcomes (symptom scores, medication scores, disease control scores, and satisfaction or quality-of-life scales) have been assessed for construct, content, and/or criterion validity, reliability, responsiveness, and the minimal clinically important difference. We searched the PubMed database from January 1997 to June 2018 with logical combinations of key words related to validation, AR, and patient-rated outcomes and scales. From a total of 1705 potentially relevant publications, 55 were reviewed. Despite the current emphasis on a combined symptom-medication score for evaluating the efficacy of allergen immunotherapy in AR, symptom scores have not been extensively validated, and we did not find any publications describing the validation of a medication score. Disease control scales (mainly the Rhinitis Control Assessment Test, the Control of Allergic Rhinitis and Asthma Test, and the Allergic Rhinitis Control Test) and health-related quality-of-life scales (mainly the Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ] and the mini-RQLQ) have been extensively validated in AR but have some practical disadvantages as primary efficacy criteria in clinical trials.
Collapse
Affiliation(s)
- Moises A Calderón
- National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital NHS, London, United Kingdom
| | - Thomas B Casale
- Division of Allergy and Immunology, University of South Florida, Tampa, Fla
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France; Sorbonne Universités, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France.
| |
Collapse
|
22
|
Werner CU, Koch L, Linde K, Kriston L, Schultz K, Atmann O, Schneider A. Prospective observational study validating the German version of the Control of Allergic Rhinitis and Asthma Test (CARAT10). NPJ Prim Care Respir Med 2018; 28:45. [PMID: 30514843 PMCID: PMC6279774 DOI: 10.1038/s41533-018-0112-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/11/2018] [Indexed: 11/10/2022] Open
Abstract
The Control of Allergic Rhinitis and Asthma Test (CARAT10), developed by Portuguese experts, is the only questionnaire assessing asthma control under additional consideration of a frequently concurrent allergic rhinitis (AR), providing sub-scores for both diseases. Aims of this study were the translation and validation of its German version. Asthma patients both with and without AR were included at three primary care pulmologists´ practices in Southern Germany. After translation process, patients completed the CARAT10, the Asthma Control Questionnaire (ACQ), the Asthma Control Test (ACT), and the Standardised Asthma Quality of Life Questionnaire (AQLQ(S)). Item and scale characteristics as well as measures of reliability and validity of the CARAT10 were determined. A confirmatory factor analysis was conducted to test factorial validity. Data of 213 patients were analysed, 101 (47%) of them with concurrent AR. Missing responses were minimal and unsystematic. Cronbach´s α was 0.87 for the CARAT10 total score (TS) and 0.84 for each sub-score. Spearman´s correlation coefficients for the association of the CARAT10 TS with ACQ, ACT and AQLQ(S) were moderate to high and slightly higher in patients with AR. Higher correlations were found for its lower airway sub-score than the upper airway sub-score (all around 0.8 to all around 0.3). Confirmatory factor analysis confirmed the two-factorial scale structure of the CARAT10, with a two-factor model showing a better fit to the data than a one-factor model. The German version of the CARAT10 is an acceptable, reliable and valid tool. Our results suggest a recommended use in asthma patients with AR. A newly-translated German version of a two-factor asthma test shows promise as a reliable tool for assessing disease control. Asthma frequently co-exists with allergic rhinitis (AR), a condition in which allergies cause irritation and inflammation of the nasal passages. To verify asthma control under AR, a Portuguese team developed the Control of Allergic Rhinitis and Asthma Test (CARAT10). Now, Christoph Ulrich Werner at the Technical University of Munich in Germany and co-workers have translated CARAT10 into German and verified its reliability and validity for use in the German population. The team trialed their CARAT10 version with 213 patients, 101 of whom had concurrent AR, and compared the results with three standardised asthma questionnaires. They found that CARAT10 was a better fit to verify disease control for patients with co-existing AR than in such.
Collapse
Affiliation(s)
- Christoph Ulrich Werner
- Technical University of Munich, TUM School of Medicine, Institute of General Practice, Munich, Germany.
| | - Luisa Koch
- Technical University of Munich, TUM School of Medicine, Institute of General Practice, Munich, Germany
| | - Klaus Linde
- Technical University of Munich, TUM School of Medicine, Institute of General Practice, Munich, Germany
| | - Levente Kriston
- University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall, Center for Rehabilitation, Pulmonology and Orthopedics, Bad Reichenhall, Germany
| | - Oxana Atmann
- Technical University of Munich, TUM School of Medicine, Institute of General Practice, Munich, Germany
| | - Antonius Schneider
- Technical University of Munich, TUM School of Medicine, Institute of General Practice, Munich, Germany
| |
Collapse
|
23
|
Flokstra-de Blok BMJ, Baretta HJ, Fonseca JA, van Heijst E, Kollen BJ, de Kroon J, van der Molen T, Tsiligianni I, de Jong C, Kocks JH. Control of Allergic Rhinitis and Asthma Test with 1-week recall: Validation of paper and electronic version. Allergy 2018; 73:2381-2385. [PMID: 30028515 PMCID: PMC6586218 DOI: 10.1111/all.13564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Bertine M. J. Flokstra-de Blok
- Department of General Practice and Elderly Care; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC); University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - Hendrik-Jan Baretta
- Department of General Practice and Elderly Care; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC); University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - João A. Fonseca
- Faculdade de Medicina da Universidade do Porto & MEDIDA; CINTESIS; Porto Portugal
| | - Ellen van Heijst
- Groningen Research Institute for Asthma and COPD (GRIAC); University of Groningen; University Medical Center Groningen; Groningen The Netherlands
- Certe Laboratories; Groningen The Netherlands
| | - Boudewijn J. Kollen
- Department of General Practice and Elderly Care; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - Jorn de Kroon
- Department of General Practice and Elderly Care; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - Thys van der Molen
- Department of General Practice and Elderly Care; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC); University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - Ioanna Tsiligianni
- Department of Social Medicine; Faculty of Medicine; University of Crete; Crete Greece
| | - Corina de Jong
- Department of General Practice and Elderly Care; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC); University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| | - JanWillem H. Kocks
- Department of General Practice and Elderly Care; University of Groningen; University Medical Center Groningen; Groningen The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC); University of Groningen; University Medical Center Groningen; Groningen The Netherlands
| |
Collapse
|
24
|
Bousquet J, Arnavielhe S, Bedbrook A, Bewick M, Laune D, Mathieu-Dupas E, Murray R, Onorato GL, Pépin JL, Picard R, Portejoie F, Costa E, Fonseca J, Lourenço O, Morais-Almeida M, Todo-Bom A, Cruz AA, da Silva J, Serpa FS, Illario M, Menditto E, Cecchi L, Monti R, Napoli L, Ventura MT, De Feo G, Larenas-Linnemann D, Fuentes Perez M, Huerta Villabolos YR, Rivero-Yeverino D, Rodriguez-Zagal E, Amat F, Annesi-Maesano I, Bosse I, Demoly P, Devillier P, Fontaine JF, Just J, Kuna TP, Samolinski B, Valiulis A, Emuzyte R, Kvedariene V, Ryan D, Sheikh A, Schmidt-Grendelmeier P, Klimek L, Pfaar O, Bergmann KC, Mösges R, Zuberbier T, Roller-Wirnsberger RE, Tomazic P, Fokkens WJ, Chavannes NH, Reitsma S, Anto JM, Cardona V, Dedeu T, Mullol J, Haahtela T, Salimäki J, Toppila-Salmi S, Valovirta E, Gemicioğlu B, Yorgancioglu A, Papadopoulos N, Prokopakis EP, Bosnic-Anticevich S, O'Hehir R, Ivancevich JC, Neffen H, Zernotti E, Kull I, Melen E, Wickman M, Bachert C, Hellings P, Palkonen S, Bindslev-Jensen C, Eller E, Waserman S, Sova M, De Vries G, van Eerd M, Agache I, Casale T, Dykewickz M, Naclerio RN, Okamoto Y, Wallace DV. MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence. Clin Transl Allergy 2018; 8:45. [PMID: 30386555 PMCID: PMC6201545 DOI: 10.1186/s13601-018-0227-6] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/07/2018] [Indexed: 12/11/2022] Open
Abstract
mHealth, such as apps running on consumer smart devices is becoming increasingly popular and has the potential to profoundly affect healthcare and health outcomes. However, it may be disruptive and results achieved are not always reaching the goals. Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best evidence-based approach to care pathways suited to real-life using mobile technology in allergic rhinitis (AR) and asthma multimorbidity. Patients largely use over-the-counter medications dispensed in pharmacies. Shared decision making centered around the patient and based on self-management should be the norm. Mobile Airways Sentinel networK (MASK), the Phase 3 ARIA initiative, is based on the freely available MASK app (the Allergy Diary, Android and iOS platforms). MASK is available in 16 languages and deployed in 23 countries. The present paper provides an overview of the methods used in MASK and the key results obtained to date. These include a novel phenotypic characterization of the patients, confirmation of the impact of allergic rhinitis on work productivity and treatment patterns in real life. Most patients appear to self-medicate, are often non-adherent and do not follow guidelines. Moreover, the Allergy Diary is able to distinguish between AR medications. The potential usefulness of MASK will be further explored by POLLAR (Impact of Air Pollution on Asthma and Rhinitis), a new Horizon 2020 project using the Allergy Diary.
Collapse
Affiliation(s)
- J Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.,Euforea, Brussels, Belgium
| | | | - A Bedbrook
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - D Laune
- KYomed-INNOV, Montpellier, France
| | | | - R Murray
- MedScript Ltd, Dundalk, Co Louth Ireland
| | - G L Onorato
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
| | - J L Pépin
- 7Laboratoire HP2, Grenoble, INSERM, U1042, Université Grenoble Alpes, Grenoble, France.,8CHU de Grenoble, Grenoble, France
| | - R Picard
- Conseil Général de l'Economie Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - F Portejoie
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
| | - E Costa
- 10UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto (Porto4Ageing), Porto, Portugal
| | - J Fonseca
- 11Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Medida, Lda, Porto, Portugal
| | - O Lourenço
- 13Faculty of Health Sciences and CICS - UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | | | - A Todo-Bom
- 15Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A A Cruz
- 16ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Vitória da Conquista, Brazil.,WHO GARD Planning Group, Salvador, Brazil
| | - J da Silva
- 18Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianópolis, Brazil
| | - F S Serpa
- 19Asthma Reference Center, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria, Vitória, Esperito Santo Brazil
| | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - E Menditto
- 21CIRFF, Federico II University, Naples, Italy
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - R Monti
- 23Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - L Napoli
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - M T Ventura
- 25Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - G De Feo
- 26Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - D Larenas-Linnemann
- 27Center of Excellence in Asthma and Allergy, Hospital Médica Sur, México City, Mexico
| | | | | | | | | | - F Amat
- 31Allergology Department, Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand-Trousseau (APHP), Paris, France.,32UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, Equipe EPAR, 75013 Paris, France
| | - I Annesi-Maesano
- 33Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, UPMC Sorbonne Université, Medical School Saint Antoine, Paris, France
| | | | - P Demoly
- 35Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - P Devillier
- 36UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - J Just
- 31Allergology Department, Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand-Trousseau (APHP), Paris, France.,32UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, Equipe EPAR, 75013 Paris, France
| | - T P Kuna
- 38Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - B Samolinski
- 39Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - A Valiulis
- 40Clinic of Children's Diseases, and Institute of Health Sciences Department of Public Health, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - R Emuzyte
- 42Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Kvedariene
- 43Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - D Ryan
- Woodbrook Medical Centre, Loughborough, UK.,45Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Medical School, Edinburgh, UK
| | - A Sheikh
- 46Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - P Schmidt-Grendelmeier
- 47Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany.,49Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany.,49Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - K C Bergmann
- 50Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | - R Mösges
- 52Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.,CRI-Clinical Research International-Ltd, Hamburg, Germany
| | - T Zuberbier
- 50Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | | | - P Tomazic
- 55Department of ENT, Medical University of Graz, Graz, Austria
| | - W J Fokkens
- 56Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - N H Chavannes
- 57Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - S Reitsma
- 56Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,59IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,60CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,61Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Cardona
- 62Allergy Section, Department of Internal Medicine, Hospital Vall 'dHebron & ARADyAL Research Network, Barcelona, Spain
| | - T Dedeu
- 63AQuAS, Barcelona, Spain.,EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - J Mullol
- 65Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.,66Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - T Haahtela
- 67Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - J Salimäki
- Association of Finnish Pharmacists, Helsinki, Finland
| | - S Toppila-Salmi
- 67Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - E Valovirta
- 69Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.,Terveystalo Allergy Clinic, Turku, Finland
| | - B Gemicioğlu
- 71Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - A Yorgancioglu
- 72Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.,GARD Executive Committee, Manisa, Turkey
| | - N Papadopoulos
- 74Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,75Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, 11527 Athens, Greece
| | - E P Prokopakis
- 76Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - S Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - R O'Hehir
- 78Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia.,79Department of Immunology, Monash University, Melbourne, VIC Australia
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - H Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina Center for Allergy and Immunology, Santa Fe, Argentina
| | - E Zernotti
- 82Universidad Católica de Córdoba, Córdoba, Argentina
| | - I Kull
- 83Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - E Melen
- 84Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,85Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Wickman
- 86Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - C Bachert
- 87Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - P Hellings
- Euforea, Brussels, Belgium.,88Department of Otorhinolaryngology, Univ Hospitals Leuven, Louvain, Belgium.,89Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - S Palkonen
- 90EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - E Eller
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - S Waserman
- 92Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - M Sova
- 93University Hospital Olomouc, Olomouc, Czech Republic
| | - G De Vries
- Peercode BV, Geldermalsen, The Netherlands
| | - M van Eerd
- Peercode BV, Geldermalsen, The Netherlands
| | - I Agache
- 95Faculty of Medicine, Transylvania University, Brasov, Romania
| | - T Casale
- 96Division of Allergy/Immunology, University of South Florida, Tampa, USA
| | - M Dykewickz
- 97Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - R N Naclerio
- 98Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Y Okamoto
- 99Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - D V Wallace
- 100Nova Southeastern University, Fort Lauderdale, Florida USA
| | | |
Collapse
|
25
|
Assessing patient-reported outcomes in asthma and COPD patients: which can be recommended in clinical practice? Curr Opin Pulm Med 2018; 24:18-23. [PMID: 29084018 DOI: 10.1097/mcp.0000000000000447] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW There is a clear need for simple and reliable patient-reported outcome measures for chronic obstructive pulmonary disease (COPD) and asthma in daily practice. The purpose of this review is to facilitate the choice for clinicians of patient-reported outcomes which they can use in their daily practice. RECENT FINDINGS More than 50 patient-reported outcome measures for asthma and COPD exist and clinicians are often left confused on which to use. Four tools (two for asthma and two for COPD) can be suggested based on validity/reliability, responsiveness, practicality and are particularly convenient in terms of time to measure. SUMMARY On the basis of ample evidence, the COPD assessment test and the clinical COPD questionnaire for COPD and asthma control questionnaire and the asthma control test for asthma can be recommended for use in both primary care and other clinical settings. A simple guide figured as smiley faces has been designed to assist physicians to easily select the appropriate measure. With the current direction of thinking into treatable traits, targeted measures that evaluate the upper airways like the control of allergic rhinitis and asthma test may also be more used in the future.
Collapse
|
26
|
Wang YC, Sindhu BS, Kapellusch J, Yen SC, Lehman L. Global rating of change: perspectives of patients with lumbar impairments and of their physical therapists. Physiother Theory Pract 2018; 35:851-859. [DOI: 10.1080/09593985.2018.1458930] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ying-Chih Wang
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Bhagwant S. Sindhu
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jay Kapellusch
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Sheng-Che Yen
- Department of Physical Therapy, Northeastern University, Boston, MA, USA
| | - Leigh Lehman
- Department of Occupational Therapy, Augusta University, Augusta, GA, USA
| |
Collapse
|
27
|
Tan R, Cvetkovski B, Kritikos V, Price D, Yan K, Smith P, Bosnic-Anticevich S. The Burden of Rhinitis and the Impact of Medication Management within the Community Pharmacy Setting. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1717-1725. [PMID: 29606639 DOI: 10.1016/j.jaip.2018.01.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/18/2017] [Accepted: 01/16/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The burden of rhinitis is high. It is unknown to what extent this burden is related to inappropriate medication use. OBJECTIVE This study aimed to identify the way in which people with rhinitis medicate their condition and to evaluate the appropriateness of this medication management. METHODS Pharmacy customers who visited Sydney metropolitan community pharmacies and purchased medication for nasal symptoms were the sampling frame for this study. To determine the condition for which the participants were seeking medication and the appropriateness of their medication selection, the following data were collected with a researcher-administered questionnaire: participant's demographics, symptoms, medication selected. An expert panel of clinical researcher pharmacists and specialist respiratory physician evaluated the appropriateness of medication selection based on the Allergic Rhinitis and its Impact on Asthma international guidelines. RESULTS Two hundred and ninety-six participants were recruited from 8 pharmacies; 63.2% had a doctor's diagnosis for the symptoms for which they were selecting treatment. Seventy percent of participants self-selected their medications. Seventy-one percent of the participants were identified as having rhinitis. Overall, 16.5% of participants who had rhinitis selected optimal medications. Sixteen percent of participants with allergic rhinitis reported wheezing (6.3% selected optimal medications). CONCLUSIONS The majority of the participants with rhinitis selected suboptimal medications from community pharmacy highlighting the significant burden of rhinitis in community pharmacy and the contribution of medication management. Pharmacists need to take a proactive and evidence-based role in the management of rhinitis supported by clinical pathways when need to be articulated and promoted in all rhinitis guidelines.
Collapse
Affiliation(s)
- Rachel Tan
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia.
| | - Biljana Cvetkovski
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Vicky Kritikos
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - David Price
- Academic Primary Care, University of Aberdeen, Aberdeen, United Kingdom; Observational and Pragmatic Research Institute Pte Ltd, Singapore
| | - Kwok Yan
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia; Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Peter Smith
- Clinical Medicine, Griffith University, Southport, Queensland, Australia
| | - Sinthia Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia; Sydney Local Health District, Sydney, New South Wales, Australia
| |
Collapse
|
28
|
Bousquet J, Agache I, Aliberti MR, Angles R, Annesi-Maesano I, Anto JM, Arnavielhe S, Asayag E, Bacci E, Bedbrook A, Bachert C, Baroni I, Barreto BA, Bedolla-Barajas M, Bergmann KC, Bertorello L, Bewick M, Bieber T, Birov S, Bindslev-Jensen C, Blua A, Bochenska Marciniak M, Bogus-Buczynska I, Bosnic-Anticevich S, Bosse I, Bourret R, Bucca C, Buonaiuto R, Burguete Cabanas MT, Caillaud D, Caimmi DP, Caiazza D, Camargos P, Canfora G, Cardona V, Carriazo AM, Cartier C, Castellano G, Chavannes NH, Cecci L, Ciaravolo MM, Cingi C, Ciceran A, Colas L, Colgan E, Coll J, Conforti D, Correia de Sousa J, Cortés-Grimaldo RM, Corti F, Costa E, Courbis AL, Cousein E, Cruz AA, Custovic A, Cvetkovski B, Dario C, da Silva J, Dauvilliers Y, De Blay F, Dedeu T, De Feo G, De Martino B, Demoly P, De Vries G, Di Capua Ercolano S, Di Carluccio N, Doulapsi M, Dray G, Dubakiene R, Eller E, Emuzyte R, Espinoza-Contreras JG, Estrada-Cardona A, Farrell J, Farsi A, Ferrero J, Fokkens WJ, Fonseca J, Fontaine JF, Forti S, Gálvez-Romero JL, García-Cobas CI, Garcia Cruz MH, Gemicioğlu B, Gerth van Wijk R, Guidacci M, Gómez-Vera J, Guldemond NA, Gutter Z, Haahtela T, Hajjam J, Hellings PW, Hernández-Velázquez L, Illario M, Ivancevich JC, Jares E, Joos G, Just J, Kalayci O, Kalyoncu AF, Karjalainen J, Keil T, Khaltaev N, Klimek L, Kritikos V, Kull I, Kuna P, Kvedariene V, Kolek V, Krzych-Fałta E, Kupczyk M, Lacwik P, La Grutta S, Larenas-Linnemann D, Laune D, Lauri D, Lavrut J, Lessa M, Levato G, Lewis L, Lieten I, Lipiec A, Louis R, Luna-Pech JA, Magnan A, Malva J, Maspero JF, Matta-Campos JJ, Mayora O, Medina-Ávalos MA, Melén E, Menditto E, Millot-Keurinck J, Moda G, Morais-Almeida M, Mösges R, Mota-Pinto A, Mullol J, Muraro A, Murray R, Noguès M, Nalin M, Napoli L, Neffen H, O'Hehir RE, Onorato GL, Palkonen S, Papadopoulos NG, Passalacqua G, Pépin JL, Pereira AM, Persico M, Pfaar O, Pozzi AC, Prokopakis E, Pugin B, Raciborski F, Rimmer J, Rizzo JA, Robalo-Cordeiro C, Rodríguez-González M, Rolla G, Roller-Wirnsberger RE, Romano A, Romano M, Romano MR, Salimäki J, Samolinski B, Serpa FS, Shamai S, Sierra M, Sova M, Sorlini M, Stellato C, Stelmach R, Strandberg T, Stroetmann V, Stukas R, Szylling A, Tan R, Tibaldi V, Todo-Bom A, Toppila-Salmi S, Tomazic P, Trama U, Triggiani M, Valero A, Valovirta E, Valiulis A, van Eerd M, Vasankari T, Vatrella A, Ventura MT, Verissimo MT, Viart F, Williams S, Wagenmann M, Wanscher C, Westman M, Wickman M, Young I, Yorgancioglu A, Zernotti E, Zuberbier T, Zurkuhlen A, De Oliviera B, Senn A. Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA) - EIP on AHA Twinning Reference Site (GARD research demonstration project). Allergy 2017; 73:77-92. [PMID: 28600902 DOI: 10.1111/all.13218] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2017] [Indexed: 01/10/2023]
Abstract
The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.
Collapse
Affiliation(s)
- J Bousquet
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,VIMA, INSERM U 1168, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.,Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | | | - R Angles
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - I Annesi-Maesano
- EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris VI, Paris, France
| | - J M Anto
- ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - E Asayag
- Argentine Society of Allergy and Immunopathology, Buenos Aires, Argentina
| | - E Bacci
- Regione Liguria, Genoa, Italy
| | - A Bedbrook
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | | | - M Bedolla-Barajas
- Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalarara, Mexico
| | - K C Bergmann
- Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | | | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
| | - S Birov
- Empirica Communication and Technology Research, Bonn, Germany
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - A Blua
- Argentine Association of Respiratory Medicine, Buenos Aires, Argentina
| | - M Bochenska Marciniak
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - I Bogus-Buczynska
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - S Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - I Bosse
- Allergist, La Rochelle, France
| | - R Bourret
- Centre Hospitalier Valenciennes, Valenciennes, France
| | - C Bucca
- Chief of the University Pneumology Unit- AOU Molinette, Hospital City of Health and Science of Torino, Torino, Italy
| | - R Buonaiuto
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | | | - D Caillaud
- Service de pneumologie, CHU et université d'Auvergne, Clermont-Ferrand, France
| | - D P Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - D Caiazza
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | - P Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G Canfora
- Mayor of Sarno and President of Salerno Province, Anesthesiology Service, Sarno "Martiri del Villa Malta" Hospital, Sarno, Italy
| | - V Cardona
- S. Allergologia, S. Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - A M Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - C Cartier
- ASA - Advanced Solutions Accelerator, Clapiers, France
| | | | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - L Cecci
- S.O.S Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | | | - C Cingi
- ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - A Ciceran
- Argentine Federation of Otorhinolaryngology Societies, Buenos Aires, Argentina
| | - L Colas
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l'institut du thorax, University of Nantes, Nantes, France
| | - E Colgan
- Department of Health, Social Services and Public Safety, Belfast, UK
| | - J Coll
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - D Conforti
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | - J Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | | | - F Corti
- FIMMG (Federazione Italiana Medici di Medicina Generale), Milan, Italy
| | - E Costa
- UCIBIO, REQYULTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), Porto, Portugal
| | | | - E Cousein
- Vice Président de la CME - Centre Hospitalier, Valenciennes, France
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil.,GARD/WHO Executive Committee and Federal University of Bahia, Bahia, Brazil
| | - A Custovic
- Department of Pediatric, Imperial College London, London, UK
| | - B Cvetkovski
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - C Dario
- Azienda Provinciale per i Servizi Sanitari di Trento (APSS-Trento), Trento, Italy
| | - J da Silva
- Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianópolis, Brazil
| | - Y Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061, Montpellier, France
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T Dedeu
- AQuAS, Barcelona, Spain & EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - G De Feo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | | | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - G De Vries
- Peercode DV, Gerdermalsen, The Netherlands
| | | | - N Di Carluccio
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | - M Doulapsi
- Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - E Eller
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | | | - J Farrell
- Department of Health, Social Services and Public Safety, Belfast, UK
| | - A Farsi
- S.O.S Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - J Ferrero
- Andalusian Agency for Healthcare Quality, Seville, Spain
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J Fonseca
- Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
| | | | - S Forti
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | | | | | - M H Garcia Cruz
- Allergy Clinic, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - B Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - R Gerth van Wijk
- Department of Internal Medicine, Section of Allergology, Erasmus MC, Rotterdam, The Netherlands
| | - M Guidacci
- Member of the Brazilian Society of Pediatrics and Society of Immunization, Representative of GINA (Global Initiative Against Asthma), Brasilia, Brazil
| | - J Gómez-Vera
- Allergy Clinic, Hospital Regional del ISSSTE 'Lic. López Mateos', Mexico City, Mexico
| | - N A Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | - Z Gutter
- University Hospital Olomouc - National eHealth Centre, Olomouk, Czech Republic
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - J Hajjam
- Centich: centre d'expertise national des technologies de l'information et de la communication pour l'autonomie, Gérontopôle autonomie longévité des Pays de la Loire, Conseil régional des Pays de la Loire, Centre d'expertise Partenariat Européen d'Innovation pour un vieillissement actif et en bonne santé, Nantes, France
| | - P W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | | | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - E Jares
- Libra Foundation, Buenos Aires, Argentina
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (APHP, Paris), Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A F Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - J Karjalainen
- Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | | | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - V Kritikos
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - I Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital, Olomouc, Czech Republic
| | - E Krzych-Fałta
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - M Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - P Lacwik
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - S La Grutta
- Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, México City, Mexico
| | | | - D Lauri
- Presidente CMMC, Milano, Italy
| | - J Lavrut
- Head of the Allergy Department of Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
| | - M Lessa
- Faculdade de Medicina da Universidade Federal da Bahia, Salvador de Bahia, Brazil
| | | | - L Lewis
- Promotor B3 Action GRoup EIP on AHA and Senior Fellow, International Foundation for Integreted Care, Aberystwyth, UK
| | - I Lieten
- Tech Life Valley, Diepenbeek, Belgium
| | - A Lipiec
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | | | - A Magnan
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l'institut du thorax, University of Nantes, Nantes, France
| | - J Malva
- Faculty of Medicine, Institute of Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal.,Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - J F Maspero
- Argentine Association of Allergy and Clinical Immunology, Buenos Aires, Argentina
| | | | - O Mayora
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | | | - E Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Menditto
- CIRFF, Federico II University, Naples, Italy
| | - J Millot-Keurinck
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - G Moda
- Regione Piemonte, Torino, Italy
| | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - A Mota-Pinto
- Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.,Laboratory of General Pathology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Mullol
- Clinical & Experimental Respiratory Immunoallergy, ENT Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - A Muraro
- Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | - R Murray
- MedScript Ltd, Dundalk, Co. Louth, Ireland
| | - M Noguès
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | | | - L Napoli
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - H Neffen
- Head of Respiratory Medicine, Alassia Children's Hospital, Center for Allergy and Immunology, Santa Fe, Argentina
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - G L Onorato
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - N G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino Hospital-IST-University of Genoa, Genoa, Italy
| | - J L Pépin
- Department of Pneumology, CHU Grenoble, Grenoble, France
| | - A M Pereira
- Allergy Unit, CUF-Porto Hospital and Institute, Center for Research in Health Technologies and Information Systems, CINTESIS, Universidade do Porto, Porto, Portugal
| | - M Persico
- Sociologist, Municipality, Sorrento, Italy
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Center for Rhinology and Allergology, Wiesbaden, Germany
| | - A C Pozzi
- Vice-Presidente of IML, Milano, Italy
| | - E Prokopakis
- Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - B Pugin
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - J Rimmer
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | | | - C Robalo-Cordeiro
- Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal
| | | | - G Rolla
- Regione Piemonte, Torino, Italy
| | | | - A Romano
- Allergy Unit, Presidio Columbus, Rome, Catholic University of Sacred Heart, Rome, Italy.,IRCCS Oasi Maria S.S., Troina, Italy
| | | | | | - J Salimäki
- Association of Finnish Pharmacists, Helsinki, Finland
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | | | - S Shamai
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - M Sierra
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - M Sova
- Departement of Internal Medicine, University Hospital, Olomouc, Czech Republic
| | - M Sorlini
- IML (Lombardy Medical Initiative), Bergamo, Italy
| | - C Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - T Strandberg
- Center for Life Course Health Research, Helsinki University Hospital, Helsinki University, University of Oulu, Oulu, Finland
| | - V Stroetmann
- Empirica Communication and Technology Research, Bonn, Germany
| | - R Stukas
- Public Health Institute of Vilnius University, Vilnius, Lithuania
| | - A Szylling
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - R Tan
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | | | - A Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - U Trama
- Division on Pharmacy and Devices Policy, Campania Region, Naples, Italy
| | - M Triggiani
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - A Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland.,Allergy Clinic, Terveystalo, Turku, Finland
| | - A Valiulis
- Vilnius University Clinic of Children's Diseases and Public Health Institute, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - M van Eerd
- Peercode DV, Gerdermalsen, The Netherlands
| | - T Vasankari
- FILHA, Finnish Lung Association, Helsinki, Finland
| | - A Vatrella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M T Verissimo
- Faculty of Medicine, Institute of Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal.,Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - F Viart
- ASA - Advanced Solutions Accelerator, Clapiers, France
| | - S Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, UK
| | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - C Wanscher
- EIP on AHA Coordinator, Region of Southern Denmark, Odense, Denmark
| | - M Westman
- Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institutet and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - M Wickman
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Young
- Queen's University, Belfast, UK
| | - A Yorgancioglu
- Celal Bayar University Department of Pulmonology, GARD Executive Committee, Manisa, Turkey
| | - E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - T Zuberbier
- Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | - A Zurkuhlen
- Gesundheitsregion KölnBonn - HRCB Projekt GmbH, Kohln, Germany
| | | | - A Senn
- EC-CNECT-H2, European Commission, Brussels, Belgium
| |
Collapse
|
29
|
Chen ZY, Zhou SH, Zhou QF, Tang HB. Inflammation and airway remodeling of the lung in guinea pigs with allergic rhinitis. Exp Ther Med 2017; 14:3485-3490. [PMID: 29042937 PMCID: PMC5639300 DOI: 10.3892/etm.2017.4937] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 06/01/2017] [Indexed: 12/11/2022] Open
Abstract
Allergic rhinitis (AR) and asthma belong to the category of type I allergic diseases, whose pathological features are airway remodeling of the lung and allergic inflammation. The aim of the present study was to evaluate inflammation and remodeling of lung tissue in a guinea pig model of AR in order to confirm consistent pathological changes of upper and lower airways in AR. Male guinea pigs were randomly divided into an experimental and a control group (n=10 in each). The AR model was established by sensitization through intraperitoneal injection of ovalbumin for three weeks and bilateral nasal local excitation for twelve weeks. All tissues of nasal mucosa and lung were subjected to hematoxylin and eosin as well as toluidine blue staining, and characteristics of remodeling of lung tissue, including thickness of bronchial wall, epithelial mucosa and smooth muscle were histologically determined. Collagen deposition in lung tissue was observed by Masson's trichrome stain. Severe paroxysmal nose scratching action, frequent sneezing, visible outflow of secretion from the anterior naris and frequent nose friction were observed in the AR model group within 30 min after local excitation. The total symptom scores were significantly increased in the AR model group compared with those in the control group. Obvious inflammatory cell infiltration was observed in the AR model group. Compared with those in the control group, the numbers of eosinophils and mast cells in nasal mucosa and lung tissue were significantly increased. Obvious airway remodeling of the lung was observed in the AR model group. Compared with those in the control group, bronchial wall thickness, epithelial layer thickness and smooth muscle thickness in the airways were significantly increased in the AR model group. Increased collagen deposition was found in the AR model group compared with that in the control group. The results of the present study revealed that inflammation and airway remodeling of lungs arose in guinea pigs with AR, suggesting that pathological changes of upper and lower airways are consistent in this AR model.
Collapse
Affiliation(s)
- Zu-Yao Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Shou-Hong Zhou
- Institute of Neuroscience, School of Medicine, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Qiao-Feng Zhou
- Department of Pediatrics, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Hong-Bo Tang
- Department of Otorhinolaryngology, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| |
Collapse
|
30
|
Kuipers E, Wensing M, de Smet P, Teichert M. Self-management research of asthma and good drug use (SMARAGD study): a pilot trial. Int J Clin Pharm 2017; 39:888-896. [PMID: 28597176 PMCID: PMC5541115 DOI: 10.1007/s11096-017-0495-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/27/2017] [Indexed: 11/26/2022]
Abstract
Background Community pharmacists play an important role in supporting patients for optimal drug use. Objective To assess the effectiveness of monitoring in asthma patients with inhaled corticosteroids (ICS) on disease control. Setting Asthma patients using ICS were invited from two intervention (IG) and two control pharmacies (CG). Method Participating patients completed questionnaires at the study start and at 6-month follow-up, including the Control of Allergic Rhinitis and Asthma Test (CARAT) questionnaire. IG patients completed the CARAT questionnaire every 2 weeks and received counselling on disease management, ICS adherence, and inhalation technique when scores were suboptimal, deteriorating, or absent. For Turbuhaler users, additional electronic monitoring (EMI) was available, with daily alerts for ICS intake. Main outcome measure As the primary outcome, CARAT scores at follow-up were compared between IG and CG using linear regression. As secondary outcome, refill adherence was compared using logistic regression. Results From March to July 2015, we enrolled 39 IG and 41 CG patients. At follow-up, CARAT scores did not differ between IG and CG (−0.19; 95% confidence interval [CI], −2.57 to 2.20), neither did patient numbers with ICS adherence >80% (0.82; 95% CI, 0.28–2.37). Among EMI users, CARAT scores did not differ, but ICS adherence >80% showed a 4.52-fold increase (95% CI, 1.56–13.1) compared with EMI nonusers. Conclusion Among community-dwelling asthma patients, pharmacist monitoring did not affect CARAT scores, but EMI use showed improved ICS refill adherence.
Collapse
Affiliation(s)
- Esther Kuipers
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
- Apotheek Rosmalen, Berlicum & Empel, 's-Hertogenbosch, The Netherlands.
| | - Michel Wensing
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter de Smet
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Clinical Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Martina Teichert
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
31
|
Flokstra-de Blok BM, van der Molen T, Christoffers WA, Kocks JW, Oei RL, Oude Elberink JN, Roerdink EM, Schuttelaar ML, van der Velde JL, Brakel TM, Dubois AE. Development of an allergy management support system in primary care. J Asthma Allergy 2017; 10:57-65. [PMID: 28352197 PMCID: PMC5359130 DOI: 10.2147/jaa.s123260] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Management of allergic patients in the population is becoming more difficult because of increases in both complexity and prevalence. Although general practitioners (GPs) are expected to play an important role in the care of allergic patients, they often feel ill-equipped for this task. Therefore, the aim of this study was to develop an allergy management support system (AMSS) for primary care. Methods Through literature review, interviewing and testing in secondary and primary care patients, an allergy history questionnaire was constructed by allergists, dermatologists, GPs and researchers based on primary care and specialists’ allergy guidelines and their clinical knowledge. Patterns of AMSS questionnaire responses and specific immunoglobulin E (sIgE)-test outcomes were used to identify diagnostic categories and develop corresponding management recommendations. Validity of the AMSS was investigated by comparing specialist (gold standard) and AMSS diagnostic categories. Results The two-page patient-completed AMSS questionnaire consists of 12 (mainly) multiple choice questions on symptoms, triggers, severity and medication. Based on the AMSS questionnaires and sIgE-test outcome of 118 patients, approximately 150 diagnostic categories of allergic rhinitis, asthma, atopic dermatitis, anaphylaxis, food allergy, hymenoptera allergy and other allergies were identified, and the corresponding management recommendations were formulated. The agreement between the allergy specialists’ assessments and the AMSS was 69.2% (CI 67.2–71.2). Conclusion Using a systematic approach, it was possible to develop an AMSS that allows for the formulation of diagnostic and management recommendations for GPs managing allergic patients. The AMSS thus holds promise for the improvement of the quality of primary care for this increasing group of patients.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Emmy M Roerdink
- Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen
| | | | | | - Thecla M Brakel
- Department of General Practice; Teaching Unit, Department of Social Psychology, University of Groningen, Groningen, The Netherlands
| | - Anthony Ej Dubois
- GRIAC Research Institute; Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen
| |
Collapse
|
32
|
Emons JAM, Flokstra BMJ, de Jong C, van der Molen T, Brand HK, Arends NJT, Amaral R, Fonseca JA, Gerth van Wijk R. Use of the Control of Allergic Rhinitis and Asthma Test (CARATkids) in children and adolescents: Validation in Dutch. Pediatr Allergy Immunol 2017; 28:185-190. [PMID: 27801950 DOI: 10.1111/pai.12678] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Allergic rhinitis and asthma are common and closely related diseases. Recently, a Portuguese questionnaire has been developed 'The Control of Allergic Rhinitis and Asthma Test' (CARATkids) that measures disease control of both diseases in children. This study aims to validate the CARATkids in Dutch children and for the first time in adolescents and, in addition, to calculate the minimal clinically important difference (MCID). METHODS A prospective observational study was conducted in an outpatient clinic. After translation of the CARATkids from Portuguese to Dutch, patients (6-18 years) with asthma or asthma and allergic rhinitis completed the CARATkids, Asthma Control Test, and visual analog scale questionnaire three times. Baseline characteristics, mean scores, internal consistency, test-retest reliability, cross-sectional and longitudinal validity, discriminative properties, responsiveness, and MCID of the CARATkids were assessed. RESULTS A total of 111 patients were included. In total, 86% and 79%, respectively, completed the questionnaires at the second and third visits. All children had asthma, and 85% had concomitant allergic rhinitis. The internal consistency was good with all expected a priori correlations met. CARATkids scores were higher in patients with uncontrolled asthma and patients with moderate-severe rhinitis compared to better controlled subjects. Patients with a variable asthma control had significantly higher scores during periods of uncontrolled asthma. Also the Guyatt's responsiveness index was good. The MCID was 2.8. CONCLUSIONS The CARATkids questionnaire is a reliable and valid tool to assess allergic rhinitis and asthma control among Dutch children. The tool can be used in adolescents.
Collapse
Affiliation(s)
- J A M Emons
- Allergy Department, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - B M J Flokstra
- Department of general practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C de Jong
- Department of general practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - T van der Molen
- Department of general practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H K Brand
- Allergy Department, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - N J T Arends
- Allergy Department, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - R Amaral
- Immunoallergy Department, CUF Porto Hospital & Institute, Porto, Portugal.,Faculty of Medicine, CINTESIS, University of Porto, Porto, Portugal
| | - J A Fonseca
- Immunoallergy Department, CUF Porto Hospital & Institute, Porto, Portugal.,Faculty of Medicine, CINTESIS, University of Porto, Porto, Portugal
| | - R Gerth van Wijk
- Allergy Department, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
33
|
Bousquet J, Hellings PW, Agache I, Bedbrook A, Bachert C, Bergmann KC, Bewick M, Bindslev-Jensen C, Bosnic-Anticevitch S, Bucca C, Caimmi DP, Camargos PAM, Canonica GW, Casale T, Chavannes NH, Cruz AA, De Carlo G, Dahl R, Demoly P, Devillier P, Fonseca J, Fokkens WJ, Guldemond NA, Haahtela T, Illario M, Just J, Keil T, Klimek L, Kuna P, Larenas-Linnemann D, Morais-Almeida M, Mullol J, Murray R, Naclerio R, O'Hehir RE, Papadopoulos NG, Pawankar R, Potter P, Ryan D, Samolinski B, Schunemann HJ, Sheikh A, Simons FER, Stellato C, Todo-Bom A, Tomazic PV, Valiulis A, Valovirta E, Ventura MT, Wickman M, Young I, Yorgancioglu A, Zuberbier T, Aberer W, Akdis CA, Akdis M, Annesi-Maesano I, Ankri J, Ansotegui IJ, Anto JM, Arnavielhe S, Asarnoj A, Arshad H, Avolio F, Baiardini I, Barbara C, Barbagallo M, Bateman ED, Beghé B, Bel EH, Bennoor KS, Benson M, Białoszewski AZ, Bieber T, Bjermer L, Blain H, Blasi F, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Bunu C, Burte E, Bush A, Caballero-Fonseca F, Calderon MA, Camuzat T, Cardona V, Carreiro-Martins P, Carriazo AM, Carlsen KH, Carr W, Cepeda Sarabia AM, Cesari M, Chatzi L, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciprandi G, de Sousa JC, Cox L, Crooks G, Custovic A, Dahlen SE, Darsow U, Dedeu T, Deleanu D, Denburg JA, De Vries G, Didier A, Dinh-Xuan AT, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, Eklund P, El-Gamal Y, Ellers E, Emuzyte R, Farrell J, Fink Wagner A, Fiocchi A, Fletcher M, Forastiere F, Gaga M, Gamkrelidze A, Gemicioğlu B, Gereda JE, van Wick RG, González Diaz S, Grisle I, Grouse L, Gutter Z, Guzmán MA, Hellquist-Dahl B, Heinrich J, Horak F, Hourihane JOB, Humbert M, Hyland M, Iaccarino G, Jares EJ, Jeandel C, Johnston SL, Joos G, Jonquet O, Jung KS, Jutel M, Kaidashev I, Khaitov M, Kalayci O, Kalyoncu AF, Kardas P, Keith PK, Kerkhof M, Kerstjens HAM, Khaltaev N, Kogevinas M, Kolek V, Koppelman GH, Kowalski ML, Kuitunen M, Kull I, Kvedariene V, Lambrecht B, Lau S, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Lodrup Carlsen KC, Louis R, Lupinek C, MacNee W, Magar Y, Magnan A, Mahboub B, Maier D, Majer I, Malva J, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Mathieu-Dupas E, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Mercier J, Merk H, Miculinic N, Mihaltan F, Milenkovic B, Millot-Keurinck J, Mohammad Y, Momas I, Mösges R, Muraro A, Namazova-Baranova L, Nadif R, Neffen H, Nekam K, Nieto A, Niggemann B, Nogueira-Silva L, Nogues M, Nyembue TD, Ohta K, Okamoto Y, Okubo K, Olive-Elias M, Ouedraogo S, Paggiaro P, Pali-Schöll I, Palkonen S, Panzner P, Papi A, Park HS, Passalacqua G, Pedersen S, Pereira AM, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Pohl W, Popov TA, Portejoie F, Postma D, Poulsen LK, Price D, Rabe KF, Raciborski F, Roberts G, Robalo-Cordeiro C, Rodenas F, Rodriguez-Mañas L, Rolland C, Roman Rodriguez M, Romano A, Rosado-Pinto J, Rosario N, Rottem M, Sanchez-Borges M, Sastre-Dominguez J, Scadding GK, Scichilone N, Schmid-Grendelmeier P, Serrano E, Shields M, Siroux V, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Sterk PJ, Strandberg T, Sunyer J, Thijs C, Triggiani M, Valenta R, Valero A, van Eerd M, van Ganse E, van Hague M, Vandenplas O, Varona LL, Vellas B, Vezzani G, Vazankari T, Viegi G, Vontetsianos T, Wagenmann M, Walker S, Wang DY, Wahn U, Werfel T, Whalley B, Williams DM, Williams S, Wilson N, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zaidi A, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M. ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle. Clin Transl Allergy 2016; 6:47. [PMID: 28050247 PMCID: PMC5203711 DOI: 10.1186/s13601-016-0137-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/05/2016] [Indexed: 12/13/2022] Open
Abstract
The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.
Collapse
Affiliation(s)
- J Bousquet
- Montpellier University Hospital, Montpellier, France ; MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France ; CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - P W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - I Agache
- Transylvania University Brasov, Brasov, Romania
| | - A Bedbrook
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - K C Bergmann
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - S Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - C Bucca
- University Pneumology Unit-AOU Molinette, Hospital City of Health and Science of Torino, Turin, Italy
| | - D P Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - P A M Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G W Canonica
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL USA
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil ; GARD Executive Committee, Salvador, Bahia Brazil
| | - G De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - R Dahl
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil
| | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France ; EPAR U707 INSERM, Paris, France ; EPAR UMR-S UPMC, Paris VI, Paris, France
| | - P Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles, Saint-Quentin, France
| | - J Fonseca
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - N A Guldemond
- Institute of Health Policy and Management IBMG, Erasmus University, Rotterdam, The Netherlands
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - M Illario
- Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (APHP), Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, 75013 Paris, France
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, Mexico City, Mexico
| | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisbon, Portugal
| | - J Mullol
- ENT Department, Hospital Clinic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, Universitat de Barcelona, Barcelona, Catalonia Spain
| | - R Murray
- MedScript Ltd, Dundalk, County Louth, Ireland
| | - R Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL USA
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia ; Department of Immunology, Monash University, Melbourne, VIC Australia
| | - N G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK ; Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - P Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D Ryan
- Woodbrook Medical Centre, Loughborough, UK ; Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - H J Schunemann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - A Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, UK
| | - F E R Simons
- Department of Pediatrics and Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB Canada
| | - C Stellato
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - A Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - P V Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - A Valiulis
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Public Health Institute, Vilnius University, Vilnius, Lithuania ; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland ; Allergy Clinic, Terveystalo, Turku, Finland
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M Wickman
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Young
- Queen's University, Belfast, Northern Ireland, UK
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
| | - T Zuberbier
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - I Annesi-Maesano
- EPAR U707 INSERM, Paris, France ; EPAR UMR-S UPMC, Paris VI, Paris, France
| | - J Ankri
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J M Anto
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - A Asarnoj
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ; Department of Pediatric Pulmonology and Allergy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - H Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | | | - I Baiardini
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - C Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - M Barbagallo
- Geriatric Unit, Department of Internal Medicine (DIBIMIS), University of Palermo, Palermo, Italy
| | - E D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - E H Bel
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, Linköping University, 58185 Linköping, Sweden
| | - A Z Białoszewski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - L Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France ; EA 2991, Euromov, University Montpellier, Montpellier, France
| | - F Blasi
- Department of Pathophysiology and Transplantation, IRCCS Fondazione Ca'Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A L Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - M Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | | | | | - L P Boulet
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC Canada
| | - R Bourret
- Montpellier University Hospital, Montpellier, France
| | | | - F Braido
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - A H Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK ; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J Brozek
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - C Bunu
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - E Burte
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - A Bush
- Royal Brompton Hospital NHS, Imperial College London, London, UK
| | | | - M A Calderon
- Royal Brompton Hospital NHS, Imperial College London, London, UK ; National Heart and Lung Institute, Imperial College London, London, UK
| | - T Camuzat
- Montpellier, Région Languedoc Roussillon France
| | - V Cardona
- S. Allergologia, S. Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - P Carreiro-Martins
- CEDOC, Respiratory Research Group, Nova Medical School, Campo dos Martires da Patria, Lisbon, Portugal ; Serviço de Imunoalergologia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - A M Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - K H Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; University of Oslo, Oslo, Norway
| | - W Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia ; SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Cartagena, Colombia
| | - M Cesari
- Gérontopôle de Toulouse, 31059 Toulouse, France
| | - L Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete Greece
| | - R Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - T Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A G Chuchalin
- Pulmonolory Research Institute FMBA, Moscow, Russia ; GARD Executive Committee, Moscow, Russia
| | - K F Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - G Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - J Correia de Sousa
- ICVS/3B's-PT Government Associate Laboratory, Life and Health Sciences, Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - L Cox
- Department of Medicine, Nova Southeastern University, Davie, FL USA
| | - G Crooks
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - A Custovic
- Department of Pediatric, Imperial College London, London, UK
| | - S E Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U Darsow
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany ; ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Munich, Germany
| | - T Dedeu
- AQuAS, Barcelona, Spain ; EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - D Deleanu
- Allergology and Immunology Discipline, "Luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - J A Denburg
- Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON Canada
| | | | - A Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A T Dinh-Xuan
- Service de Physiologie Respiratoire, Hôpital Cochin, Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - D Dokic
- University Clinic of Pulmology and Allergy, Medical Faculty, Ss Cyril and Methodius University, Skopje, Republic of Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - G Du Toit
- Guy's and St Thomas' NHS Trust, Kings College London, London, UK
| | - M S Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - P Eklund
- Computing Science Department, Umeå University, Umeå, Sweden ; Four Computing Oy, Halikko, Finland
| | - Y El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - E Ellers
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Public Health Institute, Vilnius University, Vilnius, Lithuania ; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - J Farrell
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland, UK
| | - A Fink Wagner
- Global Allergy and Asthma Platform GAAPP, Altgasse 8-10, 1130 Vienna, Austria
| | - A Fiocchi
- Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children's Research Hospital Holy See, Rome, Italy
| | | | - F Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - M Gaga
- Athens Chest Hospital, Athens, Greece
| | - A Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - B Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - J E Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - R Gerth van Wick
- Section of Allergology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - S González Diaz
- Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - I Grisle
- Center of Tuberculosis and Lung Diseases, Latvian Association of Allergists, Riga, Latvia
| | - L Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, Seattle, WA USA
| | - Z Gutter
- National eHealth Centre, University Hospital Olomouc, Olomouc, Czech Republic
| | - M A Guzmán
- Immunology and Allergy Division Clinical Hospital, University of Chile, Santiago, Chile
| | - B Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - F Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J O' B Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - M Humbert
- Université Paris-Sud, Le Kremlin Bicêtre, France ; Service de Pneumologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France ; Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - M Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - G Iaccarino
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - E J Jares
- Libra Foundation, Buenos Aires, Argentina
| | - C Jeandel
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; Department of Geriatrics, Montpellier University Hospital, Montpellier, France
| | - S L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK ; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - O Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K S Jung
- Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do South Korea
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland
| | - I Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - M Khaitov
- Laboratory of Molecular Immunology, National Research Center, Institute of Immunology, Federal Medicobiological Agency, Moscow, Russia
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, School of Medicine, Hacettepe University, Ankara, Turkey
| | - A F Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - P Kardas
- First Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | - P K Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, 1280 Main Street West, Hamilton, ON Canada
| | - M Kerkhof
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H A M Kerstjens
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - M Kogevinas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M L Kowalski
- Department of Immunology, Rheumatology and Allergy and HARC, Medical University of Lodz, Lodz, Poland
| | - M Kuitunen
- Children's Hospital, University of Helsinki, Helsinki, Finland
| | - I Kull
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - V Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - B Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | | | - L T T Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P Lieberman
- Divisions of Allergy and Immunology, Department of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Germantown, TN USA
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - K C Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - C Lupinek
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - W MacNee
- The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Y Magar
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A Magnan
- Service de Pneumologie, UMR INSERM, UMR1087 and CNR 6291, l'institut du Thorax, University of Nantes, Nantes, France
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - D Maier
- Biomax Informatics AG, Munich, Germany
| | - I Majer
- Department of Respiratory Medicine, University of Bratislava, Bratislava, Slovakia
| | - J Malva
- Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal ; Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - P Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | | | - G D Marshall
- Laboratory of Behavioral Immunology Research, Division of Clinical Immunology and Allergy, The University of Mississippi Medical Center, Jackson, MS USA
| | - M R Masjedi
- Tobacco Control Research Centre, Iranian Anti Tobacco Association, Tehran, Iran
| | | | - M Maurer
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Melo-Gomes
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA USA
| | - J Mercier
- Department of Physiology, CHRU, PhyMedExp, INSERM U1046, CNRS UMR 9214, University Montpellier, Montpellier, France
| | - H Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Germany
| | | | - F Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - J Millot-Keurinck
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - Y Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - I Momas
- Department of Public Health and Health Products, EA 4064, Paris Descartes University-Sorbonne Paris Cité, Paris, France ; Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - L Namazova-Baranova
- Scientific Centre of Children's Health Under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R Nadif
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - H Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - A Nieto
- Neumología y Alergología Infantil, Hospital La Fe, Valencia, Spain
| | - B Niggemann
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - L Nogueira-Silva
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal ; Department of Internal Medicine, Centro Hospitalar Sao Joao, Porto, Portugal
| | - M Nogues
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - T D Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - K Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y Okamoto
- Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - M Olive-Elias
- Montpellier University Hospital, Montpellier, France ; Institute of Health Policy and Management IBMG, Erasmus University, Rotterdam, The Netherlands ; Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I Pali-Schöll
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine, Medical University, Vienna, Austria
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - A Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - G Passalacqua
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - S Pedersen
- University of Southern Denmark, Kolding, Denmark
| | - A M Pereira
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal ; Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany ; Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R Picard
- Conseil Général de l'Economie, Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - B Pigearias
- Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France
| | - I Pin
- Département de pédiatrie, CHU de Grenoble, Grenoble, France
| | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, Croatia ; School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - W Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Vienna, Austria
| | - T A Popov
- Clinic of Allergy and Asthma, Medical University Sofia, Sofia, Bulgaria
| | - F Portejoie
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - D Postma
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L K Poulsen
- Laboratory of Medical Allergology, Allergy Clinic, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark
| | - D Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, Scotland, UK ; Research in Real-Life, Cambridge, UK
| | - K F Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, German Center for Lung Research (DZL), Grosshansdorf, Germany ; Department of Medicine, Christian Albrechts University, Airway Research Center North, German Center for Lung Research (DZL), Kiel, Germany
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - G Roberts
- NHS Foundation Trust, University Hospitals of Southampton, Southampton, UK
| | - C Robalo-Cordeiro
- Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal
| | - F Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | | | - C Rolland
- Association Asthme et Allergie, Paris, France
| | - M Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma de Mallorca, Spain
| | - A Romano
- Allergy Unit, Complesso Integrato Columbus, Rome, Italy
| | - J Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal
| | - N Rosario
- Hospital de Clinicas, University of Parana, Curitiba, Brazil
| | - M Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
| | | | - G K Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | | | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - E Serrano
- Otolaryngology and Head and Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - M Shields
- Child Health, Queen's University, Belfast, Northern Ireland, UK ; Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK
| | - V Siroux
- INSERM, Université Grenoble Alpes, IAB, U 1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Université Joseph Fourier, Grenoble, France
| | - J C Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologıa, Asunción, Paraguay
| | - I Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - H A Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Altgasse 8-10, 1130 Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - P J Sterk
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - T Strandberg
- European Union Geriatric Medicine Society (EUGMS), Helsinki, Finland
| | - J Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - C Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - M Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | | | - E van Ganse
- PELyon, Lyon, France ; HESPER 7425, Health Services and Performance Resarch, Université Claude Bernard Lyon, Villeurbanne, France
| | - M van Hague
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ; Department of Pediatric Pulmonology and Allergy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden ; University Hospital, Stockholm, Sweden
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - L L Varona
- Philippines Society of Allergy, Asthma and Immunology, Manila, Philippines
| | - B Vellas
- Gérontopôle de Toulouse, 31059 Toulouse, France
| | - G Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S. Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy ; Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - T Vazankari
- Finnish Lung Association (FILHA), Helsinki, Finland
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy ; CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Palermo, Italy
| | | | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - S Walker
- Asthma UK, Mansell Street, London, UK
| | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - U Wahn
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - B Whalley
- School of Psychology, Plymouth University, Plymouth, UK
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC USA
| | | | - N Wilson
- Northern Health Alliance, Newcastle, UK
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - B P Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN USA
| | | | - O M Yusuf
- The Allergy and Asthma Institute, Lahore, Pakistan
| | - A Zaidi
- Social Sciences, University of Southampton, Southampton, UK
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa ; MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - M E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - L Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing, China ; Beijing Institute of Otolaryngology, Beijing, China
| | - N Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| |
Collapse
|
34
|
Bousquet J, Schünemann HJ, Hellings PW, Arnavielhe S, Bachert C, Bedbrook A, Bergmann KC, Bosnic-Anticevich S, Brozek J, Calderon M, Canonica GW, Casale TB, Chavannes NH, Cox L, Chrystyn H, Cruz AA, Dahl R, De Carlo G, Demoly P, Devillier P, Dray G, Fletcher M, Fokkens WJ, Fonseca J, Gonzalez-Diaz SN, Grouse L, Keil T, Kuna P, Larenas-Linnemann D, Lodrup Carlsen KC, Meltzer EO, Mullol J, Muraro A, Naclerio RN, Palkonen S, Papadopoulos NG, Passalacqua G, Price D, Ryan D, Samolinski B, Scadding GK, Sheikh A, Spertini F, Valiulis A, Valovirta E, Walker S, Wickman M, Yorgancioglu A, Haahtela T, Zuberbier T. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol 2016; 138:367-374.e2. [PMID: 27260321 DOI: 10.1016/j.jaci.2016.03.025] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 02/05/2016] [Accepted: 03/15/2016] [Indexed: 10/21/2022]
Abstract
The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials.
Collapse
Affiliation(s)
- Jean Bousquet
- University Hospital, Montpellier, France; MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France; INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health approaches, Paris, and Université Versailles St-Quentin-en-Yvelines, St-Quentin-en-Yvelines, France.
| | - Holger J Schünemann
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Peter W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | | | - Claus Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - Anna Bedbrook
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - Karl-Christian Bergmann
- Allergy-Centre-Charité at the Department of Dermatology, Charité-Universitätsmedizin Berlin, and Secretary General of the Global Allergy and Asthma European Network (GA(2)LEN), Berlin, Germany
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, Australia
| | - Jan Brozek
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Moises Calderon
- Imperial College London-National Heart and Lung Institute, Royal Brompton Hospital NHS, London, United Kingdom
| | - G Walter Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Thomas B Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, Fla
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Linda Cox
- Department of Medicine, Nova Southeastern University, Davie, Fla
| | | | - Alvaro A Cruz
- ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, and GARD Executive Committee, Bahia, Brazil
| | - Ronald Dahl
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Giuseppe De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Pascal Demoly
- EPAR U707 INSERM, Paris and EPAR UMR-S UPMC, Paris VI, Paris, France; Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - Phillipe Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, St-Quentin-en-Yvelines, France
| | | | | | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Joao Fonseca
- Center for Research in Health Technologies and Information Systems-CINTESIS, Universidade do Porto; the Allergy Unit, Instituto CUF Porto e Hospital CUF Porto; the Health Information and Decision Sciences Department-CIDES, Faculdade de Medicina, Universidade do Porto; Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Lawrence Grouse
- University of Washington School of Medicine, Faculty of the Department of Neurology, Seattle, Wash
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, and the Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | - Karin C Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, and the Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, Calif
| | - Jaoquim Mullol
- Unitat de Rinologia i Clínica de l'Olfacte, Servei d'ORL, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Robert N Naclerio
- Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medical Center and Pritzker School of Medicine, University of Chicago, Chicago, Ill
| | - Susanna Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Nikolaos G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, and the Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - David Price
- Academic Centre of Primary Care, University of Aberdeen, and Research in Real-Life, Cambridge, United Kingdom
| | - Dermot Ryan
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, University of Edinburgh, Edinburgh, United Kingdom
| | - Boleslaw Samolinski
- Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Glenis K Scadding
- Royal National TNE Hospital, University College London, London, United Kingdom
| | - Aziz Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - François Spertini
- Service d'Immunologie et Allergie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Arunas Valiulis
- Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | | | - Magnus Wickman
- Sachs' Children's Hospital, Stockholm, and the Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Arzu Yorgancioglu
- Department of Pulmonology, Celal Bayar University Manisa, Turkey, and GARD Executive Committee, Manisa, Turkey
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Torsten Zuberbier
- Allergy-Centre-Charité at the Department of Dermatology, Charité-Universitätsmedizin Berlin, and Secretary General of the Global Allergy and Asthma European Network (GA(2)LEN), Berlin, Germany
| | | |
Collapse
|
35
|
Bousquet J, Schunemann HJ, Fonseca J, Samolinski B, Bachert C, Canonica GW, Casale T, Cruz AA, Demoly P, Hellings P, Valiulis A, Wickman M, Zuberbier T, Bosnic-Anticevitch S, Bedbrook A, Bergmann KC, Caimmi D, Dahl R, Fokkens WJ, Grisle I, Lodrup Carlsen K, Mullol J, Muraro A, Palkonen S, Papadopoulos N, Passalacqua G, Ryan D, Valovirta E, Yorgancioglu A, Aberer W, Agache I, Adachi M, Akdis CA, Akdis M, Annesi-Maesano I, Ansotegui IJ, Anto JM, Arnavielhe S, Arshad H, Baiardini I, Baigenzhin AK, Barbara C, Bateman ED, Beghé B, Bel EH, Ben Kheder A, Bennoor KS, Benson M, Bewick M, Bieber T, Bindslev-Jensen C, Bjermer L, Blain H, Boner AL, Boulet LP, Bonini M, Bonini S, Bosse I, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Burney PG, Bush A, Caballero-Fonseca F, Calderon MA, Camargos PAM, Camuzat T, Carlsen KH, Carr W, Cepeda Sarabia AM, Chavannes NH, Chatzi L, Chen YZ, Chiron R, Chkhartishvili E, Chuchalin AG, Ciprandi G, Cirule I, Correia de Sousa J, Cox L, Crooks G, Costa DJ, Custovic A, Dahlen SE, Darsow U, De Carlo G, De Blay F, Dedeu T, Deleanu D, Denburg JA, Devillier P, Didier A, Dinh-Xuan AT, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, Emuzyte R, Fink Wagner A, Fletcher M, Fiocchi A, Forastiere F, Gamkrelidze A, Gemicioğlu B, Gereda JE, González Diaz S, Gotua M, Grouse L, Guzmán MA, Haahtela T, Hellquist-Dahl B, Heinrich J, Horak F, Hourihane JO', Howarth P, Humbert M, Hyland ME, Ivancevich JC, Jares EJ, Johnston SL, Joos G, Jonquet O, Jung KS, Just J, Kaidashev I, Kalayci O, Kalyoncu AF, Keil T, Keith PK, Khaltaev N, Klimek L, Koffi N'Goran B, Kolek V, Koppelman GH, Kowalski ML, Kull I, Kuna P, Kvedariene V, Lambrecht B, Lau S, Larenas-Linnemann D, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Louis R, Magard Y, Magnan A, Mahboub B, Majer I, Makela MJ, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Merk H, Miculinic N, Mihaltan F, Milenkovic B, Mohammad Y, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Mösges R, Namazova-Baranova L, Naclerio R, Neou A, Neffen H, Nekam K, Niggemann B, Nyembue TD, O'Hehir RE, Ohta K, Okamoto Y, Okubo K, Ouedraogo S, Paggiaro P, Pali-Schöll I, Palmer S, Panzner P, Papi A, Park HS, Pavord I, Pawankar R, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Pohl W, Popov TA, Portejoie F, Postma D, Potter P, Price D, Rabe KF, Raciborski F, Radier Pontal F, Repka-Ramirez S, Robalo-Cordeiro C, Rolland C, Rosado-Pinto J, Reitamo S, Rodenas F, Roman Rodriguez M, Romano A, Rosario N, Rosenwasser L, Rottem M, Sanchez-Borges M, Scadding GK, Serrano E, Schmid-Grendelmeier P, Sheikh A, Simons FER, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Strandberg T, Sunyer J, Thijs C, Todo-Bom A, Triggiani M, Valenta R, Valero AL, van Hage M, Vandenplas O, Vezzani G, Vichyanond P, Viegi G, Wagenmann M, Walker S, Wang DY, Wahn U, Williams DM, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M, Mercier J. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation. Allergy 2015; 70:1372-92. [PMID: 26148220 DOI: 10.1111/all.12686] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2015] [Indexed: 12/20/2022]
Abstract
Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.
Collapse
Affiliation(s)
- J Bousquet
- University Hospital, Montpellier, France.,MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Paris, France.,UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France
| | - H J Schunemann
- Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - J Fonseca
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal.,Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal.,Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - G W Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL, USA
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brasil.,GARD Executive Committee, Bahia, Brasil
| | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.,EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris, France
| | - P Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - A Valiulis
- Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania
| | - M Wickman
- Sachs' Children's Hospital, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Zuberbier
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - S Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - A Bedbrook
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - K C Bergmann
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - D Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - R Dahl
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - I Grisle
- Latvian Association of Allergists, Center of Tuberculosis and Lung Diseases of Latvia, Riga, Latvia
| | - K Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - J Mullol
- Unitat de Rinologia i Clínica de l'Olfacte, Servei d'ORL, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Catalonia, Spain
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - N Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - D Ryan
- General Practitioner, Woodbrook Medical Centre, Loughborough, UK.,Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Agache
- Transylvania University Brasov, Brasov, Romania
| | - M Adachi
- Department of Clinical Research Center, International University of Health and Welfare/Sanno Hospital, Tokyo, Japan
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J M Anto
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Barcelona, Spain.,Department of Experimental and Health Sciences, University of Pompeu Fabra, Barcelona, Spain
| | | | - H Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - I Baiardini
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - C Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - E H Bel
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Ben Kheder
- Service de Pneumologie IV, Hôpital Abderrahman Mami, Ariana, Tunisie
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - M Bewick
- Deputy National Medical Director, NHS England, England, UK
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - L Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France.,EA 2991 Movement To Health, Euromov, University Montpellier, Montpellier, France
| | - A L Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - L P Boulet
- Québec Heart and Lung Institute, Laval University, Québec City, QC, Canada
| | - M Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | - I Bosse
- Allergist, La Rochelle, France
| | - R Bourret
- Directeur Général Adjoint, Montpellier University Hospital, Montpellier, France
| | - P J Bousquet
- EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris, France
| | - F Braido
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - A H Briggs
- Health Economics and Health Technology Assessment, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - C E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK.,Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J Brozek
- Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - P G Burney
- National Heart and Lung Institute, Imperial College, London, UK.,Wellcome Centre for Global Health, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - A Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | | | - M A Calderon
- Imperial College London - National Heart and Lung Institute, Royal Brompton Hospital NHS, London, UK
| | - P A M Camargos
- Federal University of Minas Gerais, Medical School, Department of Pediatrics, Belo Horizonte, Brazil
| | - T Camuzat
- Assitant Director General, Montpellier, France.,Région Languedoc Roussillon, Roussillon, France
| | - K H Carlsen
- Department of Paediatrics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - W Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia.,SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Barranquilla, Colombia
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - L Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Y Z Chen
- National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, China
| | - R Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A G Chuchalin
- Pulmonolory Research Institute FMBA, Moscow, Russia.,GARD Executive Committee, Moscow, Russia
| | - G Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - I Cirule
- Latvian Association of Allergists, University Children Hospital of Latvia, Riga, Latvia
| | - J Correia de Sousa
- Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga, Portugal
| | - L Cox
- Department of Medicine, Nova Southeastern University, Davie, FL, USA
| | - G Crooks
- European Innovation Partnership on Active and Healthy Ageing, Reference Site, NHS Scotland, Glasgow, UK
| | - D J Costa
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - A Custovic
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, UK
| | - S E Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U Darsow
- Department of Dermatology and Allergy, Technische Universität Mänchen, Munich, Germany.,ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany
| | - G De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T Dedeu
- European Regional and Local Health Association, Brussels, Belgium
| | - D Deleanu
- Allergology and Immunology Discipline, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - J A Denburg
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - P Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, Versailles Saint-Quentin, France
| | - A Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A T Dinh-Xuan
- Service de physiologie, Hôpital Cochin, Université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France
| | - D Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, R. Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - M S Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MI, USA
| | - Y El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Fink Wagner
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | | | - A Fiocchi
- Allergy Department, The Bambino Gesù Children's Research Hospital Holy see, Rome, Italy
| | - F Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - A Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - B Gemicioğlu
- Turkish Thoracic Society Asthma-Allergy Working Group, Kocaeli, Turkey
| | - J E Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - S González Diaz
- Sociedad Latinoamericana de Allergia, Asma e Immunologia, Mexico City, Mexico
| | - M Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - L Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - M A Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - B Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - J Heinrich
- Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - F Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J O 'b Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - P Howarth
- University of Southampton Faculty of Medicine, University Hospital Southampton, Southampton, UK
| | - M Humbert
- Université Paris-Sud, Le Kremlin Bicêtre, France.,Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - M E Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - E J Jares
- Libra Foundation, Buenos Aires, Argentina
| | - S L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, UK.,MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - O Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K S Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies. Hôpital d'Enfants Armand-Trousseau, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - I Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A F Kalyoncu
- School of Medicine, Department of Chest Diseases, Immunology and Allergy Division, Hacettepe University, Ankara, Turkey
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - P K Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, Hamilton, ON, Canada
| | | | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - B Koffi N'Goran
- Société de Pneumologie de Langue Française et Espace Francophone de Pneumologie, Paris, France
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M L Kowalski
- Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland
| | - I Kull
- Sachs' Children's Hospital, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, KUNA, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- Pulmonology and Allergology Center, Vilnius University, Vilnius, Lithuania
| | - B Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, México City, México
| | - D Laune
- Digi Health, Montpellier, France
| | - L T T Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P Lieberman
- Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, TN, USA
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - Y Magard
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A Magnan
- Service de Pneumologie, University of Nantes, UMR INSERM, UMR1087/CNR 6291, l'Institut du Thorax, Nantes, France
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - I Majer
- Department of Respiratory Medicine, University Hospital, Bratislava, Slovakia
| | - M J Makela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | | | - G D Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS, USA
| | - M R Masjedi
- Respiratory Disease Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Maurer
- Allergie-Centrum-Charité at the Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Melo-Gomes
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA, USA
| | - H Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
| | | | - F Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Y Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - M Molimard
- Département de Pharmacologie, CHU de Bordeaux, Université Bordeaux, INSERM U657, Bordeaux Cedex, France
| | - I Momas
- Department of Public Health and Biostatistics, Paris Descartes University, Paris, France.,Paris Municipal Department of Social Action, Childhood and Health, Paris, France
| | | | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - L Namazova-Baranova
- Scientific Centre of Children's Health under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - A Neou
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - H Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - B Niggemann
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - T D Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Immunology, Monash University, Melbourne, Vic., Australia
| | - K Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y Okamoto
- Depatment of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K Okubo
- Depatment of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I Pali-Schöll
- Dept. of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University and University Vienna, Vienna, Austria.,Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University and University Vienna, Vienna, Austria
| | - S Palmer
- Centre for Health Economics, University of York, York, UK
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - A Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - I Pavord
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - R Picard
- Conseil Général de l'Economie. Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - B Pigearias
- Société de Pneumologie de Langue Française et Espace Francophone de Pneumologie, Paris, France
| | - I Pin
- Département de pédiatrie, CHU de Grenoble, Grenoble cedex 9, France
| | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - W Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Vienna, Austria
| | - T A Popov
- Clinic of Allergy & Asthma, Medical University Sofia, Sofia, Bulgaria
| | - F Portejoie
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - D Postma
- Department of Pulmonary Medicine and Tuberculosis, GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK.,Research in Real-Life, Cambridge, UK
| | - K F Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany.,Department of Medicine, Christian Albrechts University, Airway Research Center North, Member of the German Center for Lung Research, Kiel, Germany
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - F Radier Pontal
- Conseil Départemental de l'Ordre des Pharmaciens, Maison des Professions Libérales, Montpellier, France
| | | | - C Robalo-Cordeiro
- Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - C Rolland
- Association Asthme et Allergie, Paris, France
| | - J Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisboa, Portugal
| | - S Reitamo
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - F Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - M Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma de Mallorca, Spain
| | - A Romano
- Allergy Unit, Complesso Integrato Columbus, Rome, Italy
| | - N Rosario
- Hospital de Clinicas, University of Parana, Parana, Brazil
| | - L Rosenwasser
- Department of Allergy, Asthma and Immunology, Children's Mercy Hospitals and Clinics and Pediatrics and Medicine University of Misouri-Kansas City School of Medicine, Kansas City, MI, USA
| | - M Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad, Venezuela.,Clínica El Avila, 6a transversal Urb, Caracas, Venezuela
| | - G K Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | - E Serrano
- Otolaryngology and Head & Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland
| | - A Sheikh
- Allergy and Respiratory Research Group, Medical School, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - F E R Simons
- Department of Pediatrics & Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - J C Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologıa, Paraguay, Paraguay
| | - I Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - H A Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal medicine, Euro-Asian respiratory Society, Bishkek, Kyrgyzstan
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - T Strandberg
- European Union GeriatricMedicine Society, Vienna, Austria
| | - J Sunyer
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Barcelona, Spain.,Department of Experimental and Health Sciences, University of Pompeu Fabra, Barcelona, Spain
| | - C Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - A Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A L Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - M van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - G Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy.,Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - P Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.,CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Palermo, Italy
| | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - U Wahn
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UJ, USA
| | - B P Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN, USA
| | - P K Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.,Department of Pediatrics, Hospital "Archbishop Makarios III", Nicosia, Cyprus
| | - O M Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - M E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - L Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - N Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - J Mercier
- Vice President for Research, University Montpellier, Montpellier, France
| |
Collapse
|