Research Priorities in Pediatric Asthma: Results of a Global Survey of Multiple Stakeholder Groups by the Pediatric Asthma in Real Life (PeARL) Think Tank.

Assessment Asthma Childhood asthma Clinical research Diagnosis Management Pediatric asthma Research priorities

Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
06 2020
Historique:
received: 18 09 2019
revised: 29 01 2020
accepted: 31 01 2020
pubmed: 9 3 2020
medline: 15 5 2021
entrez: 9 3 2020
Statut: ppublish

Résumé

Pediatric asthma remains a public health challenge with enormous impact worldwide. The aim of this study was to identify and prioritize unmet clinical needs in pediatric asthma, which could be used to guide future research and policy activities. We first identified unmet needs through an open-question survey administered to international experts in pediatric asthma who were members of the Pediatric Asthma in Real Life Think Tank. Prioritization of topics was then achieved through a second, extensive survey with global reach, of multiple stakeholders (leading experts, researchers, clinicians, patients, policy makers, and the pharmaceutical industry). Differences across responder groups were compared. A total of 57 unmet clinical need topics identified by international experts were prioritized by 412 participants from 5 continents and 60 countries. Prevention of disease progression and prediction of future risk, including persistence into adulthood, emerged as the most urgent research questions. Stratified care, based on biomarkers, clinical phenotypes, the children's age, and demographics were also highly rated. The identification of minimum diagnostic criteria in different age groups, cultural perceptions of asthma, and best treatment by age group were priorities for responders from low-middle-income countries. There was good agreement across different stakeholder groups in all domains with some notable exceptions that highlight the importance of involving the whole range of stakeholders in formulation of recommendations. Different stakeholders agree in the majority of research and strategic (eg, prevention, personalized approach) priorities for pediatric asthma. Stakeholder diversity is crucial for highlighting divergent issues that future guidelines should consider.

Sections du résumé

BACKGROUND
Pediatric asthma remains a public health challenge with enormous impact worldwide.
OBJECTIVE
The aim of this study was to identify and prioritize unmet clinical needs in pediatric asthma, which could be used to guide future research and policy activities.
METHODS
We first identified unmet needs through an open-question survey administered to international experts in pediatric asthma who were members of the Pediatric Asthma in Real Life Think Tank. Prioritization of topics was then achieved through a second, extensive survey with global reach, of multiple stakeholders (leading experts, researchers, clinicians, patients, policy makers, and the pharmaceutical industry). Differences across responder groups were compared.
RESULTS
A total of 57 unmet clinical need topics identified by international experts were prioritized by 412 participants from 5 continents and 60 countries. Prevention of disease progression and prediction of future risk, including persistence into adulthood, emerged as the most urgent research questions. Stratified care, based on biomarkers, clinical phenotypes, the children's age, and demographics were also highly rated. The identification of minimum diagnostic criteria in different age groups, cultural perceptions of asthma, and best treatment by age group were priorities for responders from low-middle-income countries. There was good agreement across different stakeholder groups in all domains with some notable exceptions that highlight the importance of involving the whole range of stakeholders in formulation of recommendations.
CONCLUSIONS
Different stakeholders agree in the majority of research and strategic (eg, prevention, personalized approach) priorities for pediatric asthma. Stakeholder diversity is crucial for highlighting divergent issues that future guidelines should consider.

Identifiants

pubmed: 32146166
pii: S2213-2198(20)30147-1
doi: 10.1016/j.jaip.2020.01.059
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1953-1960.e9

Subventions

Organisme : Medical Research Council
ID : MR/S025340/1
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom

Informations de copyright

Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Alexander G Mathioudakis (AG)

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom; North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.

Adnan Custovic (A)

Department of Paediatrics, Imperial College London, London, United Kingdom.

Antoine Deschildre (A)

CHU Lille, Université Nord de France, Unité de Pneumologie et Allergologie Pédiatriques, Hôpital Jeanne de Flandre, Lille, France.

Francine M Ducharme (FM)

Department of Pediatrics, University of Montreal, Montreal, QC, Canada.

Omer Kalayci (O)

Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.

Clare Murray (C)

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom; North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.

Antonio Nieto Garcia (AN)

Pulmonology and Allergy Unity, University Hospital La Fe, Valencia, Spain.

Wanda Phipatanakul (W)

Pediatric Allergy and Immunology, Children's Hospital Boston, Boston, Mass.

David Price (D)

Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom; Observational and Pragmatic Research Institute, Singapore.

Aziz Sheikh (A)

Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.

Ioana Agache (I)

Faculty of Medicine, Transylvania University, Brasov, Romania.

Leonard Bacharier (L)

Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University, St. Louis, Mo.

Matteo Bonini (M)

Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Rome, Italy; National Heart and Lung Institute (NHLI), Imperial College London, London, United Kingdom.

Jose A Castro-Rodriguez (JA)

Department of Pediatrics, School of Medicine, Pontifical Universidad Catolica de Chile, Santiago, Chile.

Giuseppe De Carlo (G)

European Federation of Allergy and Airway Diseases Patient's Associations, Brussels, Belgium.

Timothy Craig (T)

Department of Medicine and Pediatrics, Penn State University, Hershey, Pa.

Zuzana Diamant (Z)

Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden; Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center of Groningen and QPS-NL, Groningen, the Netherlands.

Wojciech Feleszko (W)

Department of Pediatric Pulmonology and Allergy, The Medical University Children's Hospital, Warszawa, Poland.

Despo Ierodiakonou (D)

Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.

James E Gern (JE)

Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.

Jonathan Grigg (J)

Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, United Kingdom.

Gunilla Hedlin (G)

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Elham M Hossny (EM)

Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.

Tuomas Jartti (T)

Department of Paediatrics, Turku University Hospital and University of Turku, Turku, Finland.

Alan Kaplan (A)

Family Physician Airways Group of Canada, University of Toronto, Toronto, ON, Canada.

Robert F Lemanske (RF)

Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.

Peter Le Souef (P)

School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.

Mika J Makela (MJ)

Department of Allergy, Helsinki University Skin and Allergy Hospital and University of Helsinki, Helsinki, Finland.

Paolo M Matricardi (PM)

Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - University Medicine Berlin, Berlin, Germany.

Michael Miligkos (M)

Division of Pediatric Pulmonology, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece.

Mário Morais-Almeida (M)

Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.

Helena Pite (H)

Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal; Allergy Center, CUF Infante Santo Hospital, Lisbon, Portugal; Chronic Diseases Research Center (CEDOC), NOVA Medical School/Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal.

Paulo M C Pitrez (PMC)

Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

Petr Pohunek (P)

Paediatric Department, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.

Graham Roberts (G)

The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport Isle of Wight, United Kingdom; Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, United Kingdom; NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.

Sylvia Sanchez-Garcia (S)

Allergy Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

Ioanna Tsiligianni (I)

Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece.

Steve Turner (S)

Child Health, Royal Aberdeen Children's Hospital and University of Aberdeen, Aberdeen, United Kingdom.

Tonya A Winders (TA)

Allergy and Asthma Network, Vienna, Va; Global Allergy and Asthma Patient Platform, Vienna, Austria.

Gary Wong (G)

Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.

Paraskevi Xepapadaki (P)

Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.

Heather J Zar (HJ)

Department of Paediatrics and Child Health, Red Cross Children's Hospital and SA-Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.

Nikolaos G Papadopoulos (NG)

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom; Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: ngpallergy@gmail.com.

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