Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Pulmonary Division, Department of Medicine, University of the Philippines College of Medicine - Philippine General Hospital, Manila, Philippines.
J Asthma. 2023 Sep;60(9):1687-1701. doi: 10.1080/02770903.2023.2180748. Epub 2023 Mar 7.
To investigate the knowledge and perceptions of physicians on the role of modeling studies in asthma, using a modified Delphi procedure.
Group opinions among a panel of respiratory experts were obtained using two online questionnaires and a virtual scientific workshop. A consensus was pre-defined as agreement by >75% of participants.
From 26 experts who agreed to participate, 22 completed both surveys. At the end of the process, the panel rated their own understanding of modeling as good (77%) but that among physicians in general as poor (77%). Participants agreed that data from modeling studies should be used, at least sometimes, to inform treatment guidelines (91%) and could be useful for guiding clinical decisions (100%). Perceived barriers to using modeling studies were 'A lack of understanding' (81%) and 'A lack of standardized methodology' (82%). Based on data from two modeling studies, no consensus was reached on physicians recommending regular inhaled corticosteroids (ICS) versus as-needed therapy for patients with mild asthma, whereas 77% agreed that they would recommend regular ICS over maintenance and reliever therapy for ≥80% of their patients with moderate asthma. No consensus was reached on the value of modeling data in relation to empirical data.
There is overall support among respiratory experts for the usefulness of modeling data to guide asthma treatment guidelines and clinical decision making. More publications on modeling data using robust models and accessible terminology will aid the understanding of physicians in general and help clarify the evidence-based value of modeling studies.
采用改良 Delphi 法调查医师对模型研究在哮喘中作用的认识和看法。
使用两份在线问卷和一次虚拟科学研讨会获取呼吸专家小组的意见。将>75%的参与者达成一致的意见定义为共识。
在 26 名同意参与的专家中，有 22 名完成了两次调查。在整个过程结束时，专家组对其自身对模型的理解评价为良好（77%），而对一般医师的评价则为较差（77%）。参与者一致认为应至少有时使用模型研究数据来为治疗指南提供信息（91%），并可用于指导临床决策（100%）。认为使用模型研究存在障碍的因素包括“缺乏理解”（81%）和“缺乏标准化方法”（82%）。基于两项模型研究的数据，医师对于推荐轻度哮喘患者常规使用吸入性皮质激素（ICS）与按需治疗未达成共识，而对于中重度哮喘患者的治疗，77%的专家同意常规使用 ICS 优于维持和缓解治疗。在模型数据的价值与经验数据方面未达成共识。
呼吸专家总体上支持使用模型数据来指导哮喘治疗指南和临床决策。更多使用稳健模型和通俗易懂的术语来发表模型数据将有助于提高一般医师的理解，有助于阐明模型研究的循证价值。
