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临床实践中的哮喘控制难题——来自两阶段德尔菲调查和文献综述的数据

Asthma control conundrum in clinical practice - Data from a two-stage Delphi survey and literature review.

作者信息

Canonica Giorgio Walter, Spanevello Antonio, de Llano Luis Pérez, Ribas Christian Domingo, Blakey John D, Garcia Gabriel, Inoue Hiromasa, Dalcolmo Margareth, Yang Dong, Mokashi Soniya, Kurne Abhishek, Butta Aman Kapil

机构信息

Humanitas University, Personalized Medicine Asthma & Allergy Clinic-Humanitas Research Hospital IRCCS, Milan, Italy.

Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria, Varese, Italy, Dipartimento di Medicina e Riabilitazione Cardio-Respiratoria, Istituti Clinici Scientici Maugeri, IRCCS Tradate (VA), Italy.

出版信息

Data Brief. 2023 Jul 18;50:109422. doi: 10.1016/j.dib.2023.109422. eCollection 2023 Oct.

Abstract

Definitions and measures of asthma control used in clinical trials and practice often vary, as highlighted in the manuscript, "Is asthma control more than just an absence of symptoms? An expert consensus statement". Furthermore, the authors discussed differences between patients and healthcare professionals (HCPs) in terms of understanding and managing asthma. Given these disparities, there is a need for consensus regarding what constitutes well-controlled asthma and, especially, how best it can be measured and recorded. In the current work, we describe our data and provide more detail on the methodology from a two-stage Delphi survey and a structured literature review, which were designed to reach a consensus definition of asthma control and alleviate misalignments between patients and HCPs. Survey data were collected using a two-stage Delphi technique; a method used to collate expert opinions over a series of sequential questionnaires to reach a consensus. The collated Delphi survey data were compared with results from a comprehensive, structured literature review of 216 publications, to assess if there was a correlation between existing guidance and measures of asthma control used in clinical trials and standard clinical practice. In order to collate and interpret findings from the Delphi survey, responses from 82 panelists (73 HCPs and 9 authors) were qualitatively analyzed, quantitatively categorized, and presented as percentages or counts in Excel databases, which are detailed in the current work. Searches conducted using PubMed and Cochrane identified 664 manuscripts, and Embase was used to identify 89 congress abstracts. After applying a stringent screening method using predefined key words, the structured literature review consisted of 185 peer-reviewed manuscripts and 31 congress abstracts, and assessed existing guidance and measures of asthma control used in clinical trials. In this publication, we provide further insight into the predefined keywords, search strings, and strategy applied to identify manuscripts and congress abstracts for inclusion/exclusion, and detail methods for data extraction. Together, the data from the Delphi survey and structured literature review aimed to provide greater insights into challenges and approaches in achieving asthma control in clinical practice, with the potential for results to be used to guide a universally accepted definition and measure of asthma control that can be used and understood by patients, HCPs, and researchers. Qualitative and quantitative methodology and analysis from the Delphi survey and literature review search strategy can potentially be used to identify disparities and explore expert opinion and relevant literature in other therapeutic areas to guide a consensus where disparities exist.

摘要

正如《哮喘控制是否不仅仅是没有症状?专家共识声明》这篇手稿中所强调的,临床试验和临床实践中使用的哮喘控制定义和衡量标准常常各不相同。此外,作者还讨论了患者与医护人员在理解和管理哮喘方面的差异。鉴于这些差异,对于什么构成哮喘的良好控制,尤其是如何最好地进行测量和记录,需要达成共识。在当前的工作中,我们描述了我们的数据,并提供了来自两阶段德尔菲调查和结构化文献综述的方法的更多细节,这两者旨在达成哮喘控制的共识定义,并缓解患者与医护人员之间的不一致。调查数据是使用两阶段德尔菲技术收集的;这是一种用于通过一系列连续问卷整理专家意见以达成共识的方法。将整理后的德尔菲调查数据与对216篇出版物进行的全面结构化文献综述的结果进行比较,以评估临床试验和标准临床实践中使用的现有指南与哮喘控制衡量标准之间是否存在相关性。为了整理和解释德尔菲调查的结果,对82名小组成员(73名医护人员和9名作者)的回复进行了定性分析、定量分类,并以百分比或计数的形式呈现在Excel数据库中,这些在当前工作中有详细说明。使用PubMed和Cochrane进行的搜索识别出664篇手稿,使用Embase识别出89篇会议摘要。在应用使用预定义关键词的严格筛选方法后,结构化文献综述包括185篇同行评审手稿和31篇会议摘要,并评估了临床试验中使用的现有哮喘控制指南和衡量标准。在本出版物中,我们进一步深入探讨了用于识别纳入/排除的手稿和会议摘要的预定义关键词、搜索字符串和策略,并详细介绍了数据提取方法。德尔菲调查和结构化文献综述的数据共同旨在更深入了解临床实践中实现哮喘控制的挑战和方法,其结果有可能用于指导一个患者、医护人员和研究人员都能使用和理解的普遍接受的哮喘控制定义和衡量标准。德尔菲调查和文献综述搜索策略的定性和定量方法及分析有可能用于识别差异,并探索其他治疗领域的专家意见和相关文献,以在存在差异的地方指导达成共识。

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本文引用的文献

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Is asthma control more than just an absence of symptoms? An expert consensus statement.
Respir Med. 2022 Oct;202:106942. doi: 10.1016/j.rmed.2022.106942. Epub 2022 Aug 4.
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Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study.
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Research guidelines for the Delphi survey technique.
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