Almonacid Carlos, Ausín Pilar, Villacampa José Miguel, Dávila Ignacio, Pinilla Mayte, Dominguez-Ortega Javier
Department of Respiratory Medicine, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
Department of Respiratory Medicine, Hospital del Mar, Barcelona, Spain.
J Asthma Allergy. 2024 Dec 27;17:1325-1332. doi: 10.2147/JAA.S496193. eCollection 2024.
To generate an evaluation checklist for the multidisciplinary approach to patients with asthma or suspected asthma.
This was a qualitative study based on a literature review and expert opinions. A multidisciplinary steering committee with knowledge and experience in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) was established and comprised two pneumologists, two allergologists, and two otorhinolaryngologists. They designed a preliminary evaluation checklist based on the best evidence available and their experience. An extra panel of 21 experts (five pneumologists, five allergologists, and 11 otorhinolaryngologists) analyzed and discussed the checklist, leading to the final version.
The checklist for the multidisciplinary approach to patients with asthma or suspected asthma includes the first and the follow-up visits. It is organized into several sections covering 1) current asthma and past history (diagnosis, symptoms, severity, control, etc.); 2) comorbidities (CRSwNP, atopic dermatitis, etc.); 3) physical examination and diagnostic tests (spirometry, bronchodilator reversibility test, fractional exhaled nitric oxide, etc.); 4) complementary tests (imaging, laboratory, allergy tests, etc.); 5) red flags (near-fatal asthma, CRSwNP complications); and 6) biological treatment (indication, response to treatment, decision making, etc.). Each section is divided into sub-sections detailing the recommended evaluation items. These items contain explanations, definitions, or variable lists that can be measured using direct questions, validated questionnaires, or other procedures such as imaging techniques or biomarkers. The checklist also proposes clinical actions.
This evaluation checklist might help improve and standardize the clinical management of patients with asthma or suspected asthma.
制定一份针对哮喘或疑似哮喘患者多学科诊疗方法的评估清单。
这是一项基于文献综述和专家意见的定性研究。成立了一个在哮喘和伴有鼻息肉的慢性鼻-鼻窦炎(CRSwNP)方面具有知识和经验的多学科指导委员会,由两名肺病学家、两名过敏症专科医生和两名耳鼻喉科医生组成。他们根据现有最佳证据和自身经验设计了一份初步评估清单。另外一组由21名专家(五名肺病学家、五名过敏症专科医生和11名耳鼻喉科医生)对该清单进行分析和讨论,得出最终版本。
针对哮喘或疑似哮喘患者多学科诊疗方法的清单包括初诊和复诊。它分为几个部分,涵盖:1)当前哮喘情况及既往史(诊断、症状、严重程度、控制情况等);2)合并症(CRSwNP、特应性皮炎等);3)体格检查和诊断测试(肺量计检查、支气管扩张剂可逆性试验、呼出一氧化氮分数等);4)补充检查(影像学检查、实验室检查、过敏试验等);5)警示信号(近乎致命的哮喘、CRSwNP并发症);6)生物治疗(适应症、治疗反应、决策制定等)。每个部分又分为若干子部分,详细列出推荐的评估项目。这些项目包含解释、定义或变量列表,可通过直接提问、经过验证的问卷或其他程序(如影像学技术或生物标志物)进行测量。该清单还提出了临床行动建议。
这份评估清单可能有助于改善和规范哮喘或疑似哮喘患者的临床管理。