Abstract:
Severe asthma affects about 10% of the population with asthma and is characterized by low lung function and a high count of blood leukocytes, mainly eosinophils. Various definitions are used in clinical practice and in the literature to identify asthma remission: clinical remission, inflammatory remission, and complete remission. This work highlights a consensus for asthma remission using a Delphi method. In the context of the Severe Asthma Network Italy, which accounts for 57 severe asthma centers and more than 2,200 patients, a board of six experts drafted a list of candidate statements in a questionnaire, which has been revised to minimize redundancies and ensure clear and consistent wording for the first round (R1) of the analysis. Thirty-two statements were included in the R1 questionnaire and then submitted to a panel of 80 experts, which used a 5-point Likert scale to measure agreement regarding each statement. Then, an interim analysis of R1 data was performed, and items were discussed and considered to produce a consistent questionnaire for round 2 (R2) of the analysis. Then, the board set the R2 questionnaire, which included only important topics. Panelists were asked to vote on the statements in the R2 questionnaire afterward. During R2, the criteria of complete clinical remission (the absence of the need for oral corticosteroids, symptoms, exacerbations or attacks, and pulmonary function stability) and those of partial clinical remission (the absence of the need for oral corticosteroids, and two of three criteria: the absence of symptoms, exacerbations or attacks, and pulmonary stability) were confirmed. This Severe Asthma Network Italy Delphi analysis defined a valuable and independent tool that is easy to use, to test the efficacy of different treatments in patients with severe asthma enrolled into the SANI registry.
摘要:
严重哮喘影响约10%的哮喘人群,它的特点是肺功能低下和血液白细胞计数较高,主要是嗜酸性粒细胞。迄今为止,在临床实践和文献中使用各种定义来确定哮喘缓解:临床缓解,炎症缓解,完全缓解。这项工作的目的是强调使用德尔菲法缓解哮喘的共识。在SANI(意大利严重哮喘网络)的背景下,占57个重症哮喘中心和2200多个患者,由六名专家组成的委员会在问卷中起草了一份候选人陈述清单,已对其进行了修订,以最大程度地减少冗余,并确保第一轮(R1)分析的措辞清晰一致。R1问卷中包含了32个陈述,然后提交给一个由80名专家组成的小组,他们使用5分的李克特量表来衡量他们对每个陈述的同意。然后,已经对R1数据进行了中期分析,对项目进行了讨论,认为这些项目为第2轮(R2)分析提供了一致的问卷.在这之后,董事会设置了R2问卷,其中只包括重要的关键主题。随后,小组成员被要求对R2问卷中的陈述进行投票。在R2期间,临床完全缓解的标准(不需要OCS,症状,恶化/攻击,和肺功能稳定)和部分临床缓解(不需要OCS,3个标准中有2个:没有症状,恶化/攻击,和肺稳定性)得到证实。这个SANIDelphi分析定义了一个有价值的,独立且易于使用的工具来测试SANI注册的重度哮喘患者不同治疗方法的疗效.