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Pfaar O, Sousa-Pinto B, Papadopoulos NG, Larenas-Linnemann DE, Ordak M, Torres MJ, Mösges R, Klimek L, Zuberbier T, Matricardi PM, Berger UE, Berger M, Dramburg S, Mahler V, Toppila-Salmi SK, Bergmann KC, Ollert M, Tripodi S, Jutel M, Agache I, Eguiluz-Gracia I, Canonica GW, Akdis CA, Sokolowska M, Sofiev M, Shamji MH, Czarlewski W, Fonseca JA, Bedbrook A, Bousquet J. Digitally-enabled, person-centred care (PCC) in allergen immunotherapy: An ARIA-EAACI Position Paper. Allergy 2024. [PMID: 38700063 DOI: 10.1111/all.16135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 05/05/2024]
Abstract
In rhinitis and asthma, several mHealth apps have been developed but only a few have been validated. However, these apps have a high potential for improving person-centred care (PCC), especially in allergen immunotherapy (AIT). They can provide support in AIT initiation by selecting the appropriate patient and allergen shared decision-making. They can also help in (i) the evaluation of (early) efficacy, (ii) early and late stopping rules and (iii) the evaluation of (carried-over) efficacy after cessation of the treatment course. Future perspectives have been formulated in the first report of a joint task force (TF)-Allergic Rhinitis and Its Impact on Asthma (ARIA) and the European Academy of Allergy and Clinical Immunology (EAACI)-on digital biomarkers. The TF on AIT now aims to (i) outline the potential of the clinical applications of mHealth solutions, (ii) express their current limitations, (iii) make proposals regarding further developments for both clinical practice and scientific purpose and (iv) suggest which of the tools might best comply with the purpose of digitally-enabled PCC in AIT.
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Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Désirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Michal Ordak
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland
| | - Maria J Torres
- Allergy Unit, Hospital Regional Universitario de Malaga, IBIMA-Plataforma BIONAND, Universidad de Malaga, RICORS de Enfermedades Inflamatorias, Malaga, Spain
| | - Ralph Mösges
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
- ClinCompetence Cologne GmbH, Cologne, Germany
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Paolo M Matricardi
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
- Department of Pediatric Respiratory Medecine, Immunology and Critical Care Medicine, Charité-Universitaetsmedizin - Berlin, Berlin, Germany
| | - Uwe E Berger
- Department of Botany, University of Innsbruck, Innsbruck, Austria
- European Aeroallergen Network (EAN), Vienna, Austria
| | - Markus Berger
- Department of Botany, University of Innsbruck, Innsbruck, Austria
- European Aeroallergen Network (EAN), Vienna, Austria
- Department of Oto-Rhino-Laryngology, Klinik Hietzing, Wiener Gesundheitsverbund, Vienna, Austria
| | - Stephanie Dramburg
- Department of Pediatric Respiratory Medecine, Immunology and Critical Care Medicine, Charité-Universitaetsmedizin - Berlin, Berlin, Germany
| | | | - Sanna K Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karl-Christian Bergmann
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | | | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland
- ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Ioana Agache
- Faculty of Medicine, Transylvania University of Brasov, Brasov, Romania
| | - Ibon Eguiluz-Gracia
- Allergy Unit, Hospital Regional Universitario de Malaga, IBIMA-Plataforma BIONAND, Universidad de Malaga, RICORS de Enfermedades Inflamatorias, Malaga, Spain
| | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Asthma and Allergy Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | | | - Joao A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Anna Bedbrook
- MASK-air, Montpellier, France
- ARIA, Montpellier, France
| | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
- MASK-air, Montpellier, France
- ARIA, Montpellier, France
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2
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Bousquet J, Sousa-Pinto B, Anto JM, Bedbrook A, Fonseca JA, Zuberbier T. MASK-air: An OECD (Organisation for Economic Co-operation and Development) Best Practice for Public Health on Integrated Care for Chronic Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00286-1. [PMID: 38521122 DOI: 10.1016/j.jaip.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/17/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]
Abstract
In the recent report of the Organisation for Economic Co-operation and Development (OECD) on Best Practices (BPs) for Integrating Care to Prevent and Manage Chronic Diseases, an app on rhinitis and asthma (MASK-air [Mobile Airways Sentinel networK for airway diseases]) has been listed. The OECD is a reliable source of evidence-based policy analysis and economic data largely used by governments. It has published several BPs on public health. On May 10, 2023, the OECD published 13 BPs for Integrating Care to Prevent and Manage Chronic Diseases in the European Union. The report did not cover all models of integrated care; rather, it "focuse(d) on those that are of key strategic interest to policy makers." New MASK-air studies (not published in the report) include equity, usability of the app in old-age adults, economic impact, quality of life, and allergen immunotherapy. MASK-air is freely available on iOS and Android in 30 countries and has been recently introduced in the United States. The MASK-air OECD BP represents a model of digitally enabled, patient-centered care for chronic diseases using a holistic approach of shared decision making.
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Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; MASK-air, Montpellier, France; ARIA, Montpellier, France.
| | - Bernardo Sousa-Pinto
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Anna Bedbrook
- MASK-air, Montpellier, France; ARIA, Montpellier, France
| | - Joao A Fonseca
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
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3
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Bousquet J, Haahtela T, Anto JM, Haveri H, Puggioni F, Makela M, Bourret R, Canonica GW. The contribution of digital health to net zero patient care in allergic diseases: From concept to practice. Allergy 2024; 79:281-285. [PMID: 37712588 DOI: 10.1111/all.15880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- ARIA, Montpellier, France
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- MASK-air, Montpellier, France
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Hanna Haveri
- Health and Hospital Care Services, Wellbeing Services County of Päijät-Häme, Lahti, Finland
| | - Francesca Puggioni
- Personalized Medicine Asthma & Allergy, IRCCS Humanitas Research Center, Rozzano, Italy
| | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Center, Rozzano, Milan, Italy
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Savouré M, Bousquet J, Leynaert B, Ribet C, Goldberg M, Zins M, Jacquemin B, Nadif R. Asthma is associated with increased severity and duration of rhinitis: A study with the Allergic Rhinitis and its Impact on Asthma classes in the Constances cohort. Clin Transl Allergy 2023; 13:e12316. [PMID: 38006378 PMCID: PMC10668004 DOI: 10.1002/clt2.12316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/06/2023] [Accepted: 10/30/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Few population-based studies have described allergic rhinitis (AR) according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification, and none have assessed the impact of asthma on this classification. Our aims were to 1) describe AR according to four ARIA classes and 2) within each of the four ARIA classes, compare participants with AR alone versus those with AR and asthma. METHODS Cross-sectional analyses were performed using data from the 2014 annual follow-up questionnaire of the French adult population-based cohort Constances. Current AR was defined by the report of sneezing, runny, or blocked nose in the last 12 months and the report of nasal allergies. Following ARIA recommendations, rhinitis was classified according to its severity (mild or moderate-severe) and duration (intermittent or persistent). Ever asthma was also defined by a questionnaire. RESULTS Among the 4675 participants with AR (57% women, mean age 50.2 ± 12.7 years), 44% were classified as mild/intermittent, 16% mild/persistent, 25% moderate-severe/intermittent, and 15% moderate-severe/persistent. Within each of the four ARIA classes, compared to participants with rhinitis alone, participants with rhinitis and asthma had significantly more severe symptoms, more conjunctivitis, a higher mean eosinophil count and more treatments with intra-nasal corticosteroids and oral antihistamines co-medication. CONCLUSIONS This is a paradigm shift study as for the first time this large population-based study in adults showed that asthma status has a profound effect on the ARIA classification. Rhinitis alone and rhinitis with asthma represent two distinct phenotypes. These results reinforce the need to include asthma status in the ARIA classification and guidelines.
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Affiliation(s)
- Marine Savouré
- Université Paris‐SaclayUVSQUniv. Paris‐SudInsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
- French Environment and Energy Management AgencyAngersFrance
| | - Jean Bousquet
- Université Paris‐SaclayUVSQUniv. Paris‐SudInsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
- CharitéUniversitätsmedizin BerlinHumboldt‐Universität zu BerlinBerlinGermany
- Department of Dermatology and AllergyComprehensive Allergy CenterBerlin Institute of HealthBerlinGermany
- Centre Hospitalier UniversitaireMontpellierFrance
- MASK‐airMontpellierFrance
| | - Bénédicte Leynaert
- Université Paris‐SaclayUVSQUniv. Paris‐SudInsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
| | - Céline Ribet
- Université Paris‐CitéUniversité Paris‐SaclayUVSQ, InsermUMS 11 Cohortes Epidémiologiques en populationVillejuifFrance
| | - Marcel Goldberg
- Université Paris‐CitéUniversité Paris‐SaclayUVSQ, InsermUMS 11 Cohortes Epidémiologiques en populationVillejuifFrance
| | - Marie Zins
- Université Paris‐CitéUniversité Paris‐SaclayUVSQ, InsermUMS 11 Cohortes Epidémiologiques en populationVillejuifFrance
| | - Bénédicte Jacquemin
- Univ RennesInsermEHESPIrset (Institut de recherche en Santé, environnement et travail) ‐ UMR_S 1085RennesFrance
| | - Rachel Nadif
- Université Paris‐SaclayUVSQUniv. Paris‐SudInsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
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Matricardi PM, Sousa-Pinto B, Dramburg S, Bousquet J. Beyond ARIA: Will e-diaries replace retrospective questionnaires in measuring the severity of allergic rhinitis in clinical research and daily practice? Clin Exp Allergy 2023; 53:1004-1010. [PMID: 37488953 DOI: 10.1111/cea.14372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/12/2023] [Accepted: 06/05/2023] [Indexed: 07/26/2023]
Abstract
Retrospective questionnaires are used since decades to assess the severity and/or control of allergic diseases. Applications on smartphones have recently facilitated the use of prospective clinical diaries, based on questionnaires filled every day by the patient. Once limited to clinical trials, these e-diaries, based on validated disease control scores and visual analogue scales, permit a quantitative day-by-day measure free of recall bias. Given the advantages of this procedure, its use could be extended to the daily clinical practice. E-diaries may facilitate (1) a more precise identification of the culprit allergen in the diagnostic work-up of poly-sensitized patients, (2) the stratification of patients for treatment, (3) the follow-up of the patients under treatment for optimized shared decision-making, and (4) a careful assessment of preventive therapies. While a few apps are being used in scientific studies, consensus on their use in daily practice should be reached and guidelines for specialists should be elaborated by scientific associations.
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Affiliation(s)
- Paolo M Matricardi
- Department of Pediatric Respiratory Care, Immunology, and Intensive Care Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE - Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Stephanie Dramburg
- Department of Pediatric Respiratory Care, Immunology, and Intensive Care Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- University Hospital Montpellier, Montpellier, France
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6
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Sousa-Pinto B, Jácome C, Pereira AM, Regateiro FS, Almeida R, Czarlewski W, Kulus M, Shamji MH, Boulet LP, Bonini M, Brussino L, Canonica GW, Cruz AA, Gemicioglu B, Haahtela T, Kupczyk M, Kvedariene V, Larenas-Linnemann D, Louis R, Niedoszytko M, Pham-Thi N, Puggioni F, Romantowski J, Sastre J, Scichilone N, Taborda-Barata L, Ventura MT, Vieira RJ, Agache I, Bedbrook A, Bergmann KC, Amaral R, Azevedo LF, Bosnic-Anticevich S, Brusselle G, Buhl R, Cecchi L, Charpin D, Loureiro CC, de Blay F, Del Giacco S, Devillier P, Jassem E, Joos G, Jutel M, Klimek L, Kuna P, Laune D, Luna Pech J, Makela M, Morais-Almeida M, Nadif R, Neffen HE, Ohta K, Papadopoulos NG, Papi A, Pétré B, Pfaar O, Yeverino DR, Cordeiro CR, Roche N, Sá-Sousa A, Samolinski B, Sheikh A, Ulrik CS, Usmani OS, Valiulis A, Vandenplas O, Vieira-Marques P, Yorgancioglu A, Zuberbier T, Anto JM, Fonseca JA, Bousquet J. Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study. Lancet Digit Health 2023; 5:e227-e238. [PMID: 36872189 DOI: 10.1016/s2589-7500(23)00020-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Validated questionnaires are used to assess asthma control over the past 1-4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). METHODS We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16-90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test-retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. FINDINGS We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0·68-0·82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0·59-0·68). They also displayed high test-retest reliability (intraclass correlation coefficients range 0·79-0·95) and moderate-to-high responsiveness (correlation coefficient range 0·69-0·79; effect size measures range 0·57-0·99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0·70; 95% CI 0·61-0·78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0·73; 95% CI 0·68-0·78). INTERPRETATION e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. FUNDING None.
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Affiliation(s)
- Bernardo Sousa-Pinto
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Cristina Jácome
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Margarida Pereira
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal; Patient Centred Innovation and Technology, Centro de Investigação em Tecnologias e Serviços de Saúde, Centre for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra and Institute of Immunology, and Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rute Almeida
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Marek Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College & National Institutes for Health Imperial Biomedical Research Centre, London, UK
| | | | - Matteo Bonini
- Department of Cardiovascular and Respiratory Sciences, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Neurological, Ear, Nose, and Throat, and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; National Heart and Lung Institute, Imperial College London, London, UK
| | - Luisa Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Alvaro A Cruz
- Fundaçao ProAR, Federal University of Bahia and Global Alliance Against Chronic Respiratory Diseases and WHO Planning Group, Salvador, Bahia, Brazil
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Türkiye
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology and Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Desirée Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Renaud Louis
- Department of Pulmonary Medicine, Centre Hospitalier Universitaire Liege, and GIGA Infection, Immunity, Inflammation Laboratories research group, University of Liege, Liege, Belgium
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Nhân Pham-Thi
- Institut de Recherche bio-Médicale des Armées, Bretigny sur Orge, France; École Polytechnique de Palaiseau, Palaiseau, France; Université Paris Cité, Paris, France
| | - Francesca Puggioni
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Jan Romantowski
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Joaquin Sastre
- Allergy Service, Fundacion Jimenez Diaz, Faculty of Medicine Universidad Autonoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | | | - Luis Taborda-Barata
- University of Beira Interior Air, Clinical & Experimental Lung Centre and Centro de Investigação em Ciências da Saúde-University of Beira Interior Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - Rafael José Vieira
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ioana Agache
- Faculty of Medicine, Transylvania University Brasov, Brasov, Romania
| | - Anna Bedbrook
- Allergic Rhinitis and its Impact on Asthma, Montpellier, France
| | - Karl C Bergmann
- Institute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany
| | - Rita Amaral
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sinthia Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, The University of Sydney, and Sydney Local Health District, Sydney, NSW, Australia
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Roland Buhl
- Department of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany
| | - Lorenzo Cecchi
- Struttura Organizzativa Semplice Allergology and Clinical Immunology Unita Sanitaria Locale, Toscana Centro, Prato, Italy
| | - Denis Charpin
- Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France
| | - Claudia Chaves Loureiro
- Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Frédéric de Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital Duilio Casula, University of Cagliari, Cagliari, Italy
| | - Philippe Devillier
- Virologie et Immunologie Moléculaires Suresnes, Unités Mixtes de Recherche 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | - Ewa Jassem
- Medical University of Gdańsk, Department of Pneumonology, Gdansk, Poland
| | - Guy Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland; All-Medicine Medical Research Institute, Wroclaw, Poland
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | | | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Rachel Nadif
- Université Paris-Saclay, Université Versailles-St Quentin, Université Paris-Sud, Paris, France; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, Villejuif, France
| | - Hugo E Neffen
- Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
| | - Ken Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan; JATA Fukujuji Hospital, Tokyo, Japan
| | | | - Alberto Papi
- Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Benoit Pétré
- Department of Public Health, University of Liege, Liege, Belgium
| | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Daniela Rivero Yeverino
- Allergy and Clinical Immunology Department, Hospital Universitario de Puebla, Puebla, Mexico
| | | | - Nicolas Roche
- Pneumologie, Assistance Publique - Hôpitaux de Paris, Centre Université de Paris Cité, Hôpital Cochin, Paris, France
| | - Ana Sá-Sousa
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal; Patient Centred Innovation and Technology, Centro de Investigação em Tecnologias e Serviços de Saúde, Centre for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Omar S Usmani
- National Heart and Lung Institute, Imperial College London, London, UK; Royal Brompton Hospital, Airways Disease Section, London, UK
| | - Arunas Valiulis
- Institute of Clinical Medicine and Institute of Health Sciences and Medical Faculty of Vilnius University, Vilnius, Lithuania
| | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL, Namur, Belgium; Université Catholique de Louvain, Yvoir, Belgium
| | - Pedro Vieira-Marques
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Türkiye
| | - Torsten Zuberbier
- Institute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - João A Fonseca
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Institute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, Villejuif, France; University Hospital Montpellier, Montpellier, France.
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7
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Bousquet J, Anto JM, Sousa‐Pinto B, Czarlewski W, Bedbrook A, Haahtela T, Klimek L, Pfaar O, Kuna P, Kupczyk M, Regateiro FS, Samolinski B, Valiulis A, Yorgancioglu A, Arnavielhe S, Basagaña X, Bergmann KC, Bosnic‐Anticevich S, Brussino L, Canonica GW, Cardona V, Cecchi L, Chaves‐Loureiro C, Costa E, Cruz AA, Gemicioglu B, Fokkens WJ, Ivancevich JC, Kraxner H, Kvedariene V, Larenas‐Linnemann DE, Laune D, Louis R, Makris M, Maurer M, Melén E, Micheli Y, Morais‐Almeida M, Mullol J, Niedoszytko M, Okamoto Y, Papadopoulos NG, Patella V, Pham‐Thi N, Rouadi PW, Sastre J, Scichilone N, Sheikh A, Sofiev M, Taborda‐Barata L, Toppila‐Salmi S, Tsiligianni I, Valovirta E, Ventura MT, Vieira RJ, Zidarn M, Amaral R, Ansotegui IJ, Bédard A, Benveniste S, Bewick M, Bindslev‐Jensen C, Blain H, Bonini M, Bourret R, Braido F, Carreiro‐Martins P, Charpin D, Cherrez‐Ojeda I, Chivato T, Chu DK, Cingi C, Del Giacco S, de Blay F, Devillier P, De Vries G, Doulaptsi M, Doyen V, Dray G, Fontaine J, Gomez RM, Hagemann J, Heffler E, Hofmann M, Jassem E, Jutel M, Keil T, Kritikos V, Kull I, Kulus M, Lourenço O, Mathieu‐Dupas E, Menditto E, Mösges R, Murray R, Nadif R, Neffen H, Nicola S, O’Hehir R, Olze H, Palamarchuk Y, Pépin J, Pétré B, Picard R, Pitsios C, Puggioni F, Quirce S, Raciborski F, Reitsma S, Roche N, Rodriguez‐Gonzalez M, Romantowski J, Sá‐Sousa A, Serpa FS, Savouré M, Shamji MH, Sova M, Sperl A, Stellato C, Todo‐Bom A, Tomazic PV, Vandenplas O, Van Eerd M, Vasankari T, Viart F, Waserman S, Fonseca JA, Zuberbier T. Digitally-enabled, patient-centred care in rhinitis and asthma multimorbidity: The ARIA-MASK-air ® approach. Clin Transl Allergy 2023; 13:e12215. [PMID: 36705508 PMCID: PMC9823305 DOI: 10.1002/clt2.12215] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/19/2022] [Indexed: 01/09/2023] Open
Abstract
MASK-air® , a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air® is a Good Practice of DG Santé on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air® results should lead to change management in rhinitis and asthma.
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Affiliation(s)
- Jean Bousquet
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany,University Hospital MontpellierMontpellierFrance,InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance
| | - Josep M. Anto
- ISGlobalBarcelona Institute for Global HealthBarcelonaSpain,IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain,Universitat Pompeu Fabra (UPF)BarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)BarcelonaSpain
| | - Bernardo Sousa‐Pinto
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | | | | | - Tari Haahtela
- Skin and Allergy HospitalHelsinki University HospitalUniversity of HelsinkiHelsinkiFinland
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck SurgeryUniversitätsmedizin MainzMainzGermany,Center for Rhinology and AllergologyWiesbadenGermany
| | - Oliver Pfaar
- Section of Rhinology and AllergyDepartment of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital MarburgPhilipps‐Universität MarburgMarburgGermany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and AllergyBarlicki University HospitalMedical University of LodzLodzPoland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and AllergyBarlicki University HospitalMedical University of LodzLodzPoland
| | - Frederico S. Regateiro
- Allergy and Clinical Immunology UnitCentro Hospitalar e Universitário de CoimbraCoimbraPortugal,ICBR, Coimbra Institute for Clinical and Biomedical Research, CIBBFaculty of MedicineUniversity of CoimbraCoimbraPortugal,Institute of ImmunologyFaculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarsawPoland
| | - Arunas Valiulis
- Institute of Clinical Medicine and Institute of Health SciencesVilniusLithuania,Medical Faculty of Vilnius UniversityVilniusLithuania
| | - Arzu Yorgancioglu
- Department of Pulmonary DiseasesCelal Bayar University, Faculty of MedicineManisaTurkey
| | | | - Xavier Basagaña
- ISGlobalBarcelona Institute for Global HealthBarcelonaSpain,IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain,Universitat Pompeu Fabra (UPF)BarcelonaSpain,CIBER Epidemiología y Salud Pública (CIBERESP)BarcelonaSpain
| | - Karl C. Bergmann
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany
| | - Sinthia Bosnic‐Anticevich
- Quality Use of Respiratory Medicine GroupWoolcock Institute of Medical ResearchThe University of SydneySydneyNSWAustralia,Sydney Local Health DistrictSydneyNSWAustralia
| | - Luisa Brussino
- Department of Medical SciencesAllergy and Clinical Immunology UnitUniversity of TorinoTorinoItaly,Mauriziano HospitalTorinoItaly
| | - G. Walter Canonica
- Department of Biomedical SciencesHumanitas University, Pieve EmanueleMilanItaly,Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Center IRCCSRozzanoItaly
| | - Victoria Cardona
- Allergy SectionDepartment of Internal MedicineHospital Vall d'HebronBarcelonaSpain,ARADyAL Research NetworkBarcelonaSpain
| | - Lorenzo Cecchi
- SOS Allergology and Clinical ImmunologyUSL Toscana CentroPratoItaly
| | - Claudia Chaves‐Loureiro
- Pneumology UnitHospitais da Universidade de CoimbraCentro Hospitalar e Universitário de CoimbraCoimbraPortugal
| | - Elisio Costa
- UCIBIO, REQUINTEFaculty of Pharmacy and Competence Center on Active and Healthy AgeingUniversity of Porto (Porto4Ageing)PortoPortugal
| | - Alvaro A. Cruz
- Fundaçao ProARFederal University of Bahia and GARD/WHO Planning GroupSalvadorBahiaBrazil
| | - Bilun Gemicioglu
- Cerrahpasa Faculty of MedicineDepartment of Pulmonary DiseasesIstanbul University‐CerrahpasaIstanbulTurkey
| | - Wytske J. Fokkens
- Department of OtorhinolaryngologyAmsterdam University Medical Centres, location AMCAmsterdamthe Netherlands
| | | | - Helga Kraxner
- Department of Otorhinolaryngology, Head and Neck SurgerySemmelweis UniversityBudapestHungary
| | - Violeta Kvedariene
- Faculty of MedicineInstitute of Clinical MedicineClinic of Chest Diseases and AllergologyVilnius UniversityVilniusLithuania,Faculty of MedicineDepartment of PathologyInstitute of Biomedical SciencesVilnius UniversityVilniusLithuania
| | | | | | - Renaud Louis
- Department of Pulmonary MedicineCHU LiegeLiègeBelgium,GIGA I3 Research GroupUniversity of LiegeLiègeBelgium
| | - Michael Makris
- Allergy Unit “D Kalogeromitros”2nd Department of Dermatology and VenereologyNational & Kapodistrian University of Athens“Attikon” University HospitalAthensGreece
| | - Marcus Maurer
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany
| | - Erik Melén
- Sach's Children and Youth HospitalSödersjukhusetStockholmSweden,Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
| | | | | | - Joaquim Mullol
- Rhinology Unit & Smell ClinicENT DepartmentHospital ClínicBarcelonaSpain,Clinical & Experimental Respiratory ImmunoallergyIDIBAPS, CIBERESUniversity of BarcelonaBarcelonaSpain
| | | | | | | | - Vincenzo Patella
- Division of Allergy and Clinical ImmunologyDepartment of Medicine“Santa Maria della Speranza” Hospital, BattipagliaSalernoItaly,Agency of Health ASLSalernoItaly
| | - Nhân Pham‐Thi
- Ecole Polytechnique PalaiseauIRBA (Institut de Recherche Bio‐Médicale des Armées)BretignyFrance
| | - Philip W. Rouadi
- Department of Otolaryngology, Head and Neck SurgeryEye and Ear University HospitalBeirutLebanon,Department of Otorhinolaryngology, Head and Neck SurgeryDar Al Shifa HospitalSalmiyaKuwait
| | - Joaquin Sastre
- Fundacion Jimenez Diaz, CIBERESFaculty of MedicineAutonoma University of MadridMadridSpain
| | | | - Aziz Sheikh
- Usher InstituteThe University of EdinburghEdinburghUK
| | | | - Luis Taborda‐Barata
- Department of ImmunoallergologyCova da Beira University Hospital CentreCovilhãPortugal,UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
| | - Sanna Toppila‐Salmi
- Skin and Allergy HospitalHelsinki University HospitalUniversity of HelsinkiHelsinkiFinland
| | - Ioanna Tsiligianni
- International Primary Care Respiratory Group IPCRGAberdeenScotland,Health Planning UnitFaculty of MedicineDepartment of Social MedicineUniversity of CreteCreteGreece
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical ImmunologyUniversity of TurkuTurkuFinland,Terveystalo Allergy ClinicTurkuFinland
| | | | - Rafael José Vieira
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic DiseasesGolnikSlovenia,Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Rita Amaral
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | | | - Annabelle Bédard
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance,Université Paris‐Saclay, UVSQUniversity Paris‐SudVillejuifFrance
| | - Samuel Benveniste
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO)Broca HospitalParisFrance,Mines ParisTech CRI ‐ PSL Research UniversityFontainebleauFrance
| | - Michael Bewick
- University of Central Lancashire Medical SchoolPrestonUK
| | - Carsten Bindslev‐Jensen
- Odense Research Center for Anaphylaxis (ORCA)OdenseDenmark,Department of Dermatology and Allergy CentreOdense University HospitalOdenseFinland
| | - Hubert Blain
- Department of GeriatricsMontpellier University Hospital, MUSEMontpellierFrance
| | - Matteo Bonini
- Department of Clinical and Surgical SciencesFondazione Policlinico Universitario A Gemelli IRCCSRomeItaly,National Heart and Lung InstituteRoyal Brompton Hospital & Imperial College LondonLondonUK
| | | | - Fulvio Braido
- Department of Internal Medicine (DiMI)University of GenoaGenovaItaly,IRCCS Ospedale Policlinico San MartinoGenovaItaly
| | - Pedro Carreiro‐Martins
- NOVA Medical School/Comprehensive Health Research Centre (CHRC)LisbonPortugal,Serviço de ImunoalergologiaHospital de Dona EstefâniaCentro Hospitalar Universitário de Lisboa CentralLisbonPortugal
| | - Denis Charpin
- Clinique des BronchesAllergie et SommeilHôpital NordMarseilleFrance
| | - Ivan Cherrez‐Ojeda
- Universidad Espíritu SantoSamborondónEcuador,Respiralab Research GroupGuayaquil, GuayasEcuador
| | - Tomas Chivato
- School of MedicineUniversity CEU San PabloMadridSpain
| | - Derek K. Chu
- Department of Health Research Methods, Evidence, and Impact & Department of MedicineMcMaster UniversityHamiltonONCanada
| | - Cemal Cingi
- Medical FacultyENT DepartmentEskisehir Osmangazi UniversityEskisehirTurkey
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical ImmunologyUniversity Hospital “Duilio Casula”University of CagliariCagliariItaly
| | - Frédéric de Blay
- Allergy DivisionChest Disease DepartmentUniversity Hospital of StrasbourgStrasbourgFrance,Federation of Translational MedicineUniversity of StrasbourgStrasbourgFrance
| | - Philippe Devillier
- VIM Suresnes, UMR 0892Pôle des Maladies des Voies RespiratoiresHôpital FochUniversité Paris‐SaclaySuresnesFrance
| | | | - Maria Doulaptsi
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of CreteHeraklion, CreteGreece
| | - Virginie Doyen
- Department of Chest MedicineCentre Hospitalier Universitaire UCL NamurNamurBelgique,Université Catholique de LouvainYvoirBelgium
| | | | | | | | - Jan Hagemann
- Department of Otolaryngology, Head and Neck SurgeryUniversitätsmedizin MainzMainzGermany,Center for Rhinology and AllergologyWiesbadenGermany
| | - Enrico Heffler
- Department of Biomedical SciencesHumanitas University, Pieve EmanueleMilanItaly,Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Center IRCCSRozzanoItaly
| | - Maja Hofmann
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Berlin Institute of HealthBerlinGermany
| | - Ewa Jassem
- Department of PneumologyMedical University of GdańskGdańskPoland
| | - Marek Jutel
- Department of Clinical ImmunologyWrocław Medical UniversityWrocławPoland,ALL‐MED Medical Research InstituteWroclawPoland
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health EconomicsCharité ‐ Universitätsmedizin BerlinBerlinGermany,Institute for Clinical Epidemiology and BiometryUniversity of WuerzburgWuerzburgGermany,State Institute of Health, Bavarian Health and Food Safety AuthorityErlangenGermany
| | - Vicky Kritikos
- Quality Use of Respiratory Medicine GroupWoolcock Institute of Medical ResearchThe University of SydneySydneyNSWAustralia
| | - Inger Kull
- Sach's Children and Youth HospitalSödersjukhusetStockholmSweden,Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
| | - Marek Kulus
- Department of Pediatric Respiratory Diseases and AllergologyMedical University of WarsawWarsawPoland
| | - Olga Lourenço
- Faculty of Health Sciences and CICS – UBIHealth Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
| | | | - Enrica Menditto
- CIRFFDepartment of PharmacyUniversity of Naples Federico IINaplesItaly
| | - Ralph Mösges
- CRI‐Clinical Research International‐LtdHamburgGermany
| | - Ruth Murray
- Medical Communication ConsultantMedscript Ltd, DundalkIreland and WellingtonNew Zealand,Research FellowOPCCambridgeUK
| | - Rachel Nadif
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance,Université Paris‐Saclay, UVSQUniversity Paris‐SudVillejuifFrance
| | - Hugo Neffen
- Center of Allergy, Immunology and Respiratory DiseasesSanta FeArgentina
| | - Stefania Nicola
- Department of Medical SciencesAllergy and Clinical Immunology UnitUniversity of TorinoTorinoItaly
| | - Robyn O’Hehir
- Department of Allergy, Immunology and Respiratory MedicineAlfred Hospital and Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Heidi Olze
- Berlin Institute of HealthBerlinGermany,Department of OtorhinolaryngologyCharité‐Universitätsmedizin BerlinBerlinGermany
| | | | - Jean‐Louis Pépin
- Université Grenoble AlpesLaboratoire HP2GrenobleFrance,INSERMU1042VillejuifFrance
| | | | - Robert Picard
- Conseil Général de l'Economie Ministère de l'Economiede l'Industrie et du NumériqueParisFrance
| | | | - Francesca Puggioni
- Department of Biomedical SciencesHumanitas University, Pieve EmanueleMilanItaly,Personalized Medicine, Asthma and AllergyHumanitas Clinical and Research Center IRCCSRozzanoItaly
| | - Santiago Quirce
- Department of AllergyHospital La Paz Institute for Health Research (IdiPAZ)MadridSpain
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarsawPoland
| | - Sietze Reitsma
- Department of OtorhinolaryngologyAmsterdam University Medical Centres, AMCAmsterdamthe Netherlands
| | - Nicolas Roche
- PneumologieAP‐HP Centre Université de Paris CitéHôpital CochinParisFrance,UMR 1016Institut CochinParisFrance
| | | | - Jan Romantowski
- Department of AllergologyMedical University of GdańskGdanskPoland
| | - Ana Sá‐Sousa
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | - Faradiba S. Serpa
- Asthma Reference Center ‐ School of Medicine of Santa Casa de Misericórdia of VitóriaVitoria, Espirito SantoBrazil
| | - Marine Savouré
- InsermEquipe d’Epidémiologie Respiratoire IntégrativeCESPVillejuifFrance,Université Paris‐Saclay, UVSQUniversity Paris‐SudVillejuifFrance
| | - Mohamed H. Shamji
- National Heart and Lung InstituteImperial CollegeLondonUK,NIHR Imperial Biomedical Research CentreLondonUK
| | - Milan Sova
- Department of Respiratory Medicine and TuberculosisUniversity HospitalBrnoCzech Republic
| | - Annette Sperl
- Center for Rhinology and AllergologyWiesbadenGermany
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoSalernoItaly
| | - Ana Todo‐Bom
- ImunoalergologiaCentro Hospitalar Universitário de CoimbraFaculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Peter Valentin Tomazic
- Department of General ORLH&NSMedical University of GrazENT‐University Hospital GrazGrazSteiermarkAustria
| | - Olivier Vandenplas
- Department of Chest MedicineCentre Hospitalier Universitaire UCL NamurNamurBelgique,Université Catholique de LouvainYvoirBelgium
| | | | - Tuula Vasankari
- Fihla, Finnish Lung AssociationHelsinkiFinland,University of TurkuTurkuFinland
| | | | - Susan Waserman
- Department of Medicine, Clinical Immunology and AllergyMcMaster UniversityHamiltonOntarioCanada
| | - Joao A. Fonseca
- MEDCIDS ‐ Department of Community Medicine, Information and Health Decision SciencesFaculty of MedicineUniversity of PortoPortoPortugal,CINTESIS – Health Research NetworkFaculty of Medicine, University of PortoPortoPortugal,RISE – Health Research Network, MEDCIDSFaculty of Medicine, University of PortoPortoPortugal
| | - Torsten Zuberbier
- Institute of AllergologyCharité – Universitätsmedizin BerlinCorporate Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany,Fraunhofer Institute for Translational Medicine and Pharmacology ITMPAllergology and ImmunologyBerlinGermany
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Sousa-Pinto B, Sá-Sousa A, Vieira RJ, Amaral R, Pereira AM, Anto JM, Klimek L, Czarlewski W, Mullol J, Pfaar O, Bedbrook A, Brussino L, Kvedariene V, Larenas-Linnemann DE, Okamoto Y, Ventura MT, Ansotegui IJ, Bosnic-Anticevich S, Canonica GW, Cardona V, Cecchi L, Chivato T, Cingi C, Costa EM, Cruz AA, Del Giacco S, Devillier P, Fokkens WJ, Gemicioglu B, Haahtela T, Ivancevich JC, Kuna P, Kaidashev I, Kraxner H, Laune D, Louis R, Makris M, Monti R, Morais-Almeida M, Mösges R, Niedoszytko M, Papadopoulos NG, Patella V, Pham-Thi N, Regateiro FS, Reitsma S, Rouadi PW, Samolinski B, Sheikh A, Sova M, Taborda-Barata L, Toppila-Salmi S, Sastre J, Tsiligianni I, Valiulis A, Yorgancioglu A, Zidarn M, Zuberbier T, Fonseca JA, Bousquet J. Cutoff Values of MASK-air Patient-Reported Outcome Measures. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 11:1281-1289.e5. [PMID: 36566778 DOI: 10.1016/j.jaip.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND In clinical and epidemiological studies, cutoffs of patient-reported outcome measures can be used to classify patients into groups of statistical and clinical relevance. However, visual analog scale (VAS) cutoffs in MASK-air have not been tested. OBJECTIVE To calculate cutoffs for VAS global, nasal, ocular, and asthma symptoms. METHODS In a cross-sectional study design of all MASK-air participants, we compared (1) approaches based on the percentiles (tertiles or quartiles) of VAS distributions and (2) data-driven approaches based on clusters of data from 2 comparators (VAS work and VAS sleep). We then performed sensitivity analyses for individual countries and for VAS levels corresponding to full allergy control. Finally, we tested the different approaches using MASK-air real-world cross-sectional and longitudinal data to assess the most relevant cutoffs. RESULTS We assessed 395,223 days from 23,201 MASK-air users with self-reported allergic rhinitis. The percentile-oriented approach resulted in lower cutoff values than the data-driven approach. We obtained consistent results in the data-driven approach. Following the latter, the proposed cutoff differentiating "controlled" and "partly-controlled" patients was similar to the cutoff value that had been arbitrarily used (20/100). However, a lower cutoff was obtained to differentiate between "partly-controlled" and "uncontrolled" patients (35 vs the arbitrarily-used value of 50/100). CONCLUSIONS Using a data-driven approach, we were able to define cutoff values for MASK-air VASs on allergy and asthma symptoms. This may allow for a better classification of patients with rhinitis and asthma according to different levels of control, supporting improved disease management.
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Affiliation(s)
- Bernardo Sousa-Pinto
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Ana Sá-Sousa
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Rafael José Vieira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Rita Amaral
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Ana Margarida Pereira
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Josep M Anto
- Department of Research & Development, ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Department of Medical Research & Environment, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Epidemiology of Asthma, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | | | - Joaquim Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Anna Bedbrook
- Department of Allergy, ARIA & MASK-air, Montpellier, France
| | - Luisa Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino and Mauriziano Hospital, Torino, Italy
| | - Violeta Kvedariene
- Department of Pathology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Desirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology, Chiba University Hospital and Chiba Rosai Hospital, Chiba, Japan
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School and Institute of Sciences of Food Production, National Research Council (Ispa-Cnr), Bari, Italy
| | - Ignacio J Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - Sinthia Bosnic-Anticevich
- Quality Use of Respiratory Medicines Group, Woolcock Institute of Medical Research, Sydney, Sydney Pharmacy School, The University of Sydney, Sydney Local Health District, Sydney, NSW, Australia
| | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Tomas Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - Cemal Cingi
- ENT Department, Eskisehir Osmangazi University, Medical Faculty, Eskisehir, Turkey
| | - Elísio M Costa
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - Alvaro A Cruz
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - Philippe Devillier
- VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Igor Kaidashev
- Department of Internal Medicine, Poltava State Medical University, Poltava, Ukraine
| | - Helga Kraxner
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Daniel Laune
- Department Recherches & Développement, KYomed INNOV, Montpellier, France
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Liege, and GIGA I3 research group, University of Liege, Liege, Belgium
| | - Michael Makris
- Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - Riccardo Monti
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Ralph Mösges
- IMSB, Medical Faculty, University at Cologne, and ClinCompetence Cologne GmbH, Cologne, Germany
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | | | - Vincenzo Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy
| | - Nhân Pham-Thi
- Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (ICBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sietze Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
| | - Philip W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon; Department of Otolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Poland
| | - Aziz Sheikh
- Usher Institute, the University of Edinburgh, Edinburgh, UK
| | - Milan Sova
- Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic
| | - Luis Taborda-Barata
- UBIAir-Clinical & Experimental Lung Centre, University of Beira Interior, Covilhã and CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Joaquin Sastre
- Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
| | - Ioanna Tsiligianni
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece; International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - Arunas Valiulis
- Institute of Clinical Medicine and Institute of Health Sciences, Vilnius, Lithunia; Medical Faculty of Vilnius University, Vilnius, Lithuania
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik & University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Joao A Fonseca
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany; Department of Pneumology, University Hospital, Montpellier, France.
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