Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico
Main Article Content
Keywords
Asthma, Asthma prevention, Asthma diagnosis, Lung function test, Asthma guidelines, AGREE-II, ADAPTE, Wheezing, Paediatric
Abstract
Background: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma.
Methods: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-IIto selectthree mother guidelines. Key clinical questions were formulated covering each step of the asthma management.
Results: The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age groups: children with asthma ≤5 years, 6-11 years and ≥12 years.
Conclusions: For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.
References
2. Pearce N, Ait-Khaled N, Beasley R, Mallol J, Keil U, Mitchell E, et al. Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2007;62: 758-66.
3. Lopez Perez G, Morfin Maciel BM, Huerta Lopez J, Mejia Covarrubias F, Lopez Lopez J, Aguilar G, et al. Prevalence of allergic diseases in Mexico City. Rev Alerg Mex. 2009;56:72-9.
4. Larenas-Linnemann D, Salas-Hernandez J, Vazquez-Garcia JC, Ortiz-Aldana I, Fernandez-Vega M, Del Rio-Navarro BE, et al. [Mexican Asthma Guidelines: GUIMA 2017]. Rev Alerg Mex. 2017;64 Suppl 1:s11-28.
5. ADAPTE Collaboration. The ADAPTE manual and resource toolkit for guideline adaptation. Version 2.0; 2010. http://www.g-i-n-net [accessed 11.02.14].
6. Consortium ANS. El Instrumento AGREE II Versión electrónica; 2009. http://www.agreetrust.org; Spanish version: http://www.guiasalud.es [accessed 11.02.14].
7. British Thoracic S, Scottish Intercollegiate Guidelines N. British guideline on the management of asthma. Thorax. 2014;69 Suppl.:1-192.
8. Global initiative for asthma. Global strategy for asthma management and prevention. Revised 2014; 2014. http://www.ginasthma.org
9. Global Initiative for Asthma. Global strategy for asthma management and prevention, 2016; 2016. http://ginasthma.org [accessed 22.01.16].
10. Plaza Moral V, Comite Ejecutivo de G. GEMA(4.0). Guidelines for asthma management. Arch Bronconeumol. 2015;51 Suppl.:2-54.
11. Brozek JL, Akl EA, Alonso-Coello P, Lang D, Jaeschke R, Williams JW, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009;64: 669-77.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.