Marek Ruszczyński1, Dominika Ambrożej2, Aleksander Adamiec1,2, Klaudia Ryczaj2, Varpu Elenius3, Ozlem Cavkaytar4, Paraskevi Maggina5, Heidi Makrinioti6, Nikolaos Papadopoulos5,7, Gunilla Hedlin8,9, Jon R Konradsen8,9, Bianca Schaub10, Hermelijn H Smits11, Tuomas Jartti3,12, Wojciech Feleszko2. 1. Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland. 2. Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland. 3. Department of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland. 4. Department of Pediatric Allergy and Immunology, Goztepe Training and Research Hospital, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey. 5. Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece. 6. Imperial College Healthcare NHS Trust, London, UK. 7. Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, UK. 8. Astrid Lindgren Children's Hospital Karolinska University Hospital, Stockholm, Sweden. 9. Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 10. Pediatric Allergology, Department of Pediatrics, German Center for Lung Research (DZL), Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany. 11. Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. 12. Department of Pediatrics, University of Oulu, Oulu, Finland.
Abstract
BACKGROUND: Asthma-like symptoms in preschool children, such as wheezing and dyspnea, are common time- and resource-consuming diagnostic and management challenges. Quality of wheezing and asthma recommendations varies. The purpose of this study, carried out by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force for Preschool Wheeze, was to systematically review and assess the quality of guidelines for diagnosis and treatment of preschool wheezing and/or asthma. METHODS: The Cochrane Library, MEDLINE, and EMBASE were searched until June 2018. The methodological rigor, quality, and transparency of relevant guidelines were assessed with the use of the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. RESULTS: We identified 26 guidelines. The quality scores for each domain varied. Of all domains, clarity and presentation had the highest mean score, whereas applicability and stakeholder involvement had the lowest. The scores (median) for individual domains were as follows: score and purpose 86%; stakeholder involvement 49%; rigor of development 54%; clarity of presentation 85%; applicability 51%; and editorial independence 63%. CONCLUSION: Although several guidelines on asthma management in children are available, however, their quality varies. Additionally, there is a considerable gap in reliable recommendations on the management and treatment of non-asthmatic preschool wheeze.
BACKGROUND:Asthma-like symptoms in preschool children, such as wheezing and dyspnea, are common time- and resource-consuming diagnostic and management challenges. Quality of wheezing and asthma recommendations varies. The purpose of this study, carried out by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force for Preschool Wheeze, was to systematically review and assess the quality of guidelines for diagnosis and treatment of preschool wheezing and/or asthma. METHODS: The Cochrane Library, MEDLINE, and EMBASE were searched until June 2018. The methodological rigor, quality, and transparency of relevant guidelines were assessed with the use of the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. RESULTS: We identified 26 guidelines. The quality scores for each domain varied. Of all domains, clarity and presentation had the highest mean score, whereas applicability and stakeholder involvement had the lowest. The scores (median) for individual domains were as follows: score and purpose 86%; stakeholder involvement 49%; rigor of development 54%; clarity of presentation 85%; applicability 51%; and editorial independence 63%. CONCLUSION: Although several guidelines on asthma management in children are available, however, their quality varies. Additionally, there is a considerable gap in reliable recommendations on the management and treatment of non-asthmatic preschool wheeze.
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