ReviewJournal of asthma and allergy2017
Managing the pediatric patient with refractory asthma: a multidisciplinary approach.
Review in Journal of asthma and allergy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 62 citations in OpenAlex.
- Update on Pediatric asthma management: Recent advances.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Review
- Marked Variation in Paediatric Problematic Severe Asthma Services Across Australia and New Zealand.Journal of paediatrics and child health · 2025Observational
- Evaluating Severe Therapy-Resistant Asthma in Children: Diagnostic and Therapeutic Strategies.Medicina (Kaunas, Lithuania) · 2024Review
- Treating severe paediatric asthma with mepolizumab or omalizumab: a protocol for the TREAT randomised non-inferiority trial.BMJ open · 2024Article
- Eosinophilia and wheeze: thinking beyond asthma.Breathe (Sheffield, England) · 2024Article
- Developments in the Management of Severe Asthma in Children and Adolescents: Focus on Dupilumab and Tezepelumab.Paediatric drugs · 2023Review
- Factors Involved in Decision-Making Dilemmas Faced by Parents of Children with Severe Asthma in PICU During the Development of Discharge Care Plans: A Phenomenological Study.Journal of asthma and allergy · 2023Article
- Bronchial eosinophils, neutrophils, and CD8 + T cells influence asthma control and lung function in schoolchildren and adolescents with severe treatment-resistant asthma.Respiratory research · 2022Article
- Alpine altitude climate treatment for severe and uncontrolled asthma: An EAACI position paper.Allergy · 2022Article
- Severe asthma in children: Description of a large multidisciplinary clinical cohort.Pediatric pulmonology · 2022Article
- Reply to: Challenging the paradigm.Breathe (Sheffield, England) · 2022Article
- An Overview of the Obese-Asthma Phenotype in Children.International journal of environmental research and public health · 2022Review
- How to Choose the Correct Drug in Severe Pediatric Asthma.Frontiers in pediatrics · 2022Review
- Growing, Growing, Gone: The Double Whammy of Early Deprivation and Impaired Evolution of Lung Function.American journal of respiratory and critical care medicine · 2021Article
- Challenging the paradigm: moving from umbrella labels to treatable traits in airway disease.Breathe (Sheffield, England) · 2021Review
- An approach to the management of children with problematic severe asthma.Acta bio-medica : Atenei Parmensis · 2020Review
- Kids, Difficult Asthma and Fungus.Journal of fungi (Basel, Switzerland) · 2020Review
- Which Child with Asthma is a Candidate for Biological Therapies?Journal of clinical medicine · 2020Review
- Pathophysiological Mechanisms of Asthma.Frontiers in pediatrics · 2019Review
- Editorial: Difficult and Severe Asthma in Children.Frontiers in pediatrics · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
Abstract
Children with asthma that is refractory to high levels of prescribed treatment are described as having problematic severe asthma. Those in whom persistent symptoms result from a failure of basic asthma management are described as having "difficult asthma", while those who remain symptomatic despite these factors having been addressed are described as having "severe therapy-resistant asthma" (STRA). The majority of children have difficult asthma; asthma that is poorly controlled because of a failure to get the basics of asthma management right. Modifiable factors including nonadherence to medication, persistent adverse environmental exposures, and psychosocial factors often contribute to poor control in these patients. As our skill in identifying and addressing modifiable factors has improved, we have found that a progressively smaller proportion of our clinic patients is categorized as having true STRA, resulting in an infrequent resort to escalation of treatment. Many of the modifiable factors associated with the diagnosis of difficult asthma can be identified in a general pediatric clinic. Characterization of more complex factors, however, requires the time, skill, and expertise of multiple health care professionals within the asthma multidisciplinary team. In this review, we will describe the structured approach adopted by The Royal Brompton Hospital in the management of the child with problematic severe asthma. We highlight the roles of members of the multidisciplinary team at various stages of assessment and focus on prominent themes in the identification and treatment of modifiable factors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.