Evidence map›Paper›PMID 40383994›Full record

SynthesisHealth technology assessment (Winchester, England)2025

Establishing the best step-up treatments for children with uncontrolled asthma despite inhaled corticosteroids: the EINSTEIN systematic review, network meta-analysis and cost-effectiveness analysis using individual participant data.

Sofia Cividini, Ian Sinha, Giovanna Culeddu, Sarah Donegan, Michelle Maden, Katie Rose, Olivia Fulton, Dyfrig Hughes, Stephen Turner, Catrin Tudur Smith and 1 more

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Health technology assessment (Winchester, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sofia CividiniDepartment of Health Data Science (HDS), University of Liverpool, Liverpool, UK.ORCID 0000-0003-2705-9224
Ian SinhaAlder Hey Children's Foundation NHS Trust, Liverpool, UK.ORCID 0000-0002-7342-5523
Giovanna CuledduCentre for Health Economics & Medicines Evaluation, Bangor University, Bangor, UK.ORCID 0000-0001-5032-4255
Sarah DoneganDepartment of Health Data Science (HDS), University of Liverpool, Liverpool, UK.ORCID 0000-0003-1709-2290
Michelle MadenLiverpool Reviews and Implementation Group (LRIG), University of Liverpool, Liverpool, UK.ORCID 0000-0003-4419-6343
Katie RoseAlder Hey Children's Foundation NHS Trust, Liverpool, UK.ORCID 0000-0002-2348-2036
Olivia FultonPatient Representative, Liverpool, UK.ORCID 0000-0001-7358-0219
Dyfrig HughesCentre for Health Economics & Medicines Evaluation, Bangor University, Bangor, UK.ORCID 0000-0001-8247-7459
Stephen TurnerUniversity Court of the University of Aberdeen, Aberdeen, UK.ORCID 0000-0001-8393-5060
Catrin Tudur SmithDepartment of Health Data Science (HDS), University of Liverpool, Liverpool, UK.ORCID 0000-0003-3051-1445
EINSTEIN collaborative group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: There is no clear preferential option for initial step-up of treatment for children with uncontrolled asthma on inhaled corticosteroid. Objectives: Evaluate the clinical effectiveness of pharmacological treatments to use in children with uncontrolled asthma on inhaled corticosteroid; identify and evaluate the potential for treatment effect modification to optimise treatment delivery; assess the cost-effectiveness of treatments. Methods: Systematic review and individual participant data network meta-analysis. Studies were eligible if they were parallel or crossover randomised controlled trials comparing at least one of the pharmacological treatments of interest in participants aged < 18 years with uncontrolled asthma on any dose inhaled corticosteroid alone. We searched MEDLINE Results: We identified and screened 4708 publications from the search and confirmed 144 randomised controlled trials as eligible. We obtained individual participant data from 29 trials (5381 participants) and extracted limited aggregate data from a further 19 trials. The majority of trials had low risk of bias. The network meta-analysis suggests that medium-dose inhaled corticosteroid + long-acting Discussion: Medium-dose inhaled corticosteroid + long-acting Study registration: This study is registered as PROSPERO CRD42019127599. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/110/16) and is published in full in

Indexed as

Adrenal Cortex HormonesAnti-Asthmatic AgentsAsthmaAdministration, InhalationAdolescentChildCost-Benefit AnalysisCost-Effectiveness AnalysisHumansQuality-Adjusted Life YearsQuality of LifeRandomized Controlled Trials as TopicTechnology Assessment, BiomedicalAdrenal Cortex HormonesAnti-Asthmatic AgentsADOLESCENTSANTIASTHMATIC AGENTSASTHMAASTHMA ATTACKASTHMA CONTROLCHILDRENCOST-EFFECTIVENESS ANALYSISECONOMIC EVALUATIONEXACERBATIONINDIVIDUAL PARTICIPANT DATAINHALED CORTICOSTEROIDSIPDNETWORK META-ANALYSISNETWORK META-REGRESSIONNMAPAEDIATRICSRANDOMISED CLINICAL TRIALSRESPIRATORY MEDICINESPIROMETRYSYSTEMATIC REVIEW

Identifiers

PMID40383994
PMCPMC12104851

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.