Management of Asthma in Childhood: Study Protocol of a Systematic Evidence Update by the Pediatric Asthma in Real Life (PeARL) Think Tank

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Introduction. Clinical recommendations for childhood asthma are often based on data extrapolated from studies conducted in adults, despite significant differences in mechanisms and response to treatments. The PeARL Think Tank aspires to develop recommendations based on the best available evidence from studies in children. An overview of systematic reviews on pediatric asthma maintenance management and a systematic review of treatments for acute asthma attacks in children, requiring an emergency presentation with/without hospital admission will be conducted.
Methods and analysis. Standard methodology recommended by Cochrane will be followed. Maintenance pharmacotherapy of childhood asthma will be evaluated in an overview of SRs published after 2005 and including clinical trials or real-life studies. For evaluating pharmacotherapy of acute asthma attacks leading to an emergency presentation with/without hospital admission, we opted to conduct de novo synthesis in the absence of adequate up-to-date published SRs. For the SR of acute asthma pharmacotherapy we will consider eligible SRs, clinical trials, or real-life studies without time restrictions. Our evidence updates will be based on broad searches of Pubmed/Medline and the Cochrane Library. We will use AMSTAR-2, Cochrane RoB2 and RELEVANT to evaluate the methodological quality of SRs, controlled clinical trials and real-life studies, respectively. Next, we will further assess interventions for acute severe asthma attacks with positive clinical results in meta- analyses. We will include both controlled clinical trials and observational studies and will assess their quality using the previously mentioned tools. We will employ random effect models for conducting meta-analyses, and GRADE methodology to assess certainty in the body of evidence.
Original languageEnglish
JournalBMJ Open
Publication statusAccepted/In press - 1 Jun 2021


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