Control of Allergic Rhinitis and Asthma Test for Children (CARATkids): A systematic review and meta-analysis of its measurement properties.

Control of Allergic Rhinitis and Asthma Test for Children (CARATkids) is the first patient-reported outcome measure (PROM) designed to assess both allergic rhinitis and asthma simultaneously in children aged 6 to 12 years. CARATkids has been validated in several languages and countries, highlighting the need for a review of its psychometric properties. This study aims to evaluate the measurement properties of CARATkids.

Use of artificial intelligence to support the assessment of the methodological quality of systematic reviews.

Introduction: Published systematic reviews display an heterogeneous methodological quality, which can impact decision-making. Large language models (LLMs) can support and make the assessment of the methodological quality of systematic reviews more efficient, aiding in the incorporation of their evidence in guideline recommendations. We aimed to develop a LLM-based tool for supporting the assessment of the methodological quality of systematic reviews.

Validation and Acceptability of the Mobile App Version of the Control of Allergic Rhinitis and Asthma Test for Children (CARATKids): Cross-Sectional Study.

Background: The electronic version of the Control of Allergic Rhinitis and Asthma Test for Children (CARATKids) has the potential to enhance pediatric telemonitoring but has not yet been validated.

Objective: This study aimed to validate the electronic version of CARATKids against the paper-based version.

Methods: A cross-sectional study was conducted between April and December 2024 in a tertiary hospital in northern Portugal.

Daily digital biomarkers in the follow-up and clustering of patients with asthma.

Background And Research Question: We aimed to assess whether levels of digital biomarkers can reflect monthly patterns of asthma control.

Study Design And Methods: We performed a longitudinal study on patients with asthma and comorbid rhinitis who filled ≥26 days of data in a month in the MASK-air® app and who reported at least 1 day of treatment with an inhaled corticosteroid with or without a long-acting β-agonist (ICS ± LABA). We applied k-means cluster analysis to define clusters of months according to daily asthma control and medication use.

Intranasal Treatments for Allergic Rhinitis in Preschool- and School-Age Children: Network Meta-Analysis.

Background: Intranasal medications are considered a first-line treatment of allergic rhinitis (AR).

Objective: We performed a systematic review and network meta-analysis (NMA) comparing the efficacy and safety of intranasal antihistamines (INAH), intranasal corticosteroids (INCS), and their fixed combination (INAH+INCS) for the treatment of AR in children.

Methods: We searched four electronic bibliographic and three clinical trial databases for randomized controlled trials assessing the use of INAH, INCS, and INAH+INCS in children (aged <18 years) with seasonal or perennial AR.

Comparison of Three Treatment Strategies in Mild Asthma: A Carbon-Utility Analysis.

Background: The main types of commercially available inhalers for the management of asthma include dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs). The environmental impact of pMDIs, due to hydrofluorocarbon propellants, is a growing concern.

Objective: To conduct a carbon-utility analysis in mild asthma, comparing the clinical efficacy of DPIs versus pMDIs alongside their associated environmental impacts.

Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR).

Background: Asthma characterization using blood eosinophil count (BEC) (among other biomarkers and clinical indices) is recommended in severe asthma (SA), but the masking effect of oral corticosteroids (OCS), makes this challenging.

Aim: Our aim was to explore the effect of OCS use (both intermittent [iOCS] and long-term [LTOCS]) prior to biologic initiation on SA phenotype and biomarker profile in real-life and to characterize the burden of SA among patients prescribed LTOCS by biomarker profile.

Methods: This was a registry-based cohort study, including data from 23 countries collected between 2003 and 2023 and shared with the Internatonal Severe Asthma Registry (ISAR).

Impact of Biologics Initiation on Oral Corticosteroid Use in the International Severe Asthma Registry and the Optimum Patient Care Research Database: A Pooled Analysis of Real-World Data.

Background: For severe asthma (SA) management, real-world evidence on the effects of biologic therapies in reducing the burden of oral corticosteroid (OCS) use is limited.

Objective: To estimate the efficacy of biologic initiation on total OCS (TOCS) exposure in patients with SA from real-world specialist and primary care settings.

Methods: From the International Severe Asthma Registry (ISAR, specialist care) and the Optimum Patient Care Research Database (OPCRD, primary care, United Kingdom), adult biologic initiators were identified and propensity score-matched with non-initiators (ISAR, 1:1; OPCRD, 1:2).

Impact of allergic symptoms on work productivity in allergic rhinitis: A MASK-air direct patient data study.

Background: Allergic rhinitis may impair work productivity. This study aimed to assess (i) the differential impact of allergic rhinitis symptoms on work performance, assessed by means of Visual Analogue Scale (VAS) work; and (ii) the effect of asthma comorbidity on work productivity.

Methods: We assessed data from the MASK-air mHealth app of patients with allergic rhinitis.

Prevalence of asthma in Portuguese adults - the EPI-ASTHMA study, a nationwide population-based survey.

Introduction: In 2010, 6.8% of the Portuguese adults had asthma. Contemporary studies employing more accurate methods are needed.

Adherence to Treatment in Allergic Rhinitis During the Pollen Season in Europe: A MASK-air Study.

Background: Adherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-air mHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone in patients with allergic rhinitis.

Methods: We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH, INCS or azelastine-fluticasone.

International Severe Asthma Registry (ISAR): 2017-2024 Status and Progress Update.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research.

Assessment of the underreporting of rhinitis in patients with asthma: A MASK-air® real-world study.

Rhinitis is a common comorbidity in patients with asthma. However, the frequency of underreported rhinitis in asthma is not known. In this study, we aimed to assess the characteristics of patients with self-reported asthma and no self-reported rhinitis, as well as the extent of the underreporting of rhinitis.

Type 2 inflammation: a Portuguese consensus using Web-Delphi and decision conferencing (INFLAT2-PT).

Objectives: Atopic/allergic diseases impose a growing burden on public health, affecting millions of patients worldwide. The main objective of this study was to develop a national expert consensus on relevant clinical questions related to type 2 inflammation.

Methods: We conducted: a comprehensive literature review with a qualitative analysis to identify the most repeated themes on the overlap of conditions; a modified 3-round Web-Delphi (or e-Delphi); and a final online decision conference.

Lung auscultation using smartphone built-in microphone versus digital stethoscope: a comparative early feasibility study.

Background: Lung auscultation using a smartphone built-in microphone is promising for home monitoring of pediatric respiratory diseases. Our aim was to compare respiratory sounds recorded by a smartphone and a digital stethoscope by assessing the proportion of quality recordings and adventitious sounds detected by each device.

Methods: A comparative early feasibility study with children from a public school in Northern Portugal was conducted.

Empirical estimation of disutilities and decision thresholds for composite endpoints.

Objectives: The evaluation of health benefits and harms of an intervention with GRADE Evidence to Decision (EtD) frameworks includes judgments if the effects are "trivial," "small," "moderate," or "large." Such judgments ideally require the a priori establishment of decision thresholds (DTs), whose empirical derivation for single outcomes has been previously described. In this article, we provide a methodological approach to estimate DTs for composite endpoints based on disutilities.

Efficacy and safety of intranasal medications for allergic rhinitis: Network meta-analysis.

Background: Intranasal antihistamines (INAH), corticosteroids (INCS), and their fixed combinations (INAH+INCS) are one of the cornerstones of the treatment of allergic rhinitis (AR). We performed a systematic review and network-meta-analysis comparing the efficacy and safety of INAH, INCS, and INAH+INCS in patients with AR.

Methods: We searched four electronic bibliographic databases and three clinical trial databases for randomised controlled trials assessing the use of INAH, INCS, and INAH+INCS in adults with seasonal or perennial AR.

Validation of the adult asthma epidemiological score: a secondary analysis of the EPI-ASTHMA population-based study.

Objective: The A2 score is an eight-question patient-reported outcome measure that has been validated for ruling in (score ≥4) and ruling out (score 0-1) asthma. However, this screening tool has been validated in a cohort similar to the derivation cohort used. This study aims to validate the predictive accuracy of the A2 score in a primary care population against general practitioner (GP) clinical assessment and to determine whether the proposed cut-offs are the most appropriate.

Intranasal Versus Oral Treatments for Allergic Rhinitis: A Systematic Review With Meta-Analysis.

Background: Treatments for allergic rhinitis include intranasal or oral medications.

Objective: To perform a systematic review with meta-analysis comparing the effectiveness of intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists in improving allergic rhinitis symptoms and quality of life.

Methods: We searched four bibliographic databases and three clinical trial datasets for randomized controlled trials (1) assessing patients aged 12 years and older with seasonal or perennial allergic rhinitis, and (2) comparing intranasal corticosteroids or antihistamines versus oral antihistamines or leukotriene receptor antagonists.

Impact of Allergic Rhinitis Control on Work Productivity and Costs: A Real-World Data MASK-air Study.

Background: Allergic rhinitis (AR) has a substantial socioeconomic impact associated with impaired work productivity.

Objective: To study the impact of AR on work productivity and estimate the corresponding indirect costs for 40 countries.

Methods: We conducted a cross-sectional study using direct patient data from the MASK-air app on users with self-reported AR.

Protocol for the systematic reviews on the desirable and undesirable effects of pharmacological treatments of allergic rhinitis informing the ARIA 2024 guidelines.

There is insufficient evidence regarding the comparative efficacy and safety of pharmacological treatments of allergic rhinitis (AR). In the context of informing the 2024 revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, we plan to perform three systematic reviews of randomized controlled trials (RCTs) comparing the desirable and undesirable effects (i) between intranasal and oral medications for AR; (ii) between combinations of intranasal and oral medications versus nasal or oral medications alone; and (iii) among different intranasal specific medications. We will search four electronic bibliographic databases and three clinical trials databases for RCTs examining patients ≥ 12 years old with seasonal or perennial AR.