Results Although highlighting a general lack of high- quality real-life effectiveness observational research on these clinical ly important topics , the analysis provided insights into how identified observational studies might inform asthma guidelines developers and clinicians .
Overall , RELEVANT appeared reliable and easy to use by expert review ers .
Conclusions Using such quality appraisal tools is m and atory to assess whether specific observational real-life effectiveness studies can be used to inform guideline development and /or decision-making in clinical practice
Abstract Introduction A Task Force was commissioned jointly by the European Academy of Allergy and Clinical Immunology ( EAACI ) and the Respiratory Effectiveness Group ( REG ) to develop a  quality assessment tool for real-life observational research to identify high- quality real-life asthma studies that could be considered within future guideline development .
Efficacy response of inhaled beclomethasone dipropionate in asthma is proportional to dose and is improved by formulation with a new propellant.
BACKGROUND This study tested the hypothesis that there would be improved asthma control with increasing doses of beclomethasone dipropionate ( BDP ) formulated in hydrofluoroalkane-134a ( HFA-BDP ) and the st and ard chlorofluorocarbon propellants ( CFC-BDP ) . Because HFA-BDP has improved lung deposition compared with CFC-BDP , this study also tested the hypothesis that HFA-BDP would provide more effective control of asthma than CFC-BDP . METHODS In this multicenter , r and omized , parallel-group blinded study , asthmatic subjects who had deterioration in asthma control after discontinuation of inhaled corticosteroids were r and omized to receive one of 6 possible treatments : 100 microg/d , 400 microg/d , or 800 microg/d of HFA-BDP or 100 microg/d , 400 microg/d , or 800 microg/d of CFC-BDP for 6 weeks . Changes in spirometry , daytime asthma symptom and nighttime asthma-related sleep disturbance scores , morning and evening peak expiratory flows , and daily use of inhaled beta-agonist for symptom control on diary cards were assessed over 6 weeks of treatment . RESULTS Three hundred twenty-three patients were r and omized to the 6 treatment groups , which had similar demographics and baseline lung function . There were significantly larger changes from baseline at week 6 in FEV(1 ) percent predicted with increasing doses of both HFA-BDP and CFC-BDP . The FEV(1 ) percent predicted dose-response curve for HFA-BDP was shifted to the left compared with the dose-response curve for CFC-BDP . By using the Finney bioassay method , it was calculated that 2.6 times as much CFC-BDP would be required to achieve the same improvement in FEV(1 ) percent predicted as HFA-BDP ( 95 % confidence interval , 1.1 - 11.6 ) . All treatment groups except the 100 microg/d CFC-BDP group tolerated study drug well . Ten ( 17 % ) of 59 patients in this group reported an acute asthma episode , increased asthma symptoms ( 6 of the 8 reports of increased asthma symptoms were classified as severe ) , or both , and 8 patients withdrew from the study ( 3 for adverse events related to asthma ) . CONCLUSIONS Increasing doses of inhaled corticosteroids lead to improved lung function and asthma control . Moreover , the reformulation of BDP in HFA enables effective asthma control at much lower doses than CFC-BDP
Results Although highlighting a general lack of high- quality real-life effectiveness observational research on these clinical ly important topics , the analysis provided insights into how identified observational studies might inform asthma guidelines developers and clinicians .
Overall , RELEVANT appeared reliable and easy to use by expert review ers .
Conclusions Using such quality appraisal tools is m and atory to assess whether specific observational real-life effectiveness studies can be used to inform guideline development and /or decision-making in clinical practice
Abstract Introduction A Task Force was commissioned jointly by the European Academy of Allergy and Clinical Immunology ( EAACI ) and the Respiratory Effectiveness Group ( REG ) to develop a  quality assessment tool for real-life observational research to identify high- quality real-life asthma studies that could be considered within future guideline development .