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 .
Increased Dose of Inhaled Corticosteroid versus Add-On Long-acting β-Agonist for Step-Up Therapy in Asthma.
RATIONALE Guidelines advocate adding long-acting β-agonist ( LABA ) to inhaled corticosteroid as the preferred step-up therapy to increasing inhaled corticosteroid dose for patients with uncontrolled asthma on inhaled corticosteroid monotherapy . However , less than 5 % of patients with asthma qualify for the r and omized controlled trials on which guidelines are based . Thus , real-world data are needed to complement the results of r and omized trials with narrow entry criteria . OBJECTIVES To compare the effectiveness of stepping up asthma therapy with an increased dose of various types of inhaled corticosteroid as compared with add-on LABA . METHODS We performed a historical matched cohort study using large primary care data bases to compare asthma step-up therapy with small- and st and ard size-particle inhaled corticosteroid versus added LABA for patients 12 - 80 years old . As outcomes , we examined a composite of asthma control and rates of severe exacerbations . MEASUREMENTS AND MAIN RESULTS The odds of asthma control and rates of severe exacerbations over one outcome year were comparable with increased inhaled corticosteroid dose versus added LABA . The adjusted odds ratios ( 95 % confidence interval ) for achieving asthma control with increased inhaled corticosteroid dose versus inhaled corticosteroid/LABA were 0.99 ( 0.88 - 1.12 ) for small-particle inhaled corticosteroid ( n = 3,036 per cohort ) and 0.85 ( 0.67 - 1.07 ) for st and ard size-particle inhaled corticosteroid ( n = 809 per cohort ) . The adjusted rate ratios ( 95 % confidence interval ) for severe exacerbations , compared with inhaled corticosteroid/LABA combination inhaler , were 1.04 ( 0.91 - 1.20 ) and 1.18 ( 0.92 - 1.54 ) , respectively . The results were not affected by smoking status . CONCLUSIONS When applied to a broad primary care population , antiinflammatory therapy using increased doses of small- or st and ard size-particle inhaled corticosteroid is as effective as adding LABA , as measured by outcomes important to both patients and providers . Real-world population s and outcomes need to be taken into consideration when formulating treatment recommendations
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 .