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 .
Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma.
BACKGROUND Because r and omized controlled trials of established pediatric asthma therapies are expensive and difficult to perform , observational studies may fill gaps in the evidence base . OBJECTIVES To compare the effectiveness of representative small-particle inhaled corticosteroid ( ICS ) with that of st and ard size-particle ICS for children initiating or stepping up ICS therapy for asthma ( analysis 1 ) and to compare the effectiveness of ICS dose step-up using small-particle ICS with adding long-acting β2-agonist ( LABA ) to the ICS ( analysis 2 ) . METHODS These historical matched cohort analyses drew on electronic medical records of children with asthma aged 5 to 11 years . Variables measured during 2 consecutive years ( 1 baseline year for confounder definition and 1 outcome year ) included risk-domain asthma control ( no hospital attendance for asthma , acute oral corticosteroids , or lower respiratory tract infection requiring antibiotics ) and rate of severe exacerbations ( asthma-related emergency , hospitalization , or oral corticosteroids ) . RESULTS In the initiation population ( n = 797 in each cohort ) , children prescribed small-particle ICS versus st and ard size-particle ICS experienced greater odds of asthma control ( adjusted odds ratio , 1.49 ; 95 % CI , 1.10 - 2.02 ) and lower severe exacerbation rate ( adjusted rate ratio , 0.56 ; 95 % CI , 0.35 - 0.88 ) . Step-up outcomes ( n = 206 in each cohort ) were also significantly better for small-particle ICS , with asthma control adjusted odds ratio of 2.22 ( 95 % CI , 1.23 - 4.03 ) and exacerbations adjusted rate ratio of 0.49 ( 95 % CI , 0.27 - 0.89 ) . The number needed to treat with small-particle ICS to achieve 1 additional child with asthma control was 17 ( 95 % CI , 9 - 107 ) for the initiation population and 5 ( 95 % CI , 3 - 78 ) for the step-up population . Outcomes were not significantly different for stepped-up small-particle ICS dose versus ICS/LABA combination ( n = 185 in each cohort ) . CONCLUSIONS Initiating or stepping up the ICS dose with small-particle ICS rather than with st and ard size-particle ICS is more effective and shows similar effectiveness to add-on LABA in childhood asthma
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 .