Protocol for a systematic review to identify and weight the indicators of risk of asthma exacerbations in children aged 5–12 years

Tagiyeva, Nara; McLean, Susannah; Sheikh, Aziz; Julious, Steven A.; Thomas, Mike; Paton, James Y.; Pinnock, Hilary

doi:10.1038/npjpcrm.2016.88

Cited by 1 publication

(2 citation statements)

References 33 publications

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“…The systematic review is registered with PROSPERO (CRD42016037464); the protocol is published. 11 We followed Cochrane methodology 12 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting standards. 13 …”

Section: Methodsmentioning

confidence: 99%

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At-risk children with asthma (ARC): a systematic review

Buelo

McLean

Julious

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IntroductionAsthma attacks are responsible for considerable morbidity and may be fatal. We aimed to identify and weight risk factors for asthma attacks in children (5–12 years) in order to inform and prioritise care.MethodsWe systematically searched six databases (May 2016; updated with forward citations January 2017) with no language/date restrictions. Two reviewers independently selected studies for inclusion, assessed study quality and extracted data. Heterogeneity precluded meta-analysis. Weighting was undertaken by an Expert Panel who independently assessed each variable for degree of risk and confidence in the assessment (based on study quality and size, effect sizes, biological plausibility and consistency of results) and then achieved consensus by discussion. Assessments were finally presented, discussed and agreed at a multidisciplinary workshop.ResultsFrom 16 109 records, we included 68 papers (28 cohort; 4 case-control; 36 cross-sectional studies). Previous asthma attacks were associated with greatly increased risk of attack (ORs between 2.0 and 4.1). Persistent symptoms (ORs between 1.4 and 7.8) and poor access to care (ORs between 1.2 and 2.3) were associated with moderately/greatly increased risk. A moderately increased risk was associated with suboptimal drug regimen, comorbid atopic/allergic disease, African-American ethnicity (USA), poverty and vitamin D deficiency. Environmental tobacco smoke exposure, younger age, obesity and low parental education were associated with slightly increased risk.DiscussionAssessment of the clinical and demographic features identified in this review may help clinicians to focus risk reduction management on the high-risk child. Population level factors may be used by health service planners and policymakers to target healthcare initiatives.Trial registration numberCRD42016037464.

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Section: Methodsmentioning

confidence: 99%

“…The search strategy was structured to include terms for ‘Asthma’ and ‘Exacerbations/Attacks’ and ‘Risk factors/Predictors’. 11 (Online supplementary table S1 gives detailed search strategies.) We contacted experts in the field for potentially relevant papers and anticipated risk factors to ensure we captured all likely predictors.…”

Section: Methodsmentioning

confidence: 99%