Electronic Clinical Decision Support System for allergic rhinitis management: MASK e‐CDSS

Courbis, Anne Lise; Murray, Ruth; Arnavielhe, Sylvie; Caimmi, Davide; Bedbrook, Anna; Eerd, M. van; Vries, Govert De; Dray, Gérard; Agache, Ioana; Morais‐Almeida, Mário; Bachert, Claus; Bergmann, Karl‐Christian; Bosnic‐Anticevich, Sinthia; Brožek, Jan; Bucca, Caterina; Camargos, Paulo Augusto Moreira; Canonica, Giorgio Walter; Carr, Warner; Casale, Thomas B.; Fonseca, João; Haahtela, Tari; Kalaycı, Ömer; Klimek, Ludger; Kuna, Piotr; Kvedarienė, Violeta; Larenas‐Linnemann, Désirée; Lieberman, Phil; Mullol, Joaquim; O’Hehir, Robyn E; Papadopoulos, Nikolaos G.; Price, David; Ryan, Dermot; Samoliński, Bolesław; Simons, F. Estelle R.; Tomazic, Peter Valentin; Triggiani, Massimo; Valiulis, Arūnas; Valovirta, Erkka; Wagenmann, Martin; Wickman, Magnus; Yorgancıoğlu, Arzu; Bousquet, Jean

doi:10.1111/cea.13230

Cited by 70 publications

(78 citation statements)

References 34 publications

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“…The approach proposed in this article confirms most GRADE recommendations for allergic rhinitis and the classification of allergic rhinitis treatments proposed by ARIA (Table I). 6 Some conditional evidence was supported by RWE:…”

Section: Next-generation Aria-grade Guidelinesmentioning

confidence: 96%

“…5 The ARIA algorithm for allergic rhinitis was revised by an expert group, and a proposal was made to classify allergic rhinitis treatments (Table I). 6 ARIA 2010, 2016 revision, and US Practice Parameters 2017…”

Section: Documents Considered For Development Of Aria Care Pathwaysmentioning

confidence: 99%

“…During the ICP meeting in Paris, next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for allergic rhinitis, 5,[20][21][22] RWE provided by randomized controlled trials, real-world data using mobile technology, 23,24 and chamber studies (Fig 2). 5,6,[16][17][18][19][20][25][26][27] These recommendations were used to refine the algorithm for allergic rhinitis treatment proposed by a consensus group. 5 The present report describes the process of next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA)-GRADE guidelines for the pharmacologic treatment of allergic rhinitis.…”

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confidence: 99%

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Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence

Bousquet

Schünemann

Togias

et al. 2020

Journal of Allergy and Clinical Immunology

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362

246

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Selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on (1) patient empowerment, preferences, and age; (2) prominent symptoms, symptom severity, and multimorbidity; (3) efficacy and safety of treatment 1 ; (4) speed of onset of action of treatment; (5) current treatment; (6) historic response to treatment; (7) effect on sleep and work productivity 2,3 ; (8) self-management strategies; and (9) resource use. 4,5 An algorithm was devised 5 and digitalized 6 to step up or step down allergic rhinitis treatment based on control. However, its

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Section: Next-generation Aria-grade Guidelinesmentioning

confidence: 96%

Section: Documents Considered For Development Of Aria Care Pathwaysmentioning

confidence: 99%

mentioning

confidence: 99%

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Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence

Bousquet

Schünemann

Togias

et al. 2020

Journal of Allergy and Clinical Immunology

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362

246

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“…An eCDSS now exists in allergic rhinitis [11]. It is based on MASK (Mobile Airways Sentinel NetworK) [12,13].…”

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confidence: 99%

Electronic clinical decision support system (eCDSS) in the management of asthma: from theory to practice

Bousquet

2019

Eur Respir J

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]. Controlling symptoms while minimising the side-effects of treatment is the main aim of asthma management. If a patient's asthma stabilises, the clinician should then consider stepping down the treatment [1]. In practice, the implementation of step-down or step-up strategies includes 1) the use of risk prediction, 2) tools to support shared decision-making and 3) communication between clinicians and patients about risk. Major contributors to poor asthma control include the following evidence-based care gaps [2]: 1) monitoring of control, resulting in the under-recognition of suboptimal control, 2) adjustment of medication, and 3) delivery of an asthma action plan. Asthma action plans, combined with asthma education and regular follow-up, can improve the symptoms and quality of life of the patient and can reduce hospitalisation [3]. However, it is difficult and time-consuming to regularly assess control in primary care. mHealth has the potential to transform the face of healthcare and one of its benefits can be to provide a clinical decision support system (CDSS). A CDSS is a health information technology system designed to assist clinicians and other health care professionals in clinical decision-making. In medicine, CDSSs have become a major topic in artificial intelligence. According to the National Academy of Medicine (Washington, DC, USA) [4], "facilitative clinical decision support is a practical necessity for every clinician in our rapidly-evolving health and healthcare landscape." A CDSS can reduce the burden that exponentially expanding clinical knowledge and care complexity places on clinicians, other healthcare professionals or patients. CDSSs provide clinicians and other health care professionals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and healthcare. CDSSs can enhance decision-making through the use of the following tools: 1) computerised alerts and reminders to healthcare providers and patients, 2) clinical guidelines, 3) focused patient data reports and 4) diagnostic support [5]. Several self-management mHealth tools exist for asthma. Interventions such as the mobile app, the smart inhaler, the handheld asthma monitoring device, and SMSs were used to improve asthma control [6, 7].

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“…There is a real potential for information technology (IT) to support patient management but, so far, it has made little impact on patient management. Courbis et al describe the generation of a clinical decision support system (CDSS) for allergic rhinitis using expert consensus . The CDSS is integrated into the Allergy Diary Companion which is designed to be used during patient‐physician consultations.…”

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confidence: 99%

Diagnostic and other challenges

Roberts

2018

Clin Experimental Allergy

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It was good to see so many colleagues at the EAACI Food Allergy and Anaphylaxis Meeting (FAAM) in Copenhagen in October. Once again, the meeting managed to effectively mix the wide range of stakeholders involved in food allergy. It was a really good fertile environment to promote the interdisciplinary work that is needed to progress the agenda for our patients. November saw the first meeting of the EAACI Prevention Guideline Task Force where the protocol for the revision of the guidelines was discussed and agreed. This marks the start of the revision of the 2014 Food Allergy and Anaphylaxis Guidelines; the aim is to also start the revision of anaphylaxis and food allergy in 2019. The new advances showcased at the Caption to cover illustration: The cover image is based on the Original Article Monocytes accumulate in the airways of children with fatal asthma by Ibon Eguíluz-Gracia et al, DOI: https://doi. /journal/cea Clin Exp Allergy. 2018;48:1582-1583. patient management. Courbis et al describe the generation of a clinical decision support system (CDSS) for allergic rhinitis using expert consensus. 3 The CDSS is integrated into the Allergy Diary Companion which is designed to be used during patient-physician consultations. Symptom information collected as a visual analogue score (VAS) in the diary would be used to direct management using the CDSS (Figure 2). We now need to see how the system operates in practice and whether it improves patient outcomes. Lastly in this issue of the Journal, Stoevesandt et al look at the sensitization profile of 490 dermatology patients without a history of sting-induced anaphylactic reactions. 4 The vast majority of the individuals had a Hymenoptera sting. The percentage with sensitization to each of the components were 17.3% for rVes v 1, 18.0% for rVes v 5 and 3.5% for rApi m 1 (0.35 kU/L cut off) (Figure 3). So there is a relatively high prevalence of asymptomatic sensitization which needs to be considered when interpreting venom allergic sensitization results. 5

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Electronic Clinical Decision Support System for allergic rhinitis management: MASK e‐CDSS

Abstract: The Allergy Diary Companion for providers provides guideline and expert-endorsed AR management recommendations. [MASK paper No 32].

Cited by 70 publications

References 34 publications

Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence

Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence

Electronic clinical decision support system (eCDSS) in the management of asthma: from theory to practice

Diagnostic and other challenges

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