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- Patient‐centered digital biomarkers for allergic respiratory diseases and asthma: The ARIA‐EAACI approach – ARIA‐EAACI Task Force ReportPublication . Bousquet, Jean; Shamji, Mohamed; Anto, Josep M.; Schünemann, Holger; Canonica, Giorgio Walter; Jutel, Marek; Del Giacco, Stafano; Zuberbier, Torsten; Pfaar, Oliver; Fonseca, Joao A; Pinto, Bernardo Sousa; Pétré, Benoit; Pham‐Thi, Nhân; Puggioni, Francesca; Quirce, Santiago; Roche, Nicolas; Rouadi, Philip; Sousa, Ana Sá; Sagara, Hironori; Sastre, Joaquin; Scichilone, Nicola; Sheikh, Aziz; Sova, Milan; Ulrik, Charlotte Suppli; Taborda Barata, Luis; Todo-Bom, Ana; Torres, María Jose; Tsiligianni, Ioanna; Usmani, Omar; Valovirta, Erkka; Vasankari, Tuula; Vieira, Rafael José; Wallace, Dana; Waserman, Susan; Zidarn, Mihaela; Yorgancıoglu, Arzu; Zhang, Luo; Chivato, Tomás; Ollert, Markus; Klimek, Ludger; Czarlewski, Wienczyslawa; Bedbrook, Anna; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Bosnic-Anticevich, Sinthia; Braido, Fulvio; Loureiro, Cláudia Chaves; Gemicioglu, Bilun; Haahtela, Tari; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Matricardi, Paolo Maria; Regateiro, Frederico S.; Samoliński, Bolesław; Sofiev, Mikhail; Toppila-Salmi, Sanna; Valiulis, Arunas; Ventura, Maria Teresa; Bárbara, Cristina; Bergmann, Karl-Christian; Bewick, Michael; Blain, Hubert; Bonini, Matteo; Boulet, Louis-Philippe; Bourret, Rodolphe; Brusselle, Guy; Brussino, Luisa; Buhl, Roland; Cardona, Victoria; Casale, Thomas; Cecchi, Lorenzo; Charpin, Denis; Cherrez Ojeda, Ivan; Chu, Derek K; Cing, Cemal; Costa, Elísio; Cruz, Álvaro A.; Devillier, Philippe; Dramburg, Stephanie; Fokkens, Wytske; Gotua, Maia; Heffler, Enrico; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Joos, Guy; Kaidashev, Igor; Kraxner, Helga; Kvedarienė, Violeta; Larenas Linnemann, Désirée; Laune, Daniel; Lourenço, Olga; Louis, Renaud; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Erik; Micheli, Yann; Almeida, Mário Morais; Mullol, Joaquim; Niedoszytko, Marek; O'Hehir, Robyn; Okamoto, Yoshitaka; Olze, Heidi; Papadopoulos, Nikolaos G.; Papi, Alberto; Patella, VincenzoBiomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/ or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the center of the health system and is likely to optimize the practice of allergy. Allergic Rhinitis and its Impact on Asthma (ARIA) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomized controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, was embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of- life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed.
- Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessmentPublication . Cachim, Afonso; Pereira, Ana Margarida; Almeida, Rute; Amaral, Rita; Correia, Magna Alves; Marques, Pedro Vieira; Loureiro, Cláudia Chaves; Ribeiro, Carmelita; Cardia, Francisca; Gomes, Joana; Vidal, Carmen; Silva, Eurico; Rocha, Sara; Rocha, Diana; Marques, Maria Luís; Páscoa, Rosália; Morais, Daniela; Cruz, Ana Margarida; Santalha, Marta; Simões, José Augusto Rodrigues; Silva, Sofia da; Silva, Diana; Gerardo, Rita; Bom, Filipa Todo; Morete, Ana; Vieira, Inês; Vieira, Pedro; Monteiro, Rosário; Raimundo, Rosário; Monteiro, Luís; Neves, Ângela; Santos, Carlos; Penas, Ana Margarida; Regadas, Rita; Marques, José Varanda; Rosendo, Inês; Aguiar, Margarida Abreu; Fernandes, Sara; Cardoso, Carlos Seiça; Pimenta, F.; Meireles, Patrícia; Gonçalves, Mariana; Fonseca, Joao A; Jácome, CristinaBackground Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
- Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence–Assisted ARIA Care Pathways (ARIA 2024)Publication . Bousquet, Jean; Schünemann, Holger; Sousa-Pinto, Bernardo; Zuberbier, Torsten; Togias, Alkis; Samoliński, Bolesław; Bedbrook, Anna; Czarlewski, Wienczyslawa; Hofmann-Apitius, Martin; Litynska, Justyna; Vieira, Rafael José; Giuliano, Antonio F.M.; Gotua, Maia; Gradauskiene, Brigita; Guzman, Maria Antonieta; Hossny, Elham; Hrubiško, Martin; Iinuma, Tomohisa; Irani, Carla; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Anto, Josep M.; Jartti, Tuomas; Jesenak, Milos; Julge, Kaja; Jutel, Marek; Kaidashev, Igor; Bennoor, Kazi Saifuddin; Khaltaev, Nicolai; Kirenga, Bruce; Kraxner, Helga; Kull, Inger; Fonseca, Joao A; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Kurchenko, Andriy; La Grutta, Stefania; Lane, Stephen; Miculinic, Neven; Lee, Sang Min; Le Thi Tuyet, Lan; Lkhagvaa, Battur; Brozek, Jan; Louis, Renaud; Mahboub, Bassam; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Eric; Milenkovic, Branislava; Mohammad, Yousser; Moniuszko, Marcin; Montefort, Stephen; Bognanni, Antonio; Moreira, Andre; Moreno, Pablo; Mullol, Joaquim; Nadif, Rachel; Nakonechna, Alla; Navarro-Locsin, Cecilia Gretchen; Neffen, Hugo; Nekam, Kristof; Niedoszytko, Marek; Nunes, Elizabete; Brussino, Luisa; Nyembue Tshipukane, Dieudonne; O’Hehir, Robyn; Ollert, Markus; Ohta, Ken; Okamoto, Yoshitaka; Okubo, Kimihiro; Olze, Heidi; Padukudru, Mahesh Anand; Palomares, Oscar; Pali-Schöll, Isabella; Canonica, Giorgio Walter; Panzner, Petr; Palosuo, Kati; Park, Hae-Sim; Passalacqua, Giovanni; Patella, Vincenzo; Pawankar, Ruby; Pétré, Benoît; Pitsios, Constantinos; Plavec, Davor; Popov, Todor A.; Cherrez Ojeda, Ivan; Puggioni, Francesca; Quirce, Santiago; Raciborski, Filip; Ramonaité, Agné; Recto, Marysia; Repka- Ramirez, María Susana; Roberts, Graham; Robles-Velasco, Karla; Roche, Nicolas; Rodriguez-Gonzalez, Monica; Cruz, Alvaro; Romualdez, Joel A.; Rottem, Menachem; Rouadi, Philip; Salapatas, Marianella; Sastre, Joaquin; Serpa, Faradiba; Sayah, Zineb; Scichilone, Nicola; Senna, Gianenrico; Sisul, Juan; Vecillas, Leticia De Las; Solé, Dirceu; Soto-Martinez, Manuel E.; Sova, Milan; Sozinova, Olga; Stevanovic, Katarina; Suppli Ulrik, Charlotte; Szylling, Anna; Tan, Frances M.; Tantilipikorn, Pongsakorn; Bom, Ana Todo; Dykewicz, Mark; Tomic Spiric, Vesna; Tsaryk, Vladyslav; Tsiligianni, Ioanna; Urrutia-Pereira, Marilyn; Valentin Rostan, Marylin; Sofiev, Mikhail; Valovirta, Erkka; Van Eerd, Michiel; Van Ganse, Eric; Vasankari, Tuula; Gemicioglu, Bilun; Vichyanond, Pakit; Viegi, Giovanni; Wallace, Dana; Wang, De Yun; Waserman, Susan; Wong, Gary; Worm, Margitta; Yusuf, Osman; Zaitoun, Fares; Zidarn, Mihaela; Giovannini, Mattia; Haahtela, Tari; Jacobs, Marc; Jacomelli, Cristina; Klimek, Ludger; Kvedarienė, Violeta; Linnemann, Désirée Larenas; Louis, Gilles; Lourenço, Olga; Leemann, Lucas; Almeida, Mario Morais; Neves, Ana Luisa; Nadeau, Kari; Nowak, Artur; Palamarchuk, Yuliia; Palkonen, Susanna; Papadopoulos, Nikolaos G.; Parmelli, Elena; Pereira, Ana Margarida; Pfaar, Oliver; Regateiro, Frederico S.; Savouré, Marine; Barata, Luís Taborda; Toppila-Salmi, Sanna Katriina; Torres, María Jose; Valiulis, Arunas; Ventura, Maria Teresa; Williams, Siân; Yepes-Nuñez, Juan J.; Yorgancıoglu, Arzu; Zhang, Luo; Zuberbier, Jaron; Abdul Latiff, Amir; Abdullah, Baharudin; Agache, Ioana; Al-Ahmad, Mona; Al-Nesf, Maryam A Y; Al Shaikh, A.; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Asllani, Julijana; Balotro-Torres, Maria Cristina; Bergmann, Karl-Christian; Bernstein, Jonathan; Bindslev-Jensen, Carsten; Blaiss, Michael S.; Bonaglia, Cristina; Bonini, Matteo; Bossé, Isabelle; Braido, Fulvio; Caballero-Fonseca, Fernan; Camargos, Paulo; Martins, Pedro Carreiro; Casale, Thomas; Castillo-Vizuete, José-Antonio; Cecchi, Lorenzo; Teixeira, Maria Do Céu; Chang, Yoon-Seok; Loureiro, Cláudia Chaves; Christoff, George; Ciprandi, Giorgio; Cirule, Ieva; Sousa, Jaime Correia De; Costa, Elísio; Cvetkovski, Biljana; De Vries, Govert; Del Giacco, Stefano; Devillier, Philippe; Dokic, Dejan; Douagui, Habib; Durham, Stephen; Enecilla, Maria Lourdes; Fiocchi, Alessandro; Fokkens, Wytske; Fontaine, Jean-François; Gawlik, Radoslaw; Gereda, Jose E.; Mata, Sara GilAbstract The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care.1 It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable.