ORCID Profile
0000-0002-8508-6602
Current Organisations
Deakin University
,
University of Melbourne
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Publisher: BMJ
Date: 02-2021
DOI: 10.1136/BMJOPEN-2020-040528
Abstract: Asthma affects millions of children worldwide—1.1 million children in the UK. Asthma symptoms cannot be cured but can be controlled with low-dose inhaled corticosteroids (ICSs) in the majority of in iduals. Treatment with a low-dose ICS, however, fails to control asthma symptoms in around 10%–15% of children and this places the in idual at increased risk for an asthma attack. At present, there is no clear preferred treatment option for a child whose asthma is not controlled by low-dose ICS and international guidelines currently recommend at least three treatment options. Herein, we propose a systematic review and in idual participant data network meta-analysis (IPD-NMA) aiming to synthesise all available published and unpublished evidence from randomised controlled trials (RCTs) to establish the clinical effectiveness of pharmacological treatments in children and adolescents with uncontrolled asthma on ICS and help to make evidence-informed treatment choices. This will be used to parameterise a Markov-based economic model to assess the cost-effectiveness of alternative treatment options in order to inform decisions in the context of drug formularies and clinical guidelines. We will search in MEDLINE, the Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, NICE Technology Appraisals and the National Institute for Health Research (NIHR) Health Technology Assessment series for RCTs of interventions in patients with uncontrolled asthma on ICS. All studies where children and adolescents were eligible for inclusion will be considered, and authors or sponsors will be contacted to request IPD on patients aged . The reference lists of existing clinical guidelines, along with included studies and relevant reviews, will be checked to identify further relevant studies. Unpublished studies will be located by searching across a range of clinical trial registries, including internal trial registers for pharmaceutical companies. All studies will be appraised for inclusion against predefined inclusion and exclusion criteria by two independent reviewers with disagreements resolved through discussion with a third reviewer. We will perform an IPD-NMA—eventually supplemented with aggregate data for the RCTs without IPD—to establish both the probability that a treatment is best and the probability that a particular treatment is most likely to be effective for a specific profile of the patient. The IPD-NMA will be performed for each outcome variable within a Bayesian framework, using the WinBUGS software. Also, potential patient-level characteristics that may modify treatment effects will be explored, which represents one of the strengths of this study. The Committee on Research Ethics, University of Liverpool, has confirmed that ethics review is not required. The dissemination plan consists of publishing the results in an open-access medical journal, a plain-language summary available for parents and children, dissemination via local, national and international meetings and conferences and the press offices of our Higher Education Institutions (HEIs). A synopsis of results will be disseminated to NICE and British Thoracic Society/Scottish Intercollegiate Guidelines Network (SIGN) as highly relevant to future clinical guideline updates. CRD42019127599.
Publisher: Informa UK Limited
Date: 03-04-2014
Publisher: Informa UK Limited
Date: 08-10-2019
Publisher: Informa UK Limited
Date: 02-11-2014
Publisher: Informa UK Limited
Date: 02-2006
Publisher: Routledge
Date: 03-11-2022
Publisher: Informa UK Limited
Date: 11-12-2013
Publisher: Informa UK Limited
Date: 09-2008
Publisher: Informa UK Limited
Date: 09-2010
Publisher: Elsevier BV
Date: 11-2011
Publisher: SAGE Publications Ltd
Date: 2014
Publisher: Informa UK Limited
Date: 03-2011
Publisher: SAGE Publications Ltd
Date: 2008
Publisher: SAGE Publications Ltd
Date: 2008
Publisher: Edinburgh University Press
Date: 12-2019
No related grants have been discovered for Gilbert Caluya.