Section 4. What the guidelines have missed a general discussion of the faculty Highlights of the asthma summit 2009 beyond the guidelines 英文参考文献.docVIP

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Section 4. What the guidelines have missed a general discussion of the faculty Highlights of the asthma summit 2009 beyond the guidelines 英文参考文献.doc

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Section 4. What the guidelines have missed a general discussion of the faculty Highlights of the asthma summit 2009 beyond the guidelines 英文参考文献

CONFERENCEPROCEEDINGS Section4.WhattheGuidelinesHaveMissed:AGeneral DiscussionoftheFaculty HighlightsoftheAsthmaSummit2009:BeyondtheGuidelines JudithR.Farrar,PhD,andMichaelA.Kaliner,MD then patterns of responses, we’ll have a far more educated Abstract: The sessions during the 2 days of the Asthma Summit guessastothebesttherapeuticapproach.We’renotyetready forgenotyping,whichisafarmoreadvancedapproachthat maybeavailabledowntheroad. Dr.Luskin:Ithinkweneedtotakethatwithcaution focusedlargelyonsomespeci?caspectsofthecurrentEuropeanand U.S. guidelines for managing asthma. By way of summary, the facultyaddressedthequestionofwhattheythoughttheguidelines missed, starting with consideration of those aspects of their own becausepersonalizedmedicinedependsuponwho’spractic- practicemanagementthattheybelievedarenotclearlydiscussedin ingit.OneofthereasonstheGuidelinesCommitteewasset currentguidelines. upinthe?rstplacein1989wasbecausetherewassomuch KeyWords:asthma,guidelines,ExpertPanelReport3,GINA, AsthmaSummit variabilityofpractice,andthevariabilitywasassociatedwith pooroutcomesandhighcost.SowhileI,likeanyoneofyou in this room, would like to be practicing personalized, pa- tient-centeredmedicine,I’mnotsurethatIcansaythesame forthosetakingcareofthemajorityof“standardasthmatics” inthiscountry. (WAOJournal2010;3:38–41) Dr.Hargreave:Asyousay,itisaquestionofwhois doing the treating. But, as specialists, we need to be above this. Why are we specialists if we can’t do this better than everybodyelse?So,intermsoffutureguidelines,Ithinkit mightbeadvantageoustohavesomeseparationbetweenthe specialties. Dr. Busse: The National Asthma Education and Pre- vention Program (NAEPP) tried to tactfully address this in theguidelinesintermsofthecriteriaforreferraltoanasthma specialist. But as discussed these past 2 days, despite these guidelines,controlisnotachievedinthemajorityofasthma patients, particularly those with more severe disease. Any- thingwecandotoimproveitisagoodidea. ASTHMASUMMIT2009: