原创力文档a systematic review with attempted network meta-analysis of asthma therapy recommended for five to eighteen year olds in gina steps three and four系统回顾与尝试网络荟萃分析哮喘治疗推荐5到18岁的吉娜步骤3和4.pdfVIP
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a systematic review with attempted network meta-analysis of asthma therapy recommended for five to eighteen year olds in gina steps three and four系统回顾与尝试网络荟萃分析哮喘治疗推荐5到18岁的吉娜步骤3和4
van der Mark et al. BMC Pulmonary Medicine 2012, 12:63
/1471-2466/12/63
RESEARCH ARTICLE Open Access
A systematic review with attempted network
meta-analysis of asthma therapy recommended
for five to eighteen year olds in GINA steps three
and four
1* 1 2 1 3
Lonneke B van der Mark , PH Edo Lyklema , Ronald B Geskus , Jacob Mohrs , Patrick JE Bindels ,
Wim MC van Aalderen4 and Gerben ter Riet1
Abstract
Background: The recommendations for the treatment of moderate persistent asthma in the Global Initiative for
Asthma (GINA) guidelines for paediatric asthma are mainly based on scientific evidence extrapolated from studies in
adults or on consensus. Furthermore, clinical decision-making would benefit from formal ranking of treatments in
terms of effectiveness.
Our objective is to assess all randomized trial-based evidence specifically pertaining to 5-18 year olds with
moderate persistent asthma. Rank the different drug treatments of GINA guideline steps 34 in terms of
effectiveness.
Methods: Systematic review with network meta-analysis. After a comprehensive search in Central, Medline, Embase,
CINAHL and the WHO search portal two reviewers selected RCTs performed in 4,129 children from 5-18 year old,
with moderate persistent asthma comparing any GINA step 34 medication options. Further quality was assessed
according the Cochrane Collaboration’s tool and data-extracted included papers and built a network of the trials.
Attempt at ranking treatments with formal statistical methods employing direct and indirect (e.g. through placebo)
connections between all treatments.
Results: 8,175 references were screened; 23 randomized trials (RCT), comparing head-to-head (n=17) or against
placebo (n=10), met th
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