Table 1 PICOS criteria for the search strategy
Population | Children aged 5–12 years with doctor-diagnosed ‘active’ asthma (that is who have had a prescription for asthma treatment within the previous year), across all severities and degrees of control. We will include studies with a wider range of ages if results for children aged 5–12 years are reported separately or if >50% of the children are within this age range. |
Intervention (if applicable) | Any intervention that aims to reduce exacerbation risk, specifically excluding trials of pharmacological efficacy as robust reviews are in existence for these. Examples might include interventions to improve medication-related behaviour (adherence, inhaler technique), social or lifestyle adaptation, improve residential environment (reduce housing damp/mould, improve indoor air quality) and reduce stress in mothers and children). Observational studies (cohort, case–control and cross-sectional) without a specific intervention that seek to identify relevant risk factors will also be included. |
Control/comparator (if applicable) | Usual care. |
Outcomes | Our primary outcome is severe exacerbations of asthma defined according to the ATS/ERS Task Force: asthma symptoms and/or objective evidence of obstruction outside the normal variation for the patient necessitating (a) a short course (at least 3 days) of oral corticosteroids and/or (b) a hospitalisation or emergency department visit requiring systemic corticosteroids.5 |
Moderate exacerbations as defined by the ATS/ERS task force (asthma symptoms and/or airflow obstruction) outside the normal variation for the patient prompting a temporary change of treatment (excluding systemic steroids) to prevent a severe exacerbation.5 | |
Setting | Any setting |
Study designs | Randomised controlled trials, controlled clinical trials, interrupted time series, controlled before-and-after studies, cohort and case-controlled studies (but not case studies or case series). |
