[Importance of the integrated evaluation of the child with asthma]

When evaluating the effects of the practical application of a therapeutic strategy, the results of the controlled and random clinical tests with the above mentioned treatment, as they are important, do not constitute the only factor to be considered. Especially as frequently the clinical tests only take into account the efficiency of the treatment, without considering other essential aspects such as safety, performance and cost. The combination of these factors results in the PRACTICAL efficiency of the treatment, that often differs considerably from the results obtained in clinical tests. Therefore, the clinical tests do not precisely reflect the conditions that exist when a treatment is applied in real life and thus, the evaluation of the practical efficiency of the said treatment is essential if you want to know what the real repercussion that the treatment has on a specific problem, such as asthma, represents. And this is important as, in spite of the notable advances over the last few years in the treatment of this illness, the objectives that the GINA propose in order to consider the control of asthma as sufficient, are a long way from being achieved, as the results of the AIRE study that was carried out in 7 European countries illustrate. On the other hand, the valuation of the efficiency of a treatment is a problem that is worth discussing. As, due to operational and precision reasons, of then the clinical tests consider one or a few variables as objectively as possible (for example, the lung function) when valuing the efficiency of a treatment. However, on many occasions it is possible to appreciate notable discrepancies between these objective variables and the patient's symptoms, the subjective appreciation of how the asthma is affecting them, etc. Therefore, it is necessary to take into account the fact that an integral valuation of the repercusion that asthma has on the patients, their families and their environment, and how a specific treatment changes the situation on these levels, and obligues us to consider in an integral manner, a series of medical (clinical, functional and biological), humanistic (quality of life, patients satisfaction) and economic variables.