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[External assessment of the GEMA2009 recommendations by a multidisciplinary expert panel on asthma]
Fernando Caballero Martínez1, Vicente Plaza, Santiago Quirce Gancedo
1Unidad de Formación e Investigación, Area 6 Servicio Madrileño Salud, Madrid, España.
Insights
Spanish asthma experts showed high agreement (96.5%) with GEMA 2009 guidelines. Disagreements on three recommendations highlight areas needing more research due to limited evidence.
Area of Science:
- Pulmonology
- Allergy and Immunology
- General Practice
- Otorhinolaryngology
- Pediatrics
Background:
- Clinical practice guidelines are essential for evidence-based asthma management.
- The GEMA 2009 guidelines represent a key resource for asthma care in Spain.
- Assessing expert consensus is crucial for validating and refining clinical recommendations.
Purpose of the Study:
- To evaluate the level of agreement among Spanish healthcare professionals on the GEMA 2009 clinical recommendations for asthma.
- To identify specific recommendations that may require further evidence or discussion.
Main Methods:
- A scientific committee selected GEMA recommendations for survey.
- A Delphi survey was conducted in two rounds with 74 expert panelists (pulmonologists, allergists, pediatricians, etc.).
- Results were analyzed and discussed by the scientific committee.
Main Results:
- Consensus was achieved on 49 out of 56 questions in the first round.
- After panel discussion, consensus increased to 53 items.
- Insufficient consensus was noted for three recommendations, attributed to sub-specialist disagreements or lack of expert criteria.
Conclusions:
- A high level of professional agreement (96.5%) was observed for the GEMA 2009 asthma recommendations among Spanish experts.
- The identified areas of disagreement point to a need for further research, particularly where high-level evidence is lacking.
- These findings provide valuable insights for future revisions of asthma guidelines and research priorities.
Objectives:
To assess the level of agreement on the GEMA 2009 clinical recommendations by a Spanish expert panel on asthma.
Materials And Methods:
The study was divided into four stages: 1) establishment of a 9 member scientific committee (GEMA authors) for selection of GEMA recommendations to use in the survey; 2) formation of a panel of 74 professionals with expertise in this field (pulmonologists, allergists, family doctors, ear, nose and throat and paediatric specialists); 3) Delphi survey in two rounds, sent by mail, with intermediate processing of opinions and a report to the panel members; and 4) analysis and discussion of results for the Scientific Committee.
Results:
Seventy four participants completed the two rounds of survey. During the first round, a consensus was reached in 49 out of 56 questions analysed. Following discussion by the panel, the consensus was increased to a total of 53 items in the survey. With respect to the remaining questions, Insufficient consensus was obtained on the rest of the questions, due to differing views between sub-specialists, or lack of criteria by most of the experts.
Conclusions:
The external analysis by asthma experts from different specialities showed a high level of professional agreement with the GEMA 2009 recommendations in Spain (96.5%). The disagreement shown in three recommendations reflect the lack of a high level evidence. These issues represent areas of interest for future research.
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