A computerized decision support tool to implement asthma guidelines for children and adolescents.

Area of Science:

• Pediatric pulmonology
• Clinical trial methodology
• Health informatics

Background:

• Multicenter randomized controlled trials (RCTs) for asthma management require standardized evidence-based guideline application.
• Current usual-care regimens in RCTs can benefit from improved standardization.

Purpose of the Study:

• To evaluate the Asthma Control Evaluation and Treatment (ACET) Program, a computerized decision support tool.
• To assess the ACET Program's ability to standardize usual-care regimens in asthma management RCTs.

Main Methods:

• Three multicenter RCTs involving children and adolescents with persistent uncontrolled asthma were conducted (2004-2014).
• The ACET Program computerized tool assessed asthma control and assigned treatment steps based on guidelines.
• Control determinants were collected and entered into the ACET Program to track changes.

Main Results:

• Over half of participants had uncontrolled asthma at screening.
• Significant improvement in asthma control was observed between screening and randomization.
• Good asthma control was achieved and maintained by a majority of participants throughout the trials.

Conclusions:

• The ACET Program facilitated standardized asthma assessment and treatment in multicenter RCTs.
• The tool was associated with achieving and maintaining good asthma control in most participants.
• Computerized decision support can enhance the consistency of asthma management within clinical trials.