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Updated: Jul 28, 2025

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Using Randomized Controlled Trials to Estimate the Effect of Community Interventions for Childhood Asthma

W Dana Flanders1, Tursynbek A Nurmagambetov2, Cheryl R Cornwell2,3

  • 1Rollins School of Public Health, Emory University, Atlanta, Georgia.

Preventing Chronic Disease
|June 1, 2023
PubMed

Insights

A new method uses randomized control trials (RCTs) to estimate how expanding asthma interventions can reduce adverse asthma events (AAEs). This approach helps predict the impact of asthma programs on emergency visits and hospitalizations.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Asthma is a major public health concern, leading to numerous emergency department (ED) visits and hospitalizations in children.
  • The Centers for Disease Control and Prevention's initiative aims to significantly reduce these events through evidence-based interventions.
  • Accurate methods are needed to estimate the impact of planned and existing asthma programs.

Purpose of the Study:

  • To develop and illustrate a method for calculating the anticipated effects of asthma interventions on adverse asthma events (AAEs).
  • To estimate changes in AAE rates resulting from expanded access to asthma interventions using data from randomized control trials (RCTs).

Main Methods:

  • Utilized counterfactual arguments to derive a formula for estimating the number of AAEs prevented by an intervention.
  • The formula incorporates the current AAE rate, the increase in intervention access, and the rate ratio from RCTs.
  • Applied the method to estimate the impact of asthma self-management education on ED visits and hospitalizations.

Main Results:

  • Demonstrated a formula for estimating the effect of expanding access to asthma interventions.
  • An example showed that offering asthma self-management education to 20% of patients could decrease annual ED visits by an estimated 1,643 and hospitalizations from 2,639 to 617.

Conclusions:

  • The proposed method effectively estimates the community-level impact of expanding asthma interventions.
  • This approach leverages robust evidence from RCTs to predict reductions in AAEs, informing public health strategies for asthma control.
Abstract

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