Effect of high-efficiency particulate air filter on children with asthma: a systematic review protocol of RCTs
Javeria Mansoor1, Muhammad Zia Ul Haq2, Zeeshan Ahsan2
1Community Health Sciences, The Aga Khan University, Karachi, Pakistan javeriaresearcher@gmail.com.
Insights
High-efficiency particulate air (HEPA) filters may help manage childhood asthma by reducing symptoms and hospital visits. This systematic review will assess their effectiveness in improving health outcomes and indoor air quality.
Area of Science:
- Environmental Health
- Pediatric Respiratory Medicine
- Public Health
Background:
- Asthma is a major non-communicable disease globally, with increasing prevalence in children due to worsening air quality.
- Management strategies are shifting towards non-pharmacological interventions, including air filtration.
- The effectiveness and usage guidelines for high-efficiency particulate air (HEPA) filters in asthma management require clarification.
Purpose of the Study:
- To systematically review the efficacy of HEPA filters in reducing asthma exacerbations and clinical visits in children.
- To evaluate the impact of HEPA filters on asthma symptoms, symptom-free days, and quality of life.
- To assess the effectiveness of HEPA filters in reducing indoor particulate matter (PM2.5) levels.
Main Methods:
- Systematic review of randomized controlled trials (2002-2025) from MEDLINE, Google Scholar, and Scopus.
- Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Independent study screening, quality assessment using Cochrane Risk of Bias Tool, and data synthesis in tables; potential for meta-analysis and subgroup analysis.
Main Results:
- Data synthesis will summarize outcomes related to clinical visits, exacerbations, symptoms, symptom-free days, and indoor PM2.5 levels.
- Quantitative analysis (forest plots) and subgroup analysis will be performed if study data permit.
- Publication bias will be assessed using funnel plots and Egger's test.
Conclusions:
- The review will provide evidence-based insights into the effectiveness of HEPA filters for pediatric asthma management.
- Findings will inform clinical practice and potentially guide the development of usage guidelines for HEPA filters.
- This research aims to clarify the role of HEPA filtration in improving health outcomes for children with asthma.
Introduction:
Asthma has been classified as a major non-communicable disease by the WHO. With the worsening air quality index worldwide, the burden of asthma has increased specifically in children. The focus of the management strategy of asthma has shifted from traditional pharmacological treatments towards non-pharmacological preventive and control therapy in recent decades. The use of high-efficiency particulate air (HEPA) filters is one of the methods to achieve that, despite extensive research, the efficacy of HEPA filters in this context of effectiveness and usage guidelines remains unclear. Our study aims to examine the effect of HEPA filters in (1) reducing clinical visits or hospital admissions or the number of exacerbation events, (2) reducing asthma symptoms, (3) increasing asthma symptom-free days, (4) reducing indoor particulate matter 2.5 levels for children with asthma aged 5-17 years and (5) improving quality of life.
Methods:
We will conduct a systematic review using MEDLINE, Google Scholar and Scopus as databases, article selection is planned to be restricted to randomised controlled trials only (2002-2025). We are following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines developed specifically for the protocol(s). Two reviewers will screen the studies independently and assess study quality using the Cochrane Risk of Bias Tool for Randomised Trials, V.2. The results of outcome measure(s) will be summarised in tables. If the studies are sufficient, we will also perform a quantitative analysis by creating forest plots and subgroup analysis will be performed if required. Lastly, publication bias will be assessed using a funnel plot and Egger's test and reported accordingly.
Ethics And Dissemination:
We will conduct a systematic review, therefore there is no need for a formal ethical review. After successful completion, our results will be published in a peer-reviewed journal.
Prospero Registration Number:
CR42024494949.
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