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Variability of outcome measures in trials of intravenous therapy in acute severe paediatric asthma: a systematic review
  1. Charmaine S Gray1,
  2. Colin V E Powell2,3,4,
  3. Franz E Babl5,6,7,
  4. Stuart R Dalziel8,
  5. Simon Craig9,10
  6. on behalf of the PREDICT (Paediatric Research In Emergency Departments International Collaborative) Research Network
  1. 1 Emergency Department, Women’s and Children’s Hospital, University of Adelaide, North Adelaide, South Australia, Australia
  2. 2 Emergency Department, Sidra Medical and Research Center, Doha, Qatar
  3. 3 Emergency Department, Weill Cornell University, Doha, Qatar
  4. 4 School of Medicine, Cardiff University, Cardiff, UK
  5. 5 Emergency Department, Royal Children’s Hospital, Melbourne, Victoria, Australia
  6. 6 Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  7. 7 University of Melbourne, Melbourne, Victoria, Australia
  8. 8 Children’s Emergency Department, Starship Children’s Hospital, Auckland, New Zealand
  9. 9 Monash Emergency Research Collaborative, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  10. 10 Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  1. Correspondence to Dr Charmaine S Gray, Emergency Department, Women and Children’s Hospital, North Adelaide, SA 5006, Australia; charmaine.gray2{at}


Objective To determine the variability of primary and secondary outcomes used in trials of intravenous bronchodilators in children with acute severe paediatric asthma.

Methods Systematic search of MEDLINE, EMBASE, Cochrane CENTRAL and the WHO International Clinical Trials Registry Platform for randomised trials in children (less than18 years) with acute severe paediatric asthma comparing intravenous bronchodilator therapy to another treatment. Initial search was performed on 7 January 2016 with an updated search performed on 6 September 2018. Primary and secondary outcomes were collated.

Results We identified 35 published papers and four registered study protocols. 56 primary outcomes were found, the most common being a clinical asthma score (23/56; 41%). Other identified primary outcomes included bedside tests of respiratory function (11/56; 20%) and measures of length of stay (9/56; 16%). There were a total of 60 different secondary outcomes, the most common were various length of stay measures (24/60; 40%) and adverse events (11/60; 18%).

Conclusion Studies comparing intravenous treatment modalities for children with acute severe paediatric asthma exhibit great variation in the type, number and timing of outcome measures used. There are no patient or family-specific outcomes reported. There is a need to develop international consensus.

Trial registration number CRD42017055331.

  • paediatric emergency med
  • respiratory, asthma

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  • Contributors The literature search, data collection, analysis and writing of the paper were performed by CSG and SC. Comments and editing were performed by coauthors FEB, SRD and CVEP.

  • Funding FEB has been supported by a practitioner fellowship grant from the National Health and Medical Research Foundation, Canberra, Australia, and the Melbourne Children’s Campus Clinician Scientist Fellowship, Parkville, Australia. SRD’s time was part funded by the Health Research Council of New Zealand (HRC13/556). This research was supported by a National Health and Medical Research Council Centre of Research Excellence grant for paediatric emergency medicine (GNT1058560).

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no additional unpublished data.