Final Research Report

View this project's final research report.

Evidence for Decisions

Choosing the Best Option for Managing Mild Persistent Asthma in Children
Asthma is a common chronic illness among children in the US, with disproportionate impact among racial and ethnic minorities. This study, which looked at two different approaches to managing mild persistent asthma in children and teens, adds to evidence that symptom-based adjustment of medication works as well as provider-based adjustment for treating children and teens with mild persistent asthma. The study's findings can also help you work with your doctor to choose the best option for managing your child's mild persistent asthma.

Journal Citations

Article Highlight: Results from this study support existing evidence that children with mild asthma can self-manage their condition by using medications when their symptoms occur. This contrasts with the traditional method of taking a medication daily, regardless of symptoms, and using an inhaler when symptoms arise. As reported in The Journal of Allergy and Clinical Immunology, this study focused exclusively on African-American children, who have traditionally been underserved in research and have had worse asthma-related health outcomes than other children.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:

  • The reviewers asked why the study focused on mild or mild-to-moderate asthma only and asked for clarification on whether the population included only children with mild asthma, or those with mild-to-moderate asthma. The researchers explained that the qualitative portion of the study included participants with mild-to-moderate asthma, but the main quantitative study included only children with mild asthma. The researchers focused on this population because the existing evidence supporting symptom-based adjustment of treatment is in patients with mild asthma only.
  • The reviewers noted that the patient and caregiver input section was very important to understanding and justifying the study, and recommended the researchers organize the qualitative themes and comments into tabular form. The reviewers asked the researchers to indicate the frequency of different themes. The researchers explained that the goal of the qualitative interviews, which provided the input in the section the reviewers identified, was meant to obtain broad perspectives. The qualitative analyses did not measure the frequency of different types of comments. The researchers stated they would not be able to quantify the frequency of themes as requested.
  • The reviewers noted that the researchers measured the primary outcome, change in asthma control, using one of two different tests: the asthma control test (ACT) and the childhood ACT (cACT). The reviewers asked for more justification for combining the data of these two questionnaires into a single primary outcome measure. The researchers explained that the two measures differed by respondent age group, so they transformed scores into a single, normally distributed outcome measure. This approach provided more power to find an effect of the intervention because it uses a single measure that would be more interpretable for the community.
  • The reviewers asked for greater clarity on how the researchers recruited stakeholders. The researchers explained that they asked for referrals from a wide range of people, including patients and community members, for people who are interested in childhood asthma. The researchers explained the role and time commitment to those referred to them. The researchers added that the study did not have specific inclusion criteria for advisory board members and revised the report to describe the recruitment process better.

Conflict of Interest Disclosures

Project Information

Kaharu Sumino, MD, MPH
Washington University in St. Louis
Preference and Effectiveness of Symptom-Based Adjustment of Inhaled Corticosteroid Therapy in African American Children

Key Dates

December 2013
December 2019

Study Registration Information


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Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
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Last updated: May 18, 2022