An ‘Automated’ Treatment Algorithm to Guide Asthma Care

Published May 2019 | Journal of Allergy and Clinical Immunology

A novel, computerized treatment algorithm makes it easier for doctors to provide evidence-based care to young patients with asthma. More importantly, it can also lead to better asthma control, even in high-risk groups.

Study investigators used national guidelines to design the treatment algorithm. Then, they collaborated with computer programmers to create software that “operationalized” the algorithm.

But how would the software program—called ACET (Asthma Control Evaluation and Treatment)—fare when applied to patient care? To find out, researchers utilized ACET in three multicenter randomized controlled trials of young patients with persistent, uncontrolled asthma who lived in urban areas. Each trial had unique aims and outcomes, but all investigators used ACET to assess participants’ asthma control and adjust treatment regimens over time, says Carolyn Kercsmar, MD, co-principal investigator of the study and director of the Asthma Center.

With careful adherence to ACET recommendations, 50% to 70% of participants gained asthma control within three to five weeks. More than half of participants maintained asthma control throughout the trial. The project was led by the Inner-City Asthma Consortium, which is funded by the National Institutes of Health.

“These results demonstrate that if you provide patients with guideline-based treatment, most will get better and stay controlled,” says Kercsmar. “The key is getting them the right care. Even when evidence-based treatment guidelines exist, applying those guidelines can be difficult. ACET is a practical tool that makes it easier.”

The next step is to disseminate the ACET tool among other clinicians and researchers. It may also be possible to integrate the software into electronic medical record systems, Kercsmar says.

A graphic depicting ACET program results.

Click image to learn more.

A photo of Carolyn Kercsmar, MD.

Carolyn Kercsmar, MD

Citation

Kercsmar CM, Sorkness CA, Calatroni A, Gergen PJ, Bloomberg GR, Gruchalla RS, Kattan M, Liu AH, O’Connor GT, Pongracic JA, Szefler SJ, Teach SJ, Wildfire JJ, Wood RA, Zoratti EM, Busse WW, National Institute of A, Infectious Diseases-sponsored Inner-City Asthma Consortium. A computerized decision support tool to implement asthma guidelines for children and adolescents. J Allergy Clin Immunol. 2019 May;143(5):1760-1768.