Asthma Management Handbook

Setting the clinical scope

Formulating clinical questions

The Guidelines Committee agreed on a comprehensive list of over 350 clinical questions, based on the content of the Asthma Management Handbook 2006, the advice of the expert reviewers and the user survey results.

Each working group confirmed the scope of their section at the initial contributor workshop held in August 2011 and subsequent teleconferences. For each topic area, the working group reviewed and refined the clinical questions. The agreed list of clinical questions formed the scope of the Handbook.

Selecting clinical questions for systematic review

The Guideline committee selected clinical questions for systematic review, which fulfilled the following criteria:

  • relevant to primary care (i.e. a topic on which primary care health professionals or patients need guidance, based on the experience of Guidelines Committee members)
  • likely to influence practice
  • likely to improve outcomes for people with asthma (e.g. improve clinical outcomes or provide patients with more reliable advice on their choices).

Assigning status to remaining clinical questions

Each working group assigned a status for each of the clinical questions within their section, according to one of the following categories:

  • high-priority questions for limited (non-systematic) structured literature searches
  • questions for which sufficient evidence has already been identified
  • other.

Table. Categories applied to non-systematic review clinical questions by working groups

Category Considerations Action Output
High-priority Questions for which a structured literature search warranted due to clinical relevance and genuine uncertainty on interpretation of current evidence Researcher (medical writer or volunteer working group member) conducts structured literature search and provides evidence report (search strategy, evidence table) Recommendations based on selected evidence
Sufficient existing evidence Clinical questions for which reliable evidence-based guidance exists (e.g. Cochrane reviews, other recent reviews internationally recognised clinical practice guidelines, systematic reviews undertaken by other guideline groups), and for which additional literature searches are unlikely to influence the working group’s guidance Medical writer prepares summary of sources identified by working group Recommendations adapted from existing guidance
or
Recommendations based on selected evidence
Other Questions for which a formal literature search is unlikely to affect guidance and on which it is appropriate to base guidance on subjective opinion Working group develops consensus recommendations based on clinical experience and identified evidence Consensus recommendations

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