The Merck Childhood Asthma Network (MCAN) commissioned the RAND Corporation to conduct a meta-analysis of the gap between recommended and actual asthma care for children in the United States, and what it would cost to close it.
Variability in how asthma severity, outcomes, utilization, and other measures were classified made the gap analysis impossible. However, RAND verified substantial disparities in quality of asthma care for children and the fact that disadvantaged populations appeared to receive lower quality care. The findings also suggested the need for evaluating the economic impact of these gaps and the need for research using standard definitions and outcomes to allow comparison across studies.
RAND presented “Estimating the Impact of Improving Asthma Treatment: A Review and Synthesis of the Literature” at the State of Childhood Asthma and Future Directions Conference which precipitated a priority recommendation for the NIH to standardize asthma outcome definitions and research measures. MCAN successfully encouraged the NIH to explore this recommendation and, as a result, the National Institutes of Health (NIH) convened the Asthma Outcomes Workshop in 2010.
NIH Asthma Outcomes Workshop
The workshop was co-chaired by the National Heart, Lung, and Blood Institute and the National Institute of Allergy and Infectious Diseases. Other workshop sponsors and planning committee members included MCAN, the National Center for Minority Health and Health Disparities, the National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, the Agency for Healthcare Research and Quality, and the Robert Wood Johnson Foundation.
The final recommendations of the workshop participants and committees were published as a supplement to the March, 2012 issue of the Journal of Allergy and Clinical Immunology, and have been required outcome measures in government agency-initiated asthma clinical research programs, including clinical trials, observational/cross-sectional studies, and genetic studies.