The role of modeling studies in asthma management and clinical decision-making: a Delphi survey of physician knowledge and perceptions

Abstract

Objective

To investigate the knowledge and perceptions of physicians on the role of modeling studies in asthma, using a modified Delphi procedure.

Methods

Group opinions among a panel of respiratory experts were obtained using two online questionnaires and a virtual scientific workshop. A consensus was pre-defined as agreement by >75% of participants.

Results

From 26 experts who agreed to participate, 22 completed both surveys. At the end of the process, the panel rated their own understanding of modeling as good (77%) but that among physicians in general as poor (77%). Participants agreed that data from modeling studies should be used, at least sometimes, to inform treatment guidelines (91%) and could be useful for guiding clinical decisions (100%). Perceived barriers to using modeling studies were ‘A lack of understanding’ (81%) and ‘A lack of standardized methodology’ (82%). Based on data from two modeling studies, no consensus was reached on physicians recommending regular inhaled corticosteroids (ICS) versus as-needed therapy for patients with mild asthma, whereas 77% agreed that they would recommend regular ICS over maintenance and reliever therapy for ≥80% of their patients with moderate asthma. No consensus was reached on the value of modeling data in relation to empirical data.

Conclusion

There is overall support among respiratory experts for the usefulness of modeling data to guide asthma treatment guidelines and clinical decision making. More publications on modeling data using robust models and accessible terminology will aid the understanding of physicians in general and help clarify the evidence-based value of modeling studies.

Keywords:

• Asthma
• modified Delphi procedure
• guided asthma treatment
• modeling studies

Acknowledgements

The authors thank all participants who completed the surveys and contributed to discussions in the scientific workshop. Authors also thank Rachel Butcher and Rebecca Mills of Evoke Mind + Matter for their help in preparing and administering the surveys, and in analyzing and presenting the data. Editorial support was provided by Kate Hollingworth of Continuous Improvement Ltd and was funded by GSK.

Author contributions

Conceived and designed the study: Bhumika Aggarwal, Abhay Phansalkar, Terence Seemungal

Data acquisition and/or data interpretation

All authors

Data analyses

Bhumika Aggarwal, Abhay Phansalkar, supported by Evoke Mind + Matter

All authors contributed to drafting, reviewing, and critically revising the paper, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

Declaration of interest

Thitiwat Sriprasart has no competing interests to declare. Ma Bella Siasoco has received consulting fees from GSK and for acting as a senior Technical Adviser for the USAID FHI360 Epic Project, Philippines; and has received honoraria for speaking on webinars/at symposia for Getz Pharma, GSK and Novartis. Giap Vu Van has received honoraria for lectures, presentations, speakers’ bureaus or educational events, from Abbott, AstraZeneca, Boehringer Ingelheim, GSK, MSD, Novartis, Sandoz and Sanofi. Mark Cohen has received honoraria for participating in advisory boards from AstraZeneca, Boehringer Ingelheim, GSK and Sanofi; honoraria for presentations, manuscript writing or educational events from of AstraZeneca, Boehringer Ingelheim, Chiesi, GSK and Pfizer; and support for travel/attending meetings from AstraZeneca. Terence Seemungal has received honoraria for participating in advisory boards from AstraZeneca and GSK; honoraria for lectures from AstraZeneca, Boehringer Ingelheim and GSK; and support for travel/attending meetings from AstraZeneca, Boehringer Ingelheim and GSK. Marcia Pizzichini has received consulting fees from Boehringer Ingelheim, GSK and Sanofi-Genzyme; and support for travel/attending meetings from Sanofi-Genzyme. Mahmoud Mokhtar has received honoraria for presentations, manuscript writing or educational events from Abbott, AstraZeneca, Boehringer Ingelheim, GSK, Novartis and Sanofi; and support for travel/attending meetings from AstraZeneca, Boehringer Ingelheim, GSK, Mundipharma and Sanofi. Bhumika Aggarwal, Gur Levy, Abhay Phansalkar and Peter Daley-Yates are GSK employees and hold GSK shares.

Data sharing statement

Information on GSK’s data sharing commitments and requesting access can be found at: https://www.clinicalstudydatarequest.com.

Additional information

Funding

This study was funded by GSK.