Prevalence of symptoms, severity and diagnosis of asthma in adolescents in the Province of Salamanca, Spain: Global Asthma Network (GAN) Phase I.

INTRODUCTION AND OBJECTIVES: Asthma is the most prevalent chronic disease in childhood. However, the latest data on its prevalence in Spain are from Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC), 2004. The objective of our study was to assess the prevalence of asthma symptoms, severity and diagnosis in the paediatric population aged between 13 and 14 years in the province of Salamanca. MATERIAL AND METHODS: Cross-sectional multicentre study carried out in 2017-2018 in 13-and 14-year-old school children in the province of Salamanca as a centre participating in of the Global Asthma Network (GAN) Phase I. The standardised validated written questionnaire and that directed by a video was administered; it was self-completed by the pupils. RESULTS: A total of 3485 questionnaires were completed, and the pupils' participation rate was 95.01%. Among the total, 25.7% indicated having had wheeze ever (20.7% in the video questionnaire); 14.7% indicated having had wheeze in the past 12 months (11.3% in the video questionnaire). The prevalence of current wheeze that limited speech was 3.9% (7.5% in the video questionnaire) and the current prevalence of severe wheeze was 6.5%. Regarding asthma diagnosis, 19.7% of the sample answered that they had had asthma ever, whilst 14.0% referred to having physician-diagnosed asthma. The agreement between the written questionnaire and that directed by video was acceptable for the questions of wheeze ever (Cohen Kappa index [k] = 0.53) and current wheeze (k = 0.42). CONCLUSIONS: The prevalence of current asthma (wheeze in the past 12 months) in the population aged 13 and 14 years in the province of Salamanca is higher compared with that presented in 2004 in Spain, but similar to that described at the world level (low-moderate level), according to the ISAAC Phase III studies.

A Clinical Decision Support System (KNOWBED) to Integrate Scientific Knowledge at the Bedside: Development and Evaluation Study.

BACKGROUND: The evidence-based medicine (EBM) paradigm requires the development of health care professionals' skills in the efficient search of evidence in the literature, and in the application of formal rules to evaluate this evidence. Incorporating this methodology into the decision-making routine of clinical practice will improve the patients' health care, increase patient safety, and optimize resources use. OBJECTIVE: The aim of this study is to develop and evaluate a new tool (KNOWBED system) as a clinical decision support system to support scientific knowledge, enabling health care professionals to quickly carry out decision-making processes based on EBM during their routine clinical practice. METHODS: Two components integrate the KNOWBED system: a web-based knowledge station and a mobile app. A use case (bronchiolitis pathology) was selected to validate the KNOWBED system in the context of the Paediatrics Unit of the Virgen Macarena University Hospital (Seville, Spain). The validation was covered in a 3-month pilot using 2 indicators: usability and efficacy. RESULTS: The KNOWBED system has been designed, developed, and validated to support clinical decision making in mobility based on standards that have been incorporated into the routine clinical practice of health care professionals. Using this tool, health care professionals can consult existing scientific knowledge at the bedside, and access recommendations of clinical protocols established based on EBM. During the pilot project, 15 health care professionals participated and accessed the system for a total of 59 times. CONCLUSIONS: The KNOWBED system is a useful and innovative tool for health care professionals. The usability surveys filled in by the system users highlight that it is easy to access the knowledge base. This paper also sets out some improvements to be made in the future.