Patient-centred digital biomarkers for allergic respiratory diseases and asthma: the ARIA-EAACI approach
Jean Bousquet 1 2 3, Mohamed H Shamji 4 5, Josep M Anto 6 7 8, Holger J Schünemann 9, G Walter Canonica 10 11, Marek Jutel 12 13, Stefano Del Giacco 14, Torsten Zuberbier 1 3, Oliver Pfaar 15, Joao A Fonseca 16 17, Bernardo Sousa-Pinto 16 17, Ludger Klimek 18 19, Wienczyslawa Czarlewski 20 21, Anna Bedbrook 21 22, Rita Amaral 16 17, Ignacio J Ansotegui 23, Sinthia Bosnic-Anticevich 24 25 26, Fulvio Braido 27 28, Claudia Chaves Loureiro 29, Bilun Gemicioglu 30, Tari Haahtela 31, Marek Kulus 32, Piotr Kuna 33, Maciej Kupczyk 33, Paolo M Matricardi 34, Frederico S Regateiro 35 36 37, Boleslaw Samolinski 38, Mikhail Sofiev 39, Sanna Toppila-Salmi 31, Arunas Valiulis 40, Maria Teresa Ventura 41 42, Cristina Barbara 43, Karl C Bergmann 1 3, Michael Bewick 44, Hubert Blain 45, Matteo Bonini 46 47 48, Louis-Philippe Boulet 49, Rodolphe Bourret 50, Guy Brusselle 51, Luisa Brussino 52 53, Roland Buhl 54, Victoria Cardona 55 56, Thomas Casale 57, Lorenzo Cecchi 58, Denis Charpin 59, Ivan Cherrez-Ojeda 60 61, Derek K Chu 9, Cemal Cingi 62, Elisio M Costa 63, Alvaro A Cruz 64, Philippe Devillier 65, Stephanie Dramburg 66, Wytske J Fokkens 67, Maia Gotua 68, Enrico Heffler 10 11, Zhanat Ispayeva 69, Juan Carlos Ivancevich 70, Guy Joos 51, Igor Kaidashev 71, Helga Kraxner 72, Violeta Kvedariene 73 74, Désirée E Larenas-Linnemann 75, Daniel Laune 76, Olga Lourenço 77, Renaud Louis 78 79, Mika Makela 31, Michael Makris 80, Marcus Maurer 1 3, Erik Melén 81 82, Yann Micheli 76, Mario Morais-Almeida 83, Joaquim Mullol 84 85, Marek Niedoszytko 86, Robyn O'Hehir 87, Yoshitaka Okamoto 88 89, Heidi Olze 90 91, Nikolaos G Papadopoulos 92, Alberto Papi 93, Vincenzo Patella 94 95 96, Benoit Pétré 97, Nhân Pham-Thi 98 99 100, Francesca Puggioni 101, Santiago Quirce 102, Nicolas Roche 103, Philip W Rouadi 104 105, Ana Sá-Sousa 16 17, Hironori Sagara 106, Joaquin Sastre 107, Nicola Scichilone 108, Aziz Sheikh 109, Milan Sova 110, Charlotte Suppli Ulrik 111 112, Luis Taborda-Barata 113 114, Ana Todo-Bom 115, Maria J Torres 116, Ioanna Tsiligianni 117 118, Omar S Usmani 119 48, Erkka Valovirta 120, Tuula Vasankari 121 122, Rafael José Vieira 16 17, Dana Wallace 123, Susan Waserman 124, Mihaela Zidarn 125 126, Arzu Yorgancioglu 127, Luo Zhang 128, Tomas Chivato 129, Markus Ollert 130 131
Affiliations
Affiliations
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- University Hospital Montpellier, France.
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
- National Heart and Lung Institute, Imperial College, London, UK.
- NIHR Imperial Biomedical Research Centre, London, UK.
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada.
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
- Department of Clinical Immunology, Wrocław Medical University, Poland.
- ALL-MED Medical Research Institute, Wroclaw, Poland.
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy.
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal.
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany.
- Center for Rhinology and Allergology, Wiesbaden, Germany.
- Medical Consulting Czarlewski, Levallois, France.
- MASK-air, Montpellier, France.
- ARIA, Montpellier, France.
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain.
- Quality Use of Respiratory Medicines Group, Woolcock Institute of Medical Research, Sydney, NSW, Australia.
- Sydney Local Health District, Sydney, NSW, Australia.
- Sydney Pharmacy School, The University of Sydney, Sydney, NSW, Australia.
- Respiratory Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy.
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
- Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland.
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lotz, Poland.
- Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
- Coimbra Institute for Clinical and Biomedical Research (ICBR) Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
- Finnish Meteorological Institute (FMI), Finland.
- Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
- Institute of Sciences of Food Production, National Research Council (Ispa-CNR), Bari, Italy.
- Portuguese NaTional Programme for Respiratory Diseases, Direção -Geral da Saúde, Faculdade de Medicina de Lisboa, Instituto de Saúde Ambiental, Lisbon, Portugal.
- University of Central Lancashire Medical School, Preston, UK.
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France.
- Department of Cardiovascular and Respiratory Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy.
- Department of Neurological, ENT and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, Italy.
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
- Quebec Heart and Lung Institute, Laval University, Québec City, Quebec, Canada.
- University Hospital of Nice, Nice, France.
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino, Torino, Italy.
- Mauriziano Hospital, Torino, Italy.
- Department of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany.
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain.
- ARADyAL Research Network, Barcelona, Spain.
- Division of Allergy/Immunology, University of South Florida, Tampa, USA.
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
- Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France.
- Universidad Espíritu Santo, Samborondón, Ecuador.
- Respiralab Research Group, Guayaquil, Guayas, Ecuador.
- Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing, University of Porto (Porto4Ageing), Portugal.
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil.
- VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany.
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, the Netherlands.
- Center of Allergy and Immunology, David Tvildiani Medical University, Tbilisi, Georgia.
- Kazakhstan Association of Allergology and Clinical Immunology, Department of Allergology and Clinical Immunology of the Kazakh National Medical University, Almaty, Kazakhstan.
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
- Poltava State Medical University, Poltava, Ukraine.
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
- KYomed INNOV, Montpellier, France.
- Faculty of Health Sciences and CICS - UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
- Department of Pulmonary Medicine, CHU, Liège, Liège, Belgium.
- GIGA I3 Research Group, University of Liège, Liège, Belgium.
- Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
- Sach´s Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
- Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.
- Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
- Department of Allergology, Medical University of Gdańsk, Poland.
- Allergy, Asthma and Clinical Immunology, Alfred Health and Department of Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
- Chiba Rosai Hospital, Chiba, Japan.
- Chiba University Hospital, Chiba, Japan.
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Berlin Institute of Health, Berlin, Germany.
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
- Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
- Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.
- Agency of Health ASL, Salerno, Italy.
- Postgraduate Programme in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy.
- Department of Public Health, University of Liège, Liège, Belgium.
- Ecole Polytechnique de Palaiseau, Palaiseau, France.
- IRBA (Institut de Recherche Bio-Médicale des Armées), Brétigny sur Orge, France.
- Université Paris Cité, Paris, France.
- Personalized Medicine, Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Spain.
- Pneumologie, AP-HP, Centre Université de Paris, Hôpital Cochin, Paris, France.
- Department of Otolaryngology, Head and Neck Surgery, Eye and Ear, University Hospital, Beirut, Lebanon.
- Department of Otolaryngology, Head and Neck Surgery, Dar Al Shifa Hospital-, Salmiya, Kuwait.
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan.
- Allergy Service, Fundacion Jimenez Diaz, Autonoma University of Madrid, Madrid, Spain.
- PROMISE Department, University of Palermo, Palermo, Italy.
- Usher Institute, The University of Edinburgh, Edinburgh, UK.
- Department of Respiratory Medicine and Tuberculosis, University Hospital Brno, Czech Republic.
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark.
- Institute of Cinical Medicine, University of Copenhagen, Copenhagen, Denmark.
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.
- UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Allergy Unit, Málaga Regional University Hospital-IBIMA, Málaga, Spain.
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
- Royal Brompton Hospital, Airways Disease Section, London, UK.
- Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.
- FIHLA, Finnish Lung Health Association, Helsinki, Finland.
- Department of Clinical Medicine, Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland.
- Nova Southeastern University, College of Allopathic Medicine, Fort Lauderdale, Florida, USA.
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
- University Clinic of Respiratory and Allergic Diseases, Slovenia.
- University of Ljubljana, Ljubljana, Slovenia.
- Department of Pulmonary Diseases, Celal Bayar University, Manisa, Turkey.
- Department of Otolaryngology Head and Neck Surgery, TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, Beijing, China.
- School of Medicine, University CEU San Pablo, Madrid, Spain.
- Department of Infection and Immunity, Luxembourg, Esch-sur-Alzette, Luxembourg.
- Department of Dermatology and Allergy Centre, Odense University Hospital, Research Center for Anaphylaxis (ORCA), Odense, Odense, Denmark.
Abstract
Biomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the centre of the health system and is likely to optimise the practice of allergy. ARIA (Allergic Rhinitis and its Impact on Asthma) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomised controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, were embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of-life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed.
Keywords: ARIA; EAACI; apps; asthma; digital health; rhinitis.
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