Values and Preferences of Patients and Caregivers Regarding the Management of Moderate-to-Severe Asthma: A Systematic Review and Qualitative Evidence Synthesis
Bibliographic record
Abstract
BACKGROUND: Understanding patient values and preferences can inform optimal care of moderate-to-severe asthma. OBJECTIVE: To systematically synthesize studies addressing the values and preferences of patients with moderate-to-severe asthma and their caregivers toward the management of asthma. METHODS: As part of updating the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma, and Immunology (AAAAI/ACAAI) Joint Task Force on Practice Parameters severe asthma guidelines, we searched MEDLINE, Embase, PsycINFO, and CINAHL from inception to June 1, 2025, for studies addressing the values and preferences of patients with moderate-to-severe asthma or their caregivers. Paired reviewers independently screened citations, extracted data, and assessed risk of bias. We used iterative thematic content analysis to qualitatively synthesize findings and the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Quantitative Research (GRADE-CERQual) approach to rate the confidence of the evidence. We prospectively registered our review in PROSPERO (CRD42024572812). RESULTS: Synthesizing 88 studies enrolling 9,593 patients and 274 caregivers, we identified 5 key themes: (1) Patients and their caregivers place high value on avoiding potential adverse effects of asthma treatment (high confidence). Patients probably place high value toward (2) avoiding severe asthma exacerbations, (3) having autonomy in the administration of advanced therapies, such as biologics, and (4) are probably more willing to accept treatment if provided counselling by clinicians knowledgeable in asthma (moderate confidence). (5) Patients may place a high value on asthma treatments that are practical and logistically simple to implement (low confidence). CONCLUSIONS: We identified 5 key themes on the values and preferences of patients with moderate-to-severe asthma and their caregivers to inform optimal clinical care, practice guidelines, and future research.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.054 | 0.129 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".