Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma
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Asthma is a global health problem affecting around 300 million individuals of all ages, ethnic groups and countries. It is estimated that around 250,000 people die prematurely each year as a result of asthma. Concepts of asthma severity and control are important in evaluating patients and their response to treatment, as well as for public health, registries, and research (clinical trials, epidemiologic, genetic, and mechanistic studies), but the terminology applied is not standardized, and terms are often used interchangeably. A common international approach is favored to define severe asthma, uncontrolled asthma, and when the 2 coincide, although adaptation may be required in accordance with local conditions. A World Health Organization meeting was convened April 5-6, 2009, to propose a uniform definition of severe asthma. An article was written by a group of experts and reviewed by the Global Alliance against Chronic Respiratory Diseases review group. Severe asthma is defined by the level of current clinical control and risks as "Uncontrolled asthma which can result in risk of frequent severe exacerbations (or death) and/or adverse reactions to medications and/or chronic morbidity (including impaired lung function or reduced lung growth in children)." Severe asthma includes 3 groups, each carrying different public health messages and challenges: (1) untreated severe asthma, (2) difficult-to-treat severe asthma, and (3) treatment-resistant severe asthma. The last group includes asthma for which control is not achieved despite the highest level of recommended treatment and asthma for which control can be maintained only with the highest level of recommended treatment.
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The unbearable cost of severe asthma in underprivileged populations
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Self-citationAsthma‐related mortality in France, 1980–2005: decline since the last decade
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Severity and control of severe asthma
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Results of PAL feasibility test in primary health care facilities in four regions of Bolivia.
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The Montreal Protocol: getting over the finishing line?
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International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma
Chung, K. F., Wenzel, S. E., Brozek, J. L., Bush, A., Castro, M., Sterk, P. J., Adcock, I. M., Bateman, E. D., Bel, E. H., Bleecker, E. R., et al. (2014) · European Respiratory Journal · doi:10.1183/09031936.00202013 · Cited by 3,926 · see citing works
Self-citationEpidemiology of Asthma in Children and Adults
Dharmage, S. C., Perret, J. L., & Custovic, A. (2019) · Frontiers in Pediatrics · doi:10.3389/fped.2019.00246 · Cited by 1,200 · see citing works
Allergic Rhinitis and its Impact on Asthma (ARIA): Achievements in 10 years and future needs
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The prevalence of severe asthma and low asthma control among Danish adults
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EAACI position statement on asthma exacerbations and severe asthma
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Prevalence of severe childhood asthma according to the WHO
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Rusconi (2018) · doi:10.1183/13993003.01665-2018 · Cited by 28 · see citing works
- Authors
- Bousquet, J., Mantzouranis, E., Cruz, A. A., Aït-Khaled, N., Baena-Cagnani, C. E., Bleecker, E. R., Brightling, C. E., Burney, P., Bush, A., Busse, W. W., Casale, T. B., Chan-Yeung, M., Chen, R., Chowdhury, B., Chung, K. F., Dahl, R., Drazen, J. M., Fabbri, L. M., Holgate, S. T., Kauffmann, F., Haahtela, T., Khaltaev, N., Kiley, J. P., Masjedi, M. R., Mohammad, Y., O'Byrne, P., Partridge, M. R., Rabe, K. F., Togias, A., van Weel, C., Wenzel, S., Zhong, N., & Zuberbier, T.
- Affiliations
- Inserm (FR)
- World Health Organization (CH)
- Wake Forest University Health Sciences (US)
- Imperial College London (GB)
- Royal Brompton Hospital (GB)
- University of Wisconsin–Madison (US)
- Creighton University (US)
- State Key Laboratory of Respiratory Disease (CN)
- United States Food and Drug Administration (US)
- Aarhus University Hospital (DK)
- Brigham and Women's Hospital (US)
- University of Modena and Reggio Emilia (IT)
- Southampton General Hospital (GB)
- Helsinki University Hospital (FI)
- European Organization for Nuclear Research (CH)
- National Institutes of Health (US)
- Masih Daneshvari Hospital (IR)
- Latakia University (SY)
- Charing Cross Hospital (GB)
- Leiden University Medical Center (NL)
- National Institute of Allergy and Infectious Diseases (US)
- University of Pittsburgh (US)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Bousquet, Jean
- ORCID
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 126
- Issue
- 5
- Pages
- 926-938
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2031494108
- Cited by
- 741
- References
- 101
- Citations by year
- 2026: 12 · 2025: 21 · 2024: 26 · 2023: 31 · 2022: 35 · 2021: 56 · 2020: 63 · 2019: 70 · 2018: 49 · 2017: 67 · 2016: 55 · 2015: 58 · 2014: 61 · 2013: 55 · 2012: 45
- FWCI
- 29.68
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Wellcome Trust (082265)
- National Institute for Health and Care Research (NF-SI-0508-10212)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- severe asthma, asthma severity, asthma control, asthma exacerbations, uncontrolled asthma, treatment-resistant asthma, difficult-to-treat asthma, terminology standardization, lung function, childhood asthma, adverse drug reactions
- MeSH terms
- Asthma, Clinical Trials as Topic, Humans, World Health Organization
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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