{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T20:38:50Z","timestamp":1783456730833,"version":"3.55.0"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006259","name":"Teva Pharmaceutical Industries","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006259","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Transformation funds from health insurance companies"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Severe asthma affects 3.6% of the asthma population, in which patients are uncontrolled despite optimal drug therapy and management of treatable traits. These patients are eligible for treatment with biologicals, which provide significant benefits but are costly and need precise indication. However, identifying all individual treatable traits before diagnosing severe asthma is challenging. A systematic multi-dimensional assessment may help identify and address these hidden traits, resulting in tailored treatment and reducing the number of unnecessary biological prescriptions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A literature review was conducted to address the knowledge gap on the effectiveness and added value of a systematic assessment and treatment in difficult-to-treat or severe asthma, followed by an outline of a study protocol to implement this in patients diagnosed with severe asthma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The literature review revealed limited evidence on the effectiveness of systematic assessments in difficult-to-treat or severe asthma, largely due to the use of different study methods and outcome measures. Notably, only one of the selected articles employed a randomized controlled design. To address this gap, the EXpert Asthma Copd Trajectory with digital support (EXACT@home) study was proposed, which aims to improve the assessment and treatment of treatable traits in severe asthma before (re)considering treatment with biologicals. This study uses a prospective, open label, randomized controlled trial design with the primary aim of reducing biological prescriptions. Patients are eligible for inclusion if they have previously been diagnosed with severe uncontrolled asthma with an indication for treatment with biologicals. The intervention arm undergoes a 6-week systematic assessment program targeting treatable traits followed by tailored treatment, while the control arm directly receives treatment with biologicals. Both arms are followed for 12\u00a0months with secondary outcomes including asthma control, quality of life and exacerbation frequency.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Discussion<\/jats:title>\n            <jats:p>Difficult-to-treat or severe asthma requires tailored treatments based on individual treatable traits, but challenges remain in accurately identifying these traits. Existing literature highlights the beneficial effects of systematic assessments, but conclusive evidence is lacking. The EXACT@home study aims to provide high quality evidence on the effectiveness of such an assessment in the management of severe uncontrolled asthma, addressing a gap in the current literature.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>NCT05831566 (Clinicaltrials.gov), registered at 14\u201304-2023.<\/jats:p>\n            <jats:p>\n              <jats:italic>Protocol version:<\/jats:italic> version 6, date 27\u201303-2024.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12890-025-03646-5","type":"journal-article","created":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T14:15:55Z","timestamp":1747491355000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The effect of a systematic multi-dimensional assessment in severe uncontrolled asthma: a literature review and protocol for an investigator-initiated, open-label, randomized-controlled trial (EXACT@home study)"],"prefix":"10.1186","volume":"25","author":[{"given":"L.","family":"Bult","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. J.","family":"Braunstahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. G. J. V.","family":"Aerts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"B\u00e4nffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S. J. A.","family":"van Campen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S.","family":"van Daalen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"van Dooren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Flanders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. S.","family":"Geurts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. P.","family":"Hekking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Heller - Baan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J. A.","family":"Jans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. H.","family":"Kappen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. C. A.","family":"Mies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Oppedijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"de la Roij - Hartmans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Van der Sar - Van der Brugge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"T\u00fcrk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Vis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Wolters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. C.","family":"Vasbinder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C. C. M. in \u2018t","family":"Veen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,17]]},"reference":[{"key":"3646_CR1","unstructured":"Global Initiative for Asthma (GINA). Global Strategy for Asthma management and Prevention 2023. Available from: https:\/\/ginasthma.org\/2023-gina-main-report\/."},{"issue":"4","key":"3646_CR2","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.jaci.2014.08.042","volume":"135","author":"PW Hekking","year":"2015","unstructured":"Hekking PW, Wener RR, Amelink M, Zwinderman AH, Bouvy ML, Bel EH. The prevalence of severe refractory asthma. J Allergy Clin Immunol. 2015;135(4):896\u2013902.","journal-title":"J Allergy Clin Immunol"},{"issue":"2","key":"3646_CR3","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1183\/09031936.00202013","volume":"43","author":"KF Chung","year":"2014","unstructured":"Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. International ERS\/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343\u201373.","journal-title":"Eur Respir J"},{"issue":"2","key":"3646_CR4","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1183\/13993003.01359-2015","volume":"47","author":"A Agusti","year":"2016","unstructured":"Agusti A, Bel E, Thomas M, Vogelmeier C, Brusselle G, Holgate S, et al. Treatable traits: toward precision medicine of chronic airway diseases. Eur Respir J. 2016;47(2):410\u20139.","journal-title":"Eur Respir J"},{"key":"3646_CR5","doi-asserted-by":"crossref","unstructured":"Agusti A, Bafadhel M, Beasley R, Bel EH, Faner R, Gibson PG, et al. Precision medicine in airway diseases: moving to clinical practice. Eur Respir J. 2017;50(4):1701655.","DOI":"10.1183\/13993003.01655-2017"},{"issue":"9743","key":"3646_CR6","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/S0140-6736(10)61087-2","volume":"376","author":"PG Gibson","year":"2010","unstructured":"Gibson PG, McDonald VM, Marks GB. Asthma in older adults. Lancet. 2010;376(9743):803\u201313.","journal-title":"Lancet"},{"issue":"2","key":"3646_CR7","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1155\/2010\/361071","volume":"17","author":"M Sadatsafavi","year":"2010","unstructured":"Sadatsafavi M, Lynd L, Marra C, Carleton B, Tan WC, Sullivan S, et al. Direct health care costs associated with asthma in British Columbia. Can Respir J. 2010;17(2):74\u201380.","journal-title":"Can Respir J"},{"issue":"4","key":"3646_CR8","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1136\/thoraxjnl-2013-204114","volume":"70","author":"S O\u2019Neill","year":"2015","unstructured":"O\u2019Neill S, Sweeney J, Patterson CC, Menzies-Gow A, Niven R, Mansur AH, et al. The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax. 2015;70(4):376\u20138.","journal-title":"Thorax"},{"issue":"5","key":"3646_CR9","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1016\/j.jaip.2018.12.029","volume":"7","author":"A Bourdin","year":"2019","unstructured":"Bourdin A, Fabry-Vendrand C, Ostinelli J, Ait-Yahia M, Darnal E, Bouee S, et al. The Burden of Severe Asthma in France: A Case-Control Study Using a Medical Claims Database. J Allergy Clin Immunol Pract. 2019;7(5):1477\u201387.","journal-title":"J Allergy Clin Immunol Pract"},{"key":"3646_CR10","doi-asserted-by":"crossref","unstructured":"van Toor JJ, van der Mark SC, Kappen JH, In \u2018t Veen J, Braunstahl GJ. Mepolizumab add-on therapy in a real world cohort of patients with severe eosinophilic asthma: response rate, effectiveness, and safety. J Asthma. 2021;58(5):651\u20138.","DOI":"10.1080\/02770903.2020.1723623"},{"issue":"5","key":"3646_CR11","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1111\/all.14235","volume":"75","author":"I Agache","year":"2020","unstructured":"Agache I, Rocha C, Beltran J, Song Y, Posso M, Sola I, et al. Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines - recommendations on the use of biologicals in severe asthma. Allergy. 2020;75(5):1043\u201357.","journal-title":"Allergy"},{"key":"3646_CR12","doi-asserted-by":"crossref","unstructured":"Agache I, Beltran J, Akdis C, Akdis M, Canelo-Aybar C, Canonica GW, et al. Efficacy and safety of treatment with biologicals (benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab) for severe eosinophilic asthma. A systematic review for the EAACI Guidelines - recommendations on the use of biologicals in severe asthma. Allergy. 2020;75(5):1023\u201342.","DOI":"10.1111\/all.14221"},{"key":"3646_CR13","doi-asserted-by":"crossref","unstructured":"van den Akker EF, Van\u2019t Hul AJ, Birnie E, Chavannes NH, Rutten-van Molken MP, In\u2019t Veen JC. Comprehensive Diagnostic Assessment of Health Status of Patients with Asthma or COPD: A Delphi Panel Study among Dutch Experts. COPD. 2017;14(2):190\u20139.","DOI":"10.1080\/15412555.2016.1264378"},{"key":"3646_CR14","doi-asserted-by":"crossref","unstructured":"Honkoop PJ, Pinnock H, Kievits-Smeets RM, Sterk PJ, Dekhuijzen PN, In \u2018t Veen JC. Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi. NPJ Prim Care Respir Med. 2017;27:16086.","DOI":"10.1038\/npjpcrm.2016.86"},{"key":"3646_CR15","doi-asserted-by":"crossref","unstructured":"Irwin RS, Curley FJ, French CL. Difficult-to-control asthma. Contributing factors and outcome of a systematic management protocol. Chest. 1993;103(6):1662\u20139.","DOI":"10.1378\/chest.103.6.1662"},{"issue":"7","key":"3646_CR16","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1136\/thorax.58.7.561","volume":"58","author":"LG Heaney","year":"2003","unstructured":"Heaney LG, Conway E, Kelly C, Johnston BT, English C, Stevenson M, et al. Predictors of therapy resistant asthma: outcome of a systematic evaluation protocol. Thorax. 2003;58(7):561\u20136.","journal-title":"Thorax"},{"issue":"4","key":"3646_CR17","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1378\/chest.14-3056","volume":"148","author":"D Gibeon","year":"2015","unstructured":"Gibeon D, Heaney LG, Brightling CE, Niven R, Mansur AH, Chaudhuri R, et al. Dedicated severe asthma services improve health-care use and quality of life. Chest. 2015;148(4):870\u20136.","journal-title":"Chest"},{"issue":"3","key":"3646_CR18","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1183\/13993003.00220-2016","volume":"48","author":"AN van der Meer","year":"2016","unstructured":"van der Meer AN, Pasma H, Kempenaar-Okkema W, Pelinck JA, Schutten M, Storm H, et al. A 1-day visit in a severe asthma centre: effect on asthma control, quality of life and healthcare use. Eur Respir J. 2016;48(3):726\u201333.","journal-title":"Eur Respir J"},{"key":"3646_CR19","doi-asserted-by":"crossref","unstructured":"Tay TR, Lee J, Radhakrishna N, Hore-Lacy F, Stirling R, Hoy R, et al. A Structured Approach to Specialist-referred Difficult Asthma Patients Improves Control of Comorbidities and Enhances Asthma Outcomes. J Allergy Clin Immunol Pract. 2017;5(4):956\u201364 e3.","DOI":"10.1016\/j.jaip.2016.12.030"},{"issue":"5","key":"3646_CR20","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1016\/j.jaip.2019.12.037","volume":"8","author":"E Denton","year":"2020","unstructured":"Denton E, Lee J, Tay T, Radhakrishna N, Hore-Lacy F, Mackay A, et al. Systematic Assessment for Difficult and Severe Asthma Improves Outcomes and Halves Oral Corticosteroid Burden Independent of Monoclonal Biologic Use. J Allergy Clin Immunol Pract. 2020;8(5):1616\u201324.","journal-title":"J Allergy Clin Immunol Pract"},{"key":"3646_CR21","doi-asserted-by":"crossref","unstructured":"McDonald VM, Clark VL, Cordova-Rivera L, Wark PAB, Baines KJ, Gibson PG. Targeting treatable traits in severe asthma: a randomised controlled trial. Eur Respir J. 2020;55(3):1901509.","DOI":"10.1183\/13993003.01509-2019"},{"issue":"9","key":"3646_CR22","doi-asserted-by":"publisher","first-page":"2418","DOI":"10.1111\/all.15719","volume":"78","author":"T Lin","year":"2023","unstructured":"Lin T, Pham J, Denton E, Lee J, Hore-Lacy F, Sverrild A, et al. Trait profiles in difficult-to-treat asthma: Clinical impact and response to systematic assessment. Allergy. 2023;78(9):2418\u201327.","journal-title":"Allergy"},{"issue":"1","key":"3646_CR23","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1093\/ageing\/afq134","volume":"40","author":"VM McDonald","year":"2011","unstructured":"McDonald VM, Simpson JL, Higgins I, Gibson PG. Multidimensional assessment of older people with asthma and COPD: clinical management and health status. Age Ageing. 2011;40(1):42\u20139.","journal-title":"Age Ageing"},{"issue":"10","key":"3646_CR24","doi-asserted-by":"publisher","first-page":"e12080","DOI":"10.1002\/clt2.12080","volume":"11","author":"JPM van der Valk","year":"2021","unstructured":"van der Valk JPM, Kappen JH, van Campen J, Epping G, Retera J, de Bondt D, et al. Roadmap to improve regional care for patients with severe asthma. Clin Transl Allergy. 2021;11(10):e12080.","journal-title":"Clin Transl Allergy"},{"issue":"5","key":"3646_CR25","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1164\/rccm.9120-11ST","volume":"184","author":"RA Dweik","year":"2011","unstructured":"Dweik RA, Boggs PB, Erzurum SC, Irvin CG, Leigh MW, Lundberg JO, et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med. 2011;184(5):602\u201315.","journal-title":"Am J Respir Crit Care Med"},{"key":"3646_CR26","doi-asserted-by":"crossref","unstructured":"Louis R, Satia I, Ojanguren I, Schleich F, Bonini M, Tonia T, et al. European respiratory society guidelines for the diagnosis of asthma in adults. Eur Respir J. 2022;60:2101585.","DOI":"10.1183\/13993003.01585-2021"},{"key":"3646_CR27","unstructured":"Nederlandse Vereniging van Artsen voor Longziekten en Tuberculose (NVALT). Richtlijn: Diagnostiek en behandeling van ernstig astma 2020. Available from: https:\/\/richtlijnendatabase.nl\/richtlijn\/diagnostiek_en_behandeling_van_ernstig_astma\/startpagina_-_ernstig_astma.html."},{"key":"3646_CR28","doi-asserted-by":"crossref","unstructured":"Ljungberg H, Carleborg A, Gerber H, Ofverstrom C, Wolodarski J, Menshi F, et al. Clinical effect on uncontrolled asthma using a novel digital automated self-management solution: a physician-blinded randomised controlled crossover trial. Eur Respir J. 2019;54(5):1900983.","DOI":"10.1183\/13993003.00983-2019"},{"key":"3646_CR29","doi-asserted-by":"crossref","unstructured":"Moor CC, Mostard RLM, Grutters JC, Bresser P, Aerts J, Chavannes NH, et al. Home Monitoring in Patients with Idiopathic Pulmonary Fibrosis. A Randomized Controlled Trial. Am J Respir Crit Care Med. 2020;202(3):393\u2013401.","DOI":"10.1164\/rccm.202002-0328OC"},{"issue":"4","key":"3646_CR30","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1080\/02770903.2019.1709864","volume":"58","author":"M Kupczyk","year":"2021","unstructured":"Kupczyk M, Hofman A, Koltowski L, Kuna P, Lukaszyk M, Buczylko K, et al. Home self-monitoring in patients with asthma using a mobile spirometry system. J Asthma. 2021;58(4):505\u201311.","journal-title":"J Asthma"},{"issue":"10","key":"3646_CR31","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s11882-018-0809-3","volume":"18","author":"DM Carpenter","year":"2018","unstructured":"Carpenter DM, Jurdi R, Roberts CA, Hernandez M, Horne R, Chan A. A Review of Portable Electronic Spirometers: Implications for Asthma Self-Management. Curr Allergy Asthma Rep. 2018;18(10):53.","journal-title":"Curr Allergy Asthma Rep"},{"key":"3646_CR32","doi-asserted-by":"crossref","unstructured":"Bjerg A, Ljungberg H, Dierschke K, Akerberg-Krook E, Andersson UBK, Olin AC, et al. Shorter time to clinical decision in work-related asthma using a digital tool. ERJ Open Res. 2020;6(3):00259\u20132020.","DOI":"10.1183\/23120541.00259-2020"},{"key":"3646_CR33","doi-asserted-by":"crossref","unstructured":"Deenstra DD, van Helvoort HAC, Djamin RS, van Zelst C, In\u2019t Veen J, Antons JC, et al. Prevalence of hyperventilation in patients with asthma. J Asthma. 2022; 59(8):1560\u20137.","DOI":"10.1080\/02770903.2021.1959926"},{"issue":"4","key":"3646_CR34","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1080\/02770903.2019.1702201","volume":"58","author":"B Ring","year":"2021","unstructured":"Ring B, Burbank AJ, Mills K, Ivins S, Dieffenderfer J, Hernandez ML. Validation of an app-based portable spirometer in adolescents with asthma. J Asthma. 2021;58(4):497\u2013504.","journal-title":"J Asthma"},{"key":"3646_CR35","doi-asserted-by":"crossref","unstructured":"van \u2018t Hul AJ, Frouws S, van den Akker E, van Lummel R, Starrenburg-Razenberg A, van Bruggen A, et al. Decreased physical activity in adults with bronchial asthma. Respir Med. 2016;114:72\u20137.","DOI":"10.1016\/j.rmed.2016.03.016"},{"key":"3646_CR36","doi-asserted-by":"crossref","unstructured":"Mosnaim GS, Hoyte FCL, Safioti G, Brown R, Hill TD, Li T, et al. Effectiveness of a Maintenance and Reliever Digihaler System in Asthma: 24-Week Randomized Study (CONNECT2). J Allergy Clin Immunol Pract. 2024;12(2):385\u201395 e4.","DOI":"10.1016\/j.jaip.2023.11.037"},{"issue":"7","key":"3646_CR37","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/S2213-2600(22)00534-3","volume":"11","author":"EM Hale","year":"2023","unstructured":"Hale EM, Greene G, Mulvey C, Mokoka MC, van Boven JFM, Cushen B, et al. Use of digital measurement of medication adherence and lung function to guide the management of uncontrolled asthma (INCA Sun): a multicentre, single-blinded, randomised clinical trial. Lancet Respir Med. 2023;11(7):591\u2013601.","journal-title":"Lancet Respir Med"},{"issue":"7","key":"3646_CR38","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1007\/s11136-009-9502-2","volume":"18","author":"JB Peters","year":"2009","unstructured":"Peters JB, Daudey L, Heijdra YF, Molema J, Dekhuijzen PN, Vercoulen JH. Development of a battery of instruments for detailed measurement of health status in patients with COPD in routine care: the Nijmegen Clinical Screening Instrument. Qual Life Res. 2009;18(7):901\u201312.","journal-title":"Qual Life Res"},{"issue":"2","key":"3646_CR39","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1089\/jamp.2015.1212","volume":"29","author":"V Plaza","year":"2016","unstructured":"Plaza V, Fernandez-Rodriguez C, Melero C, Cosio BG, Entrenas LM, de Llano LP, et al. Validation of the \u2018Test of the Adherence to Inhalers\u2019 (TAI) for Asthma and COPD Patients. J Aerosol Med Pulm Drug Deliv. 2016;29(2):142\u201352.","journal-title":"J Aerosol Med Pulm Drug Deliv"},{"key":"3646_CR40","doi-asserted-by":"crossref","unstructured":"Marshall AL, Smith BJ, Bauman AE, Kaur S. Reliability and validity of a brief physical activity assessment for use by family doctors. Br J Sports Med. 2005;39(5):294\u20137; discussion -7.","DOI":"10.1136\/bjsm.2004.013771"},{"issue":"6","key":"3646_CR41","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","volume":"14","author":"MW Johns","year":"1991","unstructured":"Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540\u20135.","journal-title":"Sleep"},{"key":"3646_CR42","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1186\/1471-2458-12-577","volume":"12","author":"J Rademakers","year":"2012","unstructured":"Rademakers J, Nijman J, van der Hoek L, Heijmans M, Rijken M. Measuring patient activation in The Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13). BMC Public Health. 2012;12:577.","journal-title":"BMC Public Health"},{"issue":"7","key":"3646_CR43","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1136\/thx.54.7.581","volume":"54","author":"JC Bestall","year":"1999","unstructured":"Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54(7):581\u20136.","journal-title":"Thorax"},{"key":"3646_CR44","first-page":"573","volume":"18","author":"PVCP Doorn","year":"1983","unstructured":"Doorn PVCP, Folgering HTM. Een vragenlijst voor hyperventilatieklachten [A questionnaire for hyperventilation syndrome]. De Psycholoog. 1983;18:573\u20137.","journal-title":"De Psycholoog"},{"issue":"6","key":"3646_CR45","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","volume":"67","author":"ASSR Zigmond","year":"1983","unstructured":"Zigmond ASSR. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361\u201370.","journal-title":"Acta Psychiatr Scand"},{"key":"3646_CR46","doi-asserted-by":"crossref","unstructured":"Laboratories ATSCoPSfCPF. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111\u20137.","DOI":"10.1164\/ajrccm.166.1.at1102"},{"issue":"2","key":"3646_CR47","doi-asserted-by":"publisher","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","volume":"49","author":"JM Guralnik","year":"1994","unstructured":"Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.","journal-title":"J Gerontol"},{"key":"3646_CR48","unstructured":"Bousquet J, Rao S, Manga V. Global evaluation of treatment effectiveness (GETE) is an accurate predictor of response to omalizumab in patients with severe allergic asthma: A pooled analysis. Eur Respir J. 44(58)."},{"issue":"4","key":"3646_CR49","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1034\/j.1399-3003.1999.14d29.x","volume":"14","author":"EF Juniper","year":"1999","unstructured":"Juniper EF, O\u2019Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. Eur Respir J. 1999;14(4):902\u20137.","journal-title":"Eur Respir J"},{"issue":"1","key":"3646_CR50","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1034\/j.1399-3003.1999.14a08.x","volume":"14","author":"EF Juniper","year":"1999","unstructured":"Juniper EF, Guyatt GH, Cox FM, Ferrie PJ, King DR. Development and validation of the Mini Asthma Quality of Life Questionnaire. Eur Respir J. 1999;14(1):32\u20138.","journal-title":"Eur Respir J"},{"issue":"4","key":"3646_CR51","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1164\/ajrccm\/147.4.832","volume":"147","author":"EF Juniper","year":"1993","unstructured":"Juniper EF, Guyatt GH, Ferrie PJ, Griffith LE. Measuring quality of life in asthma. Am Rev Respir Dis. 1993;147(4):832\u20138.","journal-title":"Am Rev Respir Dis"},{"issue":"7","key":"3646_CR52","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1111\/cea.13614","volume":"50","author":"C Dupin","year":"2020","unstructured":"Dupin C, Belhadi D, Guilleminault L, Gamez AS, Berger P, De Blay F, et al. Effectiveness and safety of dupilumab for the treatment of severe asthma in a real-life French multi-centre adult cohort. Clin Exp Allergy. 2020;50(7):789\u201398.","journal-title":"Clin Exp Allergy"},{"key":"3646_CR53","doi-asserted-by":"crossref","unstructured":"McDonald VM, Fingleton J, Agusti A, Hiles SA, Clark VL, Holland AE, et al. Treatable traits: a new paradigm for 21st century management of chronic airway diseases: treatable traits down under international workshop report. Eur Respir J. 2019;53(5):1802058.","DOI":"10.1183\/13993003.02058-2018"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-025-03646-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-025-03646-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-025-03646-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T14:16:01Z","timestamp":1747491361000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-025-03646-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,17]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3646"],"URL":"https:\/\/doi.org\/10.1186\/s12890-025-03646-5","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,17]]},"assertion":[{"value":"11 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval for the EXACT@home study was provided by the Medical research Ethics Committees United (NL79996.100.22). Approval by the Institutional Research Board and Board of Directors of the Franciscus Gasthuis & Vlietland (FGV) hospital was also provided. The study is registered at clinicaltrials.gov (NCT05831566). Informed consent will be obtained from all subjects ().","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"LB: Personal fees and\/or speaker fees from Teva, Sanofi. GB: Grants and\/or personal fees from AstraZeneca, Teva, Sanofi, GSK, ALK, Novartis, Glaxo Smith Kline, Sanofi, Chiesi. JA: none DB: none JC: Personal fees and\/or speaker fees from Astra Zeneca, Sanofi Genzyme, Novartis, Chiesi, GSK MD: none YD: none UF: none EG: none PH: none RH: none MJ: none JK: Grants and\/or personal fees from ALK, Chiesi, GSK, Novartis, AstraZeneca, Sanofi, Boerhinger, Teva, Viatris, Stallergen, Abbot, all outside the submitted work. RM: none BO: none MR: none SS: Personal fees and\/or speaker fees from Genzyme, Chiesi, GSK, Boehringer Ingelhem, Astra Zeneca YT: none EV: Speaker fees from Boehringer Ingelheim, Sanofi, Astra Zeneca, Periscaldes, Springer Media BV, GSK RW: none ECV: Unconditional research grants from AstraZeneca and Pfizer JV: Unrestricted faculty research grants from GSK, Teva, AZ, Chiesi, Sanofi, and speaker fees from AZ, GSK, Sanofi, Chiesi, Stichting RoLeX and Health Investment.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"240"}}