{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:44:56Z","timestamp":1776721496351,"version":"3.51.2"},"reference-count":13,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"4","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>Antecedentes: El asma es una enfermedad respiratoria cr\u00f3nica com\u00fan que afecta del 1 al 18% de la poblaci\u00f3n en todo el mundo. En M\u00e9xico el 8% de la poblaci\u00f3n padece de asma. El asma grave representa, incluso, un 10% del total de casos. La propuesta de un Centro de Excelencia de Asma tiene como meta principal desarrollar procesos clave, establecer una metodolog\u00eda y ampliar la experiencia cl\u00ednica con base en tecnolog\u00edas actualizadas y enfoque en procesos cr\u00edticos que permitan a las instituciones de salud p\u00fablica hacer eficientes sus procesos de atenci\u00f3n.\nObjetivo: Consensuar las necesidades y oportunidades identificadas en el sector p\u00fablico para crear un centro de excelencia de atenci\u00f3n en asma grave.\nMetodolog\u00eda: Se utiliz\u00f3 la metodolog\u00eda RAND\/UCLA para generar consensos, a trav\u00e9s de evidencias cient\u00edficas y la opini\u00f3n de un panel Delphi modificado, online de forma asincr\u00f3nica conformado por 14 expertos, de diferentes instituciones p\u00fablicas, con experiencia en el tratamiento del asma grave. Principales recomendaciones: Se emiten consideraciones y recomendaciones para el desarrollo de un Centro de Excelencia de atenci\u00f3n en asma grave y recomendaciones para facilitar y homologar el diagn\u00f3stico, atenci\u00f3n, tratamiento y seguimiento del paciente con asma grave, enfatizando la importancia del tratamiento de las comorbilidades, las consideraciones internacionales y estrategias para evaluar el apego al tratamiento, as\u00ed como los recursos indispensables para el desarrollo del Centro de Excelencia.\nConclusi\u00f3n: El desarrollo de Centros de Excelencia de Asma permitir\u00eda acelerar la innovaci\u00f3n cient\u00edfica y cl\u00ednica, educaci\u00f3n y abogac\u00eda, promoviendo la excelencia en educaci\u00f3n, investigaci\u00f3n, y entrenamiento en el tratamiento del asma.\nPalabras clave: Asma; Enfermedad respiratoria cr\u00f3nica; Asma grave; Centros de excelencia; M\u00e9xico; Sector p\u00fablico; Adherencia al tratamiento.<\/jats:p>","DOI":"10.29262\/ram.v72i4.1536","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:34:32Z","timestamp":1767828872000},"page":"359-366","source":"Crossref","is-referenced-by-count":0,"title":["&lt;b&gt;Necesidades, limitantes y oportunidades para crear un centro de excelencia de atenci\u00f3n en asma grave en el sistema de atenci\u00f3n p\u00fablica en M\u00e9xico &lt;\/b&gt;","&lt;b&gt;Needs, limitations and opportunities to create a center of excellence for severe asthma care in the public healthcare system in Mexico &lt;\/b&gt;"],"prefix":"10.29262","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0140-849X","authenticated-orcid":false,"given":"Aurora Alejandra","family":"Ch\u00e1vez Garc\u00eda","sequence":"first","affiliation":[{"name":"Hospital General de Zona 11, IMSS, Xalapa, Veracruz"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Lemus Rangel","sequence":"additional","affiliation":[{"name":"Centro M\u00e9dico Nacional \u201cLa raza\u201d, IMSS, Ciudad de M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3747-9855","authenticated-orcid":false,"given":"Jos\u00e9 Ernesto","family":"Ju\u00e1rez Le\u00f3n","sequence":"additional","affiliation":[{"name":"Centro M\u00e9dico Nacional 20 de Noviembre, ISSSTE, Ciudad de M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6765-5074","authenticated-orcid":false,"given":"Nadia Karina","family":"Aguilar Hinojosa","sequence":"additional","affiliation":[{"name":"l Hospital General Regional 1 Lic. Ignacio Garc\u00eda T\u00e9llez, IMSS, M\u00e9rida, Yucat\u00e1n"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5707-0240","authenticated-orcid":false,"given":"Yair Humberto","family":"Gonz\u00e1lez Tuyub","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Especialidades y Centro de Apoyo Diagnostico Leonardo y Nicolas Bravo, ISSSTE, Ciudad de M\u00e8xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9175-9412","authenticated-orcid":false,"given":"Jos\u00e9 Valent\u00edn","family":"Flores Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Regional ISSSTE Puebla, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11808","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"65464","doi-asserted-by":"crossref","unstructured":"1. Elrod JK, Fortenberry JL Jr. Centers of excellence in healthcare institutions: what they are and how to assemble them. BMC Health Serv Res. 2017; 17 (Suppl 1): 425. doi:10.1186\/s12913-017-2340-y","DOI":"10.1186\/s12913-017-2340-y"},{"key":"65465","doi-asserted-by":"crossref","unstructured":"2. Maltby S, Gibson PG, Reddel HK, et al. Severe Asthma Toolkit: an online resource for multidisciplinary health professionals-needs assessment, development process and user analytics with survey feedback. BMJ Open. 2020; 10 (3): e032877. doi:10.1136\/bmjopen-2019-032877","DOI":"10.1136\/bmjopen-2019-032877"},{"key":"65466","unstructured":"3. Organizaci\u00f3n Mundial de la Salud. www. who.int. [Online].; 2022 [cited 2022 07 05. Available from: https:\/\/www.who.int\/es\/news-room\/fact-sheets\/detail\/asthma"},{"key":"65467","unstructured":"4. Gaceta UNAM. www.gaceta.unam.mx. [Online]. 2024. https:\/\/www.gaceta.unam.mx\/entre-el-5-y-12-de-la-poblacion-tiene-asma-en-mexico\/"},{"key":"65468","unstructured":"5. Global Initiative for Asthma. www.ginasthma.org. [Online]. 2022. https:\/\/ginasthma.org\/."},{"key":"65469","unstructured":"6. Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma. www.ginasthma.org. [Online]. 2022. https:\/\/ginasthma.org\/wp-content\/uploads\/2022\/07\/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf."},{"key":"65470","doi-asserted-by":"crossref","unstructured":"7. Gereda J, Arruda-Chaves E, Larco J, Matos E, et al. Asma grave: fisiopatolog\u00eda,diagn\u00f3stico y tratamiento. Rev Alergia M\u00e9x. 2024; 71 (2): 114-127.","DOI":"10.29262\/ram.v71i2.1283"},{"key":"65471","doi-asserted-by":"crossref","unstructured":"8. Del-R\u00edo-Navarro BE, Berber A, Reyes-Noriega N, et al. Global Asthma Network Phase I study in Mexico: prevalence of asthma symptoms, risk factors and altitude associations-a cross-sectional study. BMJ Open Respir Res. 2020; 7 (1): e000658. doi:10.1136\/bmjresp-2020-000658","DOI":"10.1136\/bmjresp-2020-000658"},{"key":"65472","doi-asserted-by":"crossref","unstructured":"9. Kaplan A, Szefler SJ, Halpin DMG. Impact of comorbid conditions on asthmatic adults and children. NPJ Prim Care Respir Med. 2020; 30 (1): 36. doi:10.1038\/s41533-020-00194-9","DOI":"10.1038\/s41533-020-00194-9"},{"key":"65473","doi-asserted-by":"crossref","unstructured":"10. Mart\u00ednez-Sahuquillo A, Ruiz De Vargas E. M\u00e9todos de consenso. Uso adecuado de la evidencia en la toma de decisiones. \u00abM\u00e9todo RAND\/UCLA\u00bb. Rehabilitaci\u00f3n. 2001; 35 (6): 388-392.","DOI":"10.1016\/S0048-7120(01)73220-3"},{"key":"65474","doi-asserted-by":"crossref","unstructured":"11. Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: How to decide its appropriateness. World J Methodol. 2021; 11 (4): 116-129.","DOI":"10.5662\/wjm.v11.i4.116"},{"key":"65475","doi-asserted-by":"crossref","unstructured":"12. Sugerman DT. Centers of Excellence. JAMA. 2013; 310 (9): 994. doi:10.1001\/jama.2013.277345.","DOI":"10.1001\/jama.2013.277345"},{"key":"65476","doi-asserted-by":"crossref","unstructured":"13. Li J, Burson RC, Clapp JT, Fleisher LA. Centers of excellence: Are there standards?. 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