Prof. Giorgio Walter CanonicaAllergy and Respiratory Diseases Department
University of Genoa
Cancun, December 7, 2011
Past President 1°vice President
GA2LEN WAO GA2LEN WAO and Guidelinesand Guidelines
Compalati 09
Guyatt GHACP J Club 1991 Mar-Apr
2
20 years20 years
Bousquet J. et al.,Allergy 2004 Bousquet J. et al.,Allergy 2004
ConclusionsQualityGraphicsProceduresPrinciplesBackground
Shekelle BMJ 1999; 318; 593-596 Università degli Studi di Genova
metanalysismetanalysis
Opinion Based Opinion Based
Mildpersistent
ARIA Guidelines: Recommendationsfor Management of Allergic Rhinitis
Mildintermittent
Moderate/severe
intermittent
Moderate/severe
persistent
Consider immunotherapy
Allergen and irritant avoidance
Intranasal decongestant (<10 days) or oral decongestant
Second-generation nonsedating H1-antihistamine
Leukotriene receptor antagonists
Local chromone
Intranasal corticosteroid
Check for asthma
Bousquet et al. J Allergy Clin Immunol. 2001;108(5 suppl):S147. At: http://www.whiar.org.
EAACI/GA2LEN/EDF Guidelines for Management of Urticaria
Zuberbier et al. Allergy. 2006;61:321-331.
EAACI / WAO / GA2LEN / EDF Guidelines
Urticaria 20083rd International Consensus Meeting on Urticaria
Management
Zuberbier et al. Allergy. 2009; 64: 1427-1443.
A general process in guidelines evolutionA general process in guidelines evolution
Factors that influence the strength of a recommendation
• Balance between desirable and undesirable effects
• Quality of evidence
• Patients’ values and preferences
• Costs
Braido et al. Allergy 2010: DOI: 10.1111/j.1398-9995.2010.02383.x.
Baiardini et al 2011
2012
Thank YouThank You
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