Objective testing is cost effective
BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k899 (Published 07 March 2018) Cite this as: BMJ 2018;360:k899
- 1Royal Brompton Hospital, London SW3 6NP, UK
- 2Royal Stoke University Hospital, Stoke-on-Trent ST4 6QG, UK
- a.menzies-gow{at}rbht.nhs.uk
As co-chairs of the National Institute for Health and Care Excellence’s guideline committee on asthma, we support the aim of a guideline with contributions from both NICE and the British Thoracic Society (with the Scottish Intercollegiate Guideline Network), covering all aspects of management and care.1 NICE stands ready to take the next steps in developing a single, joint approach.
Regarding our recommendations on diagnosis and monitoring, we appreciate that there are challenges with performing spirometry and fractional exhaled nitric oxide testing in primary care and in children. But objective testing was shown to be cost effective in NICE’s primary care pilot study and in robust economic models developed by our committee, so we think it can be achieved with the right support and resources.
We acknowledge that establishing it as routine practice will take time. NICE’s advice is to use current diagnostic approaches from the British Thoracic Society’s guidance until the capacity is in place.
Footnotes
Competing interests: AM-G and JA were co-chairs of the NICE guideline on asthma: diagnosis, monitoring and chronic asthma management. AM-G has attended advisory boards for GlaxoSmithKline, Novartis, AstraZeneca, Boehringer Ingelheim, and Teva. He has received speaker fees from Novartis, AstraZeneca, Vectura, Boehringer Ingelheim, and Teva. He has participated in research with Hoffman La Roche, GlaxoSmithKline, Boehringer Ingelheim, and AstraZeneca and has attended international conferences with AstraZeneca and Boehringer Ingelheim, and has consultancy agreements with AstraZeneca and Vectura.