(2019) 9:16
Bousquet et al. Clin Transl Allergy
https://doi.org/10.1186/s13601-019-0252-0
Clinical and
Translational Allergy
Open Access
REVIEW
Guidance to 2018 good practice: ARIA
digitally‑enabled, integrated, person‑centred
care for rhinitis and asthma
J. Bousquet1,2,3,4* , A. Bedbrook1, W. Czarlewski5, G. L. Onorato1, S. Arnavielhe6, D. Laune6, E. Mathieu‑Dupas6,
J. Fonseca7, E. Costa8, O. Lourenço9, M. Morais‑Almeida10, A. Todo‑Bom11, M. Illario12, E. Menditto13,
G. W. Canonica14, L. Cecchi15, R. Monti16, L. Napoli17, M. T. Ventura18, G. De Feo19, W. J. Fokkens20,
N. H. Chavannes21, S. Reitsma20, A. A. Cruz22, J. da Silva23, F. S. Serpa24,25, D. Larenas‑Linnemann26,
J. M. Fuentes Perez27, Y. R. Huerta‑Villalobos27, D. Rivero‑Yeverino28, E. Rodriguez‑Zagal28, A. Valiulis29,30,
R. Dubakiene31, R. Emuzyte32, V. Kvedariene33, I. Annesi‑Maesano34, H. Blain35,36, P. Bonniaud37, I. Bosse38,
Y. Dauvilliers39,40, P. Devillier41, J. F. Fontaine42, J. L. Pépin43,44, N. Pham‑Thi45, F. Portejoie1, R. Picard46,
N. Roche47, C. Rolland48, P. Schmidt‑Grendelmeier49, P. Kuna50, B. Samolinski51, J. M. Anto52,53,54,55,
V. Cardona56, J. Mullol57,58, H. Pinnock59, D. Ryan60, A. Sheikh61, S. Walker62, S. Williams63, S. Becker64,
L. Klimek65, O. Pfaar66, K. C. Bergmann67,68, R. Mösges69,70, T. Zuberbier67,68, R. E. Roller‑Wirnsberger71,
P. V. Tomazic72, T. Haahtela73, J. Salimäki74, S. Toppila‑Salmi73, E. Valovirta75, T. Vasankari76, B. Gemicioğlu77,
A. Yorgancioglu78, N. G. Papadopoulos79,80, E. P. Prokopakis81, I. G. Tsiligianni61,82, S. Bosnic‑Anticevich83,
R. O’Hehir84,85, J. C. Ivancevich86, H. Neffen87, M. E. Zernotti88, I. Kull89,90, E. Melén90, M. Wickman91, C. Bachert92,
P. W. Hellings3,93,94, G. Brusselle95, S. Palkonen96, C. Bindslev‑Jensen97, E. Eller97, S. Waserman98, L. P. Boulet99,
J. Bouchard100, D. K. Chu101, H. J. Schünemann101, M. Sova102, G. De Vries103,104, M. van Eerd103,104, I. Agache105,
I. J. Ansotegui106, M. Bewick107, T. Casale108, M. Dykewick109, M. Ebisawa110, R. Murray111,112, R. Naclerio113,
Y. Okamoto114, D. V. Wallace115 and The MASK study group
Abstract
Aims: Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier,
France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity
across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities
incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change
the management strategy in chronic diseases.
Methods: MASK implements ICT technologies for individualized and predictive medicine to develop novel care
pathways by a multi-disciplinary group centred around the patients.
Stakeholders: Include patients, health care professionals (pharmacists and physicians), authorities, patient’s associa‑
tions, private and public sectors.
Results: MASK is deployed in 23 countries and 17 languages. 26,000 users have registered.
*Correspondence: jean.bousquet@orange.fr
1
MACVIA‑France, Fondation Partenariale FMC VIA-LR, CHU Arnaud de
Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier
Cedex 5, France
Full list of author information is available at the end of the article
© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Page 2 of 19
EU grants (2018): MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT
Health, DigitalHealthEurope, Euriphi and Vigour).
Lessons learnt: (i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies
should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Educa‑
tion strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases
can be expanded to chronic diseases.
Keywords: App, Asthma, Care pathways, MASK, mHealth, Rhinitis, DG Santé
Introduction
In all societies, the burden and cost of allergic and
chronic respiratory diseases (CRDs) is increasing rapidly. Most economies are struggling to deliver modern
health care effectively. There is a need to support the
transformation of the health care system for integrated
care with organizational health literacy. MASK (Mobile
Airways Sentinel Network) [1] is a new development of
the ARIA (Allergic Rhinitis and its Impact on Asthma)
initiative [2, 3]. It works closely with POLLAR (Impact
of Air POLLution on Asthma and Rhinitis, EIT Health)
[4], and collaborates with professional and patient
organizations in the field of allergy and airway diseases.
MASK proposes real-life care pathways (ICPs) centred
around the patient with rhinitis and/or asthma multimorbidity. It uses mHealth monitoring of environmental exposure and considers biodiversity. With the help
of three EU projects (DigitalHealthEurope, Eurifi and
Vigour) recently accepted on the digital transformation of health, MASK proposes a second change management strategy. The first one was the ARIA change
management associated with the recognition and wide
acceptance by all stakeholders of the essential links
between rhinitis and asthma. The second one deals
with change management of care pathways for rhinitis
and asthma [5].
In the context of implementing communication on the
digital transformation of health and care, specifically in
relation to chapter 5 of the document “Digital tools for
citizen empowerment and for person-centred care”, DG
SANTE has taken steps towards supporting the scalingup and wider implementation of good practices in the
field of digitally-enabled, integrated, person-centred
care. This work was carried out in collaboration with the
newly-established Commission Expert Group, the “Steering Group on Health Promotion, Disease Prevention and
Management of Non-Communicable Diseases”.
For this purpose, DG SANTE—in collaboration with
the Commission’s Joint Research Centre—organized a
“marketplace” workshop with the Joint Research Centre in Ispra, the third biggest European Commission site
after Brussels and Luxembourg. The aim of this workshop
was for representatives from Member States and other
countries participating in the 3rd Health Programme to
learn more about the 10 good practices and key policy
initiatives in the domain of digitally-enabled, integrated,
person-centred care, with a view to possible transfer and
replication of the presented practices.
The current paper reviews the questions raised during
the workshop concerning the good practice on allergic
rhinitis and asthma: ARIA digitally-enabled, integrated,
person-centred care for rhinitis and asthma multimorbidity using real-world evidence [1]. This practice is a
GARD (Global Alliance against Chronic Respiratory Diseases) demonstration project.
The practice
The practice includes the care pathways defined in 2014
[6–8] (Fig. 1) as well as ICT (Information and Communication Technology) solutions (cell phones for patients,
inter-operable tablets for health care professionals and
a web-based questionnaire for physicians) [1, 9] (Fig. 2).
The aim is to develop a change management strategy for
chronic diseases [5].
MASK is a patient-centred ICT system [8]. A mobile
phone app (the Allergy Diary, now called MASK-air),
central to MASK, is available in 23 countries. It has
been validated [10] and found to be an easy and effective method of assessing the symptoms of allergic rhinitis (AR) and work productivity [10–13]. MASK follows
the checklist for the evaluation of Good Practices
developed by the European Union Joint Action JACHRODIS (Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle) [14]. One
of the major aims of MASK is to provide care pathways
[15] in rhinitis and asthma multimorbidity [16] including a sentinel network using the geolocation of users
[17]. It can also inform the App users of the pollen and/
or pollution risk level in their area, by means of geolocation (Table 1).
The practice has been developed for allergic rhinitis
(and asthma multimorbidity), being the most common
chronic disease globally [18, 19] and affecting all age
groups from early childhood to old age. There are several unmet needs that should be addressed in an ICP.
Moreover, the lessons learnt will benefit all chronic
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Page 3 of 19
Goals
Self-care
1. Develop for each
step a document
with a 4-pages
pocket-guide
2. Include mHealth for
each step
3. From one step to the
next one
4. When to go to the
next step
5. Stepwise approach
for management
6. Develop machine
learning to opmize
ICPs
Pharmacist
Incorrect
diagnosis
Severity
Incorrect
diagnosis
Severity
Improvement
OTC
medicaon
Check For
asthma
Failure
YES
Improvement
Treatment
Failure
Specialist
(asthma)
Fig. 1 Care pathways for chronic respiratory diseases. From [6–8]
Self-care
Self-care
Pharmacist
Specialist
Goals
1. Develop for each
step an m-Health
tool
2. cell phone for selfcare
3. interoperable tablet
for pharmacists and
physicians
4. Physician’s
quesonnaire
5. Paent’s personal
data with maintained
privacy (GPDR)
(asthma)
Bousquet et al, Allergy 2016
Fig. 2 ICT solutions embedded in care pathways for chronic respiratory diseases
diseases since rhinitis is considered as a mild disease
although it impairs social life, school and work productivity considerably [20]. It is estimated that, in the EU,
work loss accounts for 30–100 b€ annually. Moreover,
it is essential to consider mild chronic diseases and to
establish health promotion and management strategies
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Table 1 The ICT solution
App (MASK-air) deployed in 23 countries: TRL9 (Technology Readiness
level), Electronic clinical decision support system (ARIA e-CDSS): TRL 7,
e-physician questionnaire deployed in 16 countries: TRL9
MASK-air good practice [1, 14]
5-year work
App: 26,000 users, 23 countries, 17 languages
GDPR including geolocation [105]
GP of the EIP on AHA, follows CHRODIS [14]
Based on 11 EU grants (MeDALL [106], GA2LEN [107]) including—in
2018—POLLAR [4], VIGOUR, DigitalHealthEurope and Euriphi
From a validated “research” tool (2004-2018) to large scale deploy‑
ment (2019–)
Validation with COSMIN guidelines [40]
Baseline characteristics [12]
Work productivity [41, 42]
EQ-5D [43]
Novel phenotypes of allergic diseases [44]
Adherence to treatment and novel approaches to inform the efficacy
of treatment [45].
Patient’s organizations and scientific societies involved
GARD (WHO alliance)
Presented during WHO and EU ministerial meetings
Next-generation care pathways meeting (Dec 3, 2018) with the EIP on
AHA, POLLAR (EIT Health) and GARD
47 MASK papers in 12 languages [99, 108, 109]
Dissemination according to the EIP on AHA [26]
Transfer of innovation (TWINNING [110])
Interoperable platform with MASK
25 RS plus Argentina, Australia, Brazil, Canada, Mexico [99, 108, 109]
700 patients enrolled
GDPR solutions being solved
ARIA e-CDSS [9, 111]
Interoperable platform with MASK
Based on an expert meeting
Electronic version available
GDPR solutions being solved
Developments
App for home services
App for sleep
App for COPD
App for other chronic diseases
early in life in order to prevent a severe outcome and to
promote healthy ageing [21].
Page 4 of 19
Deployment
Many of the GPs that are developed in one region
(country) take into account health systems, availability
of treatments and legal considerations which makes it
difficult to scale up the practice without customization. MASK has taken the opposite direction starting
with a tool immediately available in 10 languages and
14 countries and regularly scaled up. Moreover, the tool
is included in a generic ICP (Fig. 2) that can be customized easily in any country globally.
Geographical scope of the practice
MASK was developed in English and is currently available in 23 countries and 17 languages (Table 2).
New countries
Deployment is in process in Bolivia, Colombia, Japan
and Peru. The involvement of developing countries is
needed to offer a practice for middle- and low-income
countries that will benefit poverty areas of developed
countries and that will be in line with the mission of
GARD. Deployment to the US is being discussed with
the National Institute for Allergy and Infectious diseases (NIH).
Transfer of innovation of allergic rhinitis and asthma
multimorbidity in the elderly (MASK Reference Site Twinning,
EIP on AHA)
The EIP on AHA includes 74 Reference Sites. The aim
of this TWINNING is to transfer innovation from the
MASK App to other reference sites. The phenotypic
characteristics of rhinitis and asthma multimorbidity in
adults and the elderly have been compared using validated mHealth tools (i.e. the Allergy Diary and CARAT
[22]) in 23 Reference Sites or regions across Europe,
Argentina, Australia, Brazil and Mexico [23].
Individuals/institutions reached
ARIA has been implemented in over 70 countries globally [3], and several governments use the practice.
Approximately 26,000 users have registered to the MASK
database. 700 patients have been enrolled in the Twinning. Due to privacy, there is no possibility of assessing
users who have reported data.
Timeframe
Level of care integration
MASK is used for the integration of primary and specialist care, of primary-secondary-tertiary health
care, as well as of health and social care for disease
management.
The project was initiated in 1999 during a World Health
Organization (WHO) workshop (ARIA) and undergoes
continuous developments. The ARIA initiative, commenced during a WHO workshop in 1999 [2], has been
further developed by the WHO Collaborating Center
Bousquet et al. Clin Transl Allergy
(2019) 9:16
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Table 2 List of countries using MASK-air
AR Argentina, AT Austria, AU Australia, Be Belgium, BR Brazil, CA Canada, CH Switzerland, CZ Czech Republic, DE Germany, DK Denmark, ES Spain, FI Finland, FR France,
GB Great Britain, GR Greece, IT Italy, LT Lithuania, MX Mexico, NL The Netherlands, PL Poland, PT Portugal, SE Sweden, TR Turkey
for Asthma and Rhinitis (2002–2013). The initial goals
(Phase 1) were (1) to propose a new AR classification, (2)
to promote the concept of multimorbidity in asthma and
rhinitis and (3) to develop guidelines with all stakeholders
that could be used globally for all countries and all populations. ARIA has been disseminated and implemented
in over 70 countries [3, 19, 24–32]. It was developed as a
guideline [19] using the GRADE approach [33–39].
MASK, the Phase 3 ARIA initiative, is focusing on
(1) the implementation of multi-sectoral care pathways
(2) using emerging technologies (3) with real world
data (4) for individualized and predictive medicine (5)
in rhinitis and asthma multimorbidity (6) by a multidisciplinary group or by patients themselves (self-care)
using the AIRWAYS ICPs algorithm (7) across the life
cycle [8, 17]. It will be scaled up using the EU EIP on
AHA strategy [26].
Phase 4 began in 2018. It concerns “change management” and includes the impact of air pollution in
asthma and rhinitis (EIT Health 2018–2019: POLLAR,
Impact of Air POLLution in Asthma and Rhinitis) [4]
as well as the digital transformation of health and care
(DigitalHealthEurope, Euriphi and Vigour).
Developments for 2019 include a multimorbidity App
and the deployment of an app for home services.
The MASK project is intended to be sustainable and a
business plan has been initiated.
The medium-term future is to develop care pathways
for the prevention and control of chronic diseases to
sustain planetary health. A symposium during the Finnish Presidency of the EU Council is planned for October
2019.
Scientific evidence and conceptual framework
for configuring the practice
The scientific evidence is based on a validated “research”
tool (The Allergy Diary, –2018) that has led to large scale
deployment (MASK-air, 2019–):
• Validation of the app using COSMIN guidelines [40].
• Baseline characteristics informed [12].
• Work productivity associated with the control of
allergic diseases [41, 42].
• EQ-5D is available and has been found to correlate to
baseline characteristics [43].
• Novel phenotypes of allergic diseases have been discovered [44].
Bousquet et al. Clin Transl Allergy
(2019) 9:16
• Adherence to treatment is extremely low and novel
approaches to inform the efficacy of treatment have
been proposed [45] leading to novel studies for a better understanding of guidelines [46, 47].
Page 6 of 19
burden in all age groups [19]. By 2020, rhinitis will affect
at least 20% of the old age population [52–56]. These diseases represent an enormous burden associated to medical and social costs and they impact health and social
inequalities.
Evidence of impact
MASK has identified novel phenotypes of allergic diseases [44] that have been confirmed in classical epidemiologic studies by re-analyzing them [48–51]. One of
the studies used the MASK baseline characteristics [49].
These phenotypes allowed the re-classification of allergic
multimorbidity and the discovery of a new extreme phenotype of allergic diseases that need to be considered in
the stratification of patients.
MASK has shown real-life mHealth data for the first
time in allergy treatment in 9,950 users [1, 45]. This led
to next-generation care pathways for allergic diseases
(meeting co-organized by POLLAR, a member of EIT
Health, EIP on AHA and GARD (WHO alliance): 3-122018) and proposed a change management strategy [5].
MASK is involved in an EIT Health project (POLLAR)
which assesses the interactions between air pollution,
asthma and rhinitis [4].
With the EIP on AHA, MASK is involved in 3 EU projects on the digital transformation of health and care
(DigiHealthEurope, Euriphi and Vigour).
MASK is also involved in a large project on Planetary
Health in a side event which will take place during the
Presidency of the EU council (Finland). This event will
gather researchers, academic leaders and other experts
from European institutions as well as other stakeholders
and will discuss Planetary Health global challenges and
their scientific solutions. Experts on human health as well
as on effects of climate change, urbanization and food
production will be invited to prepare a European initiative to promote effective and sustainable research on
planetary health issues. The event similarly aims at raising political awareness about the need for multidisciplinary and systemic approaches to Planetary Health issues
globally and in the EU. The multimorbid App developed
by MASK may be used in the project.
Contextual relevance
The practice addresses a public health priority
Chronic respiratory diseases (CRDs) are major non-communicable diseases (NCDs) [18]. Rhinitis and asthma
multimorbidity is common and the two diseases should
be considered jointly [19]. Asthma is the most common NCD in children and rhinitis is the most common
chronic disease in Europe. They often start early in life,
persist across the life cycle and cause a high disease
The practice is based on a local/regional/national strategic
action plan
The Polish Presidency of the EU Council (3051st Council Conclusions) made the prevention, early diagnosis
and treatment of asthma and allergic diseases a priority
to reduce health inequalities [57, 58]. The 3206th Cyprus
Council Conclusions [59] recommended that the diagnosis and treatment of chronic diseases should be initiated as early as possible to improve AHA. Debates at the
European Parliament recommended the early diagnosis
and management of CRDs in order to promote active and
healthy ageing (AHA) [60–62].
The practice is also a WHO-associated project: Initial
workshop (1999), WHO Collaborating Center for rhinitis and asthma (2004–2014), Global Alliance against
Chronic Respiratory Diseases (GARD) [63, 64] demonstration project (2015–).
Unmet needs
Several unmet needs have been identified in allergic diseases. They include (1) suboptimal rhinitis and
asthma control due to medical, cultural and social barriers [65, 66], (2) better understanding of endotypes
[67], phenotypes and multimorbidities, (3) assessment
of allergen and pollutants as risk factors to promote
sentinel networks in care pathways, (4) stratification of
patients for optimized care pathways [68] and (5) promotion of multidisciplinary teams within integrated
care pathways, endorsing innovation in clinical trials
and encouraging patient empowerment [17, 69].
Overall goal
The general objective of AIRWAYS-ICPs [6–8] is to
develop multi-sectoral ICPs for CRDs used across European countries and regions in order to (1) reduce the
burden of the diseases in a patient-centred approach,
(2) promote AHA, (3) create a care pathways simulator tool which can be applied across the life cycle and
in older adults, (4) reduce health and social inequalities, (5) reduce gender inequalities, (6) use the lessons
learned in CRDs for chronic diseases and (7) promote
SDG3 (more specifically 3.4) (https://www.who.int/
sdg/targets/en/). In September 2015, the UN General
Assembly established the Sustainable Development
Goals (SDGs), a set of global goals for fair and sustainable health at every level from planetary biosphere to
Bousquet et al. Clin Transl Allergy
(2019) 9:16
local community [70, 71], essential for sustainable
development. SDG 3 prioritizes health and well-being
for all ages.
The aim of AIRWAYS-ICPs is also to generalise the
approach of the uniform definition of severity, control and risk of severe asthma presented to WHO [66]
and allergic diseases [72] in order to develop a uniform
risk stratification usable for chronic diseases in most
situations.
MASK further refined AIRWAYS ICPs using mobile
technology to promote the digital transformation of
health and care in developed and developing countries
for all age groups.
Target population
In the initial phase, the target population included all
patients with allergic rhinitis and asthma multimorbidity. Rhinitis and asthma are considered as a model for
all chronic diseases and the project is being extended to
chronic diseases.
All patients able to use a smartphone (≥ 12 years)
represent the target population. A special effort is being
placed in underserved populations from developing
countries as the practice is a GARD (Global Alliance
against Chronic Respiratory Diseases, WHO alliance)
demonstration project.
Page 7 of 19
countries and we have received requests from many
other countries in which MASK-air is not yet available.
Resistance or conflict of interest: None
Implementation methodology/strategy
We used the scaling up strategy of the European Innovation Partnership on Active and Healthy Ageing and proposed a 5‐step framework for developing an individual:
(1) what to scale up: (1‐a) databases of good practices,
(1‐b) assessment of viability of the scaling up of good
practices, (1‐c) classification of good practices for local
replication and (2) how to scale up: (2‐a) facilitating
partnerships for scaling up, (2‐b) implementation of key
success factors and lessons learnt, including emerging
technologies for individualized and predictive medicine.
This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation
Partnership on Active and Healthy Ageing [26].
Consistency in the pace of delivery
For the past 20 years, ARIA has been a success story in
over 72 countries [3, 8, 19, 24, 25, 27, 28, 30–32, 38, 46,
74–100]. A Pocket Guide has been translated into 52 languages. MASK is following ARIA with the same group
and the same strategy.
Main outcomes and evaluation of the practice
Stakeholders involved
Involvement in the design, implementation (including
the creation of ownership), evaluation, continuity/
sustainability
As from the very first workshop in 1999, the ARIA initiative has included all stakeholders required to develop
a WHO programme on CRDs (GARD). In particular,
patient’s organizations were involved. All health care professionals were also involved (physicians, primary care,
pharmacists, other health care professionals). Another
important component of ARIA was the deployment to
developing countries [73]. Moreover, policy makers were
also actively involved.
ARIA has grown regularly over the past 20 years and
an ARIA chapter is ongoing in over 70 countries in all
continents with a very active scaling up strategy [26].
MASK has used the ARIA working group to scale up the
practice.
All stakeholders were highly receptive
The ARIA and now the MASK community is very cohesive and all members are extremely reactive. They have
been particularly active in deploying MASK in the 23
The ARIA strategy was to change management in the
treatment of asthma and rhinitis since nasal symptoms—often the most troublesome—were not considered in most asthmatics. Over 85% of asthma in
children and adolescents is associated with rhinitis,
suggesting common pathways, whereas only 20–30%
of rhinitis patients have asthma, suggesting rhinitisspecific genes. There is a link between asthma severity and rhinitis multimorbidity. Asthma is more severe
in patients with rhinitis [101]. The strategy at all levels
of care indicates that it is essential to consider multimorbidity in the management of asthma for the benefit of the patient and the satisfaction of the treatment
as shown in many surveys (Fig. 3). Some studies have
found that the ARIA strategy is more effective than
free treatment choice [102]. Moreover, EMA has used
the ARIA recommendations for the approval of a house
dust mite immunotherapy tablet including asthma and
rhinitis multimorbidity [103].
The change management strategy of MASK has
not yet been evaluated. However, the results of the
first studies indicate that the vast majority of patients
are not adherent to treatment [45] and that nextgeneration care pathways are needed (Figs. 4 and 5).
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Page 8 of 19
Current knowledge (2000)
• Clinical pracce: allergic mul-morbidity is common and represents a paent’s need
• ECRHS: epidemiologic evidence for allergic mul-morbidity
• Nasal and bronchial biopsies confirm commonalies in rhinis and asthma
ARIA
2000
Mechanisc, epidemiological and clinical studies reinforcing the ARIA mul-morbidity concept
2010
2017
Mul-morbidity not occurring
by chance, independent of IgE
ARIA-GRADE guideline
T2 origin of mul-morbidity
Clinical pracce
EGEA
Mul-morbid poly-sensized phenotype
Birth cohorts (BAMSE, MAS….)
MASK
Novel mul-morbid paerns
SDM
MeDALL
Change management:
• Allergic mul-morbidity is adopted in clinical pracce worldwide
• The link is rhinis and not allergy
• Novel mechanisc/genec pathways of mul-morbidity
Fig. 3 Change management strategy in ARIA Phases 1 and 2. From [5]
Patient with rhinitis symptoms
Paent parcipaon, health literacy
and self-care through technology
assisted ‘paent acvaon’
Goals
Self-care
Pharmacist
ARIA in the pharmacy
Incorrect
diagnosis
Severity
Improvement
OTC
medicaon
Failure
Check For
asthma
YES
General practitioner
Next-generaon ARIA-WAO guidelines
Incorrect
diagnosis
Severity
Improvement
Treatment
Failure
Specialist
Emergency care (asthma)
1. Develop for each
step a document
with a 4-pages
pocket-guide
2. Include mHealth for
each step
3. From one step to the
next one
4. When to go to the
next step
5. Stepwise approach
for management
6. Develop machine
learning to opmize
ICPs
Fig. 4 Next-generation care pathways. From [5]
Next-generation care pathways were initiated in Paris,
December 3, 2018, as part of POLLAR, MASK and
GARD.
Additional (secondary) outcomes assessed
Work productivity and school performance are measured. When rhinitis and/or asthma are not well controlled, work productivity is impaired [1, 41, 43].
Sustainability of the practice
The MASK App, The Allergy Diary, was used to demonstrate the scientific value of the project [1]. It has been
replaced by the commercial App, MASK-air, which is version 3.0 and which includes questionnaires (e.g. tobacco
and allergens) and sleep (VAS and Epworth questionnaire
[104]) (Fig. 6). A business plan is in place for the sustainability of the practice.
Bousquet et al. Clin Transl Allergy
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Page 9 of 19
Patient with rhinitis symptoms
Goals
Self-care
Pharmacist
Aerobiology
Air polluon
Incorrect
diagnosis
Severity
Biodiversity
Other approaches
Incorrect
diagnosis
Severity
Improvement
OTC
medica on
Failure
General practitioner
Improvement
Treatment
Failure
Specialist
Emergency care (asthma)
Check For
asthma
YES
1. Embedding
environmental data
2. Preven on of
symptoms and
asthma (self-care)
3. Assess if severity of
symptoms is
associated with
allergens or pollu on
4. Predict emergency
care visits
5. Develop machine
learning to op mize
ICPs
Fig. 5 Embedding air pollution and biodiversity in care pathways. From [4]
MASK Version 3
Profile complement (tobacco)
Complement of daily surveysleep and sleepiness
quesons added
Complement quesonnaires
(Epworth)
1
Fig. 6 From The Allergy Diary to MASK-air
Communication about the practice and dissemination
of results
A communication strategy has been set up [1] and
includes a website (mask-air.com), media coverage, leaflets and newsletters, publications in scientific journals
and lay press, partners’ networks and events. The MASK
community includes over 300 members in all countries in
which MASK is deployed.
Budget required to implement the practice
The budget required to implement the MASK strategy
is around 1.5 M€. It will be provided by the private sector (1 M€) and from EU grants, in particular a Structural
and Development Fund. POLLAR has an additive budget
of 2 M€ to embed outdoor air pollution and aerobiology
data in the ICP using artificial intelligence.
It is difficult to estimate human resources since many
physicians worked in the 23 countries for the translation,
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Page 10 of 19
Fig. 7 Sponsors of the meeting (Paris, December 3, 2018). POLLAR: Impact of Air POLLution in Asthma and Rhinitis, EIT Health: European Institute
for Innovation and Technology, ARIA: Allergic Rhinitis and its Impact on Asthma, Euforea: European Forum for Research and Education in Allergy
and Airways Diseases GA2LEN: Global Allergy and Asthma European Network, CEmPac: Centre for Empowering Patients and Communities, EAACI:
European Academy of Allergy and Clinical Immunology, EFA: European Federation of Allergy and Airways Diseases Patients’ Associations, ERS:
European Respiratory Society, ERS: European Rhinology Society, GARD: Global Alliance against Chronic Respiratory Diseases (WHO Alliance), GINA:
Global Initiative for Asthma, MACVIA: Fondation VIA-LR, SPLF: Societé de Pneumologie de Langue Française, SFA: Société française d’Allergologie,
WAO: World Allergy Organization
adaptation of the practice and its implementation. It can
be proposed that 50–100 h have been spent working in
each country.
The practice has been presented to multiple national
and international meetings.
Sustainability has been carefully evaluated and a business plan is in place.
Main lessons learned
• Adherence to treatment is the major problem of
allergic disease.
• Self-management strategies should be considerably
expanded (behavioural).
• Change management is essential in allergic diseases.
• Education strategies should be reconsidered using a
patient-centred approach.
• Lessons learned for allergic diseases can be expanded
to chronic diseases.
Improvement and expansion of the practice
An expert meeting took place at the Pasteur Institute in Paris, December 3, 2018, to discuss nextgeneration care pathways and lessons learnt (Fig. 7,
Annex 1): (1) patient participation, health literacy and
self-care through technology-assisted “patient activation”, (2) implementation of care pathways by pharmacists and (3) next-generation guidelines assessing
the recommendations of GRADE guidelines in rhinitis
and asthma using real-world evidence (RWE) assessed
by mobile technology. The meeting was organized by
POLLAR and MASK in collaboration with GARD,
patient’s organizations and all European scientific societies in the field.
Abbreviations
AHA: active and healthy ageing; AIRWAYS ICPs: integrated care pathways
for airway diseases; AR: allergic rhinitis; ARIA: allergic rhinitis and its impact
on asthma; CDSS: clinical decision support system; CRD: chronic respiratory
disease; DG CONNECT: directorate general for communications networks, con‑
tent and technology; DG Santé: directorate general for health and food safety;
EIP on AHA: European innovation partnership on AHA; EIP: European innova‑
tion partnership; EQ-5D: euroquol; Euforea: European forum for research
and education in allergy and airways diseases; GARD: global alliance against
chronic respiratory diseases; GP: good practice; HCP: health care professional;
ICP: integrated care pathway; JA-CHRODIS: joint action on chronic diseases
and promoting healthy ageing across the life cycle; MACVIA-LR: contre les
MAladies chroniques pour un VIeillissement Actif (Fighting chronic diseases
for AHA); MASK: Mobile airways sentinel networK; MeDALL: Mechanisms of
the development of ALLergy (FP7); mHealth: mobile health; NCD: non-com‑
municable disease; POLLAR: impact of air POLLution on Asthma and Rhinitis;
QOL: quality of life; TRL: technology readiness level; VAS: visual analogue scale;
WHO: World Health Organization; WPAI-AS: Work Productivity and Activity
questionnaire.
Authors’ contributions
All authors are MASK members and have contributed to the design of the pro‑
ject. Many authors also included users and disseminated the project in their
own country. All authors read and approved the final manuscript.
Author details
1
MACVIA‑France, Fondation Partenariale FMC VIA-LR, CHU Arnaud de
Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5,
France. 2 INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological
Bousquet et al. Clin Transl Allergy
(2019) 9:16
and Public Health Approaches, Villejuif, Université Versailles St-Quentin-enYvelines, UMR-S 1168, Montigny Le Bretonneux, France. 3 Euforea, Brussels,
Belgium. 4 Humboldt‑Universität zu Berlin, Berlin Institute of Health,
Comprehensive Allergy Center, Department of Dermatology and Allergy,
Charité, Universitätsmedizin Berlin, Berlin, Germany. 5 Medical Consulting
Czarlewski, Levallois, France. 6 KYomed INNOV, Montpellier, France. 7 Center
for Research in Health Technology and Information Systems, Faculdade de
Medicina da Universidade do Porto, Medida, Lda Porto, Portugal. 8 UCIBIO,
REQUINTE, Faculty of Pharmacy and Competence Center on Active
and Healthy Ageing, University of Porto (Porto4Ageing), Porto, Portugal.
9
Faculty of Health Sciences and CICS – UBI, Health Sciences Research Centre,
University of Beira Interior, Covilhã, Portugal. 10 Allergy Center, CUF Descober‑
tas Hospital, Lisbon, Portugal. 11 Imunoalergologia, Centro Hospitalar
Universitário de Coimbra and Faculty of Medicine, University of Coimbra,
Coimbra, Portugal. 12 Division for Health Innovation, Campania Region
and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy.
13
CIRFF, Federico II University, Naples, Italy. 14 Personalized Medicine Clinic
Asthma and Allergy, Humanitas Research Hospital, Humanitas University,
Rozzano, Milan, Italy. 15 SOS Allergology and Clinical Immunology, USL Toscana
Centro, Prato, Italy. 16 Department of Medical Sciences, Allergy and Clinical
Immunology Unit, University of Torino & Mauriziano Hospital, Turin, Italy.
17
Consortium of Pharmacies and Services COSAFER, Salerno, Italy. 18 Unit
of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
19
Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”,
University of Salerno, Salerno, Italy. 20 Department of Otorhinolaryngology,
Amsterdam University Medical Centre (AMC), Amsterdam, The Netherlands.
21
Department of Public Health and Primary Care, Leiden University Medical
Center, Leiden, The Netherlands. 22 ProAR – Nucleo de Excelencia em Asma,
Federal University of Bahia, Vitória da Conquista, Brazil. 23 WHO GARD Planning
Group, Salvador, Brazil. 24 Department of Internal Medicine and Allergic Clinic
of Professor Polydoro Ernani de Sao, Thiago University Hospital, Federal
University of Santa Catarina (UFSC), Florianópolis, Brazil. 25 Asthma Reference
Center, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria,
Vitória, Esperito Santo, Brazil. 26 Center of Excellence in Asthma and Allergy,
Médica Sur Clinical Foundation and Hospital, Mexico City, Mexico. 27 Hospital
General Regional 1 “Dr Carlos Mc Gregor Sanchez Navarro” IMSS, Mexico City,
Mexico. 28 Allergist, Mexico City, Mexico. 29 Clinic of Children’s Diseases,
and Institute of Health Sciences Department of Public Health, Vilnius
University Institute of Clinical Medicine, Vilnius, Lithuania. 30 European
Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium. 31 Clinic of Infec‑
tious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius,
Lithuania. 32 Clinic of Children’s Diseases, Faculty of Medicine, Vilnius University,
Vilnius, Lithuania. 33 Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
34
Epidemiology of Allergic and Respiratory Diseases, Department Institute
Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Université,
Medical School Saint Antoine, Paris, France. 35 Department of Geriatrics,
Montpellier University Hospital, Montpellier, France. 36 EA 2991, Euromov,
University Montpellier, Montpellier, France. 37 CHU Dijon, Dijon, France.
38
Allergist, La Rochelle, France. 39 Sleep Unit, Department of Neurology,
Hôpital Gui-de-Chauliac Montpellier, Montpellier, France. 40 Inserm U1061,
Montpellier, France. 41 UPRES EA220, Pôle des Maladies des Voies Respiratoires,
Hôpital Foch, Université Paris-Saclay, Suresnes, France. 42 Allergist, Reims,
France. 43 Laboratoire HP2, Grenoble, INSERM, U1042, Université Grenoble
Alpes, Grenoble, France. 44 CHU de Grenoble, Grenoble, France. 45 Allergy
Department, Pasteur Institute, Paris, France. 46 Conseil Général de l’Economie
Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France.
47
Pneumologie et Soins Intensifs Respiratoires, Hôpitaux Universitaires Paris,
Centre Hôpital Cochin, Paris, France. 48 Association Asthme et Allergie, Paris,
France. 49 Allergy Unit, Department of Dermatology, University Hospital
of Zurich, Zurich, Switzerland. 50 Division of Internal Medicine, Asthma
and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz,
Poland. 51 Department of Prevention of Envinronmental Hazards and Allergol‑
ogy, Medical University of Warsaw, Warsaw, Poland. 52 ISGlobAL, Centre
for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. 53 IMIM
(Hospital del Mar Research Institute), Barcelona, Spain. 54 CIBER Epidemiología
y Salud Pública (CIBERESP), Barcelona, Spain. 55 Universitat Pompeu Fabra
(UPF), Barcelona, Spain. 56 Allergy Section, Department of Internal Medicine,
Hospital Vall ‘dHebron & ARADyAL Research Network, Barcelona, Spain.
57
Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, University
of Barcelona, Barcelona, Spain. 58 Clinical and Experimental Respiratory
Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
Page 11 of 19
59
Asthma UK Centre for Applied Research, The Usher Institute of Population
Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
60
Honorary Clinical Research Fellow, Allergy and Respiratory Research Group,
Usher Institute of Population Health Sciences and Informatics, Medical School,
University of Edinburgh, Edinburgh, UK. 61 The Usher Institute of Population
Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
62
Asthma UK, Mansell Street, London, UK. 63 International Primary Care
Respiratory Group IPCRG, Aberdeen, Scotland, UK. 64 Department of Otolaryn‑
gology, Head and Neck Surgery, University of Mainz, Mainz, Germany. 65 Center
for Rhinology and Allergology, Wiesbaden, Germany. 66 Department
of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology
and Allergy, University Hospital Marburg, Phillipps-Universität Marburg,
Marburg, Germany. 67 Corporate Member of Freie Universität Berlin,
Humboldt‑Uniersität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin,
Germany. 68 Berlin Institute of Health, Comprehensive Allergy‑Centre,
Department of Dermatology and Allergy, Member of GA2LEN, Berlin,
Germany. 69 Institute of Medical Statistics, and Computational Biology, Medical
Faculty, University of Cologne, Cologne, Germany. 70 CRI-Clinical Research
International-Ltd, Hamburg, Germany. 71 Department of Internal Medicine,
Medical University of Graz, Graz, Austria. 72 Department of ENT, Medical
University of Graz, Graz, Austria. 73 Skin and Allergy Hospital, Helsinki University
Hospital, University of Helsinki, Helsinki, Finland. 74 Association of Finnish
Pharmacies, Helsinki, Finland. 75 Department of Lung Diseases and Clinical
Immunology, Terveystalo Allergy Clinic, University of Turku, Turku, Finland.
76
FILHA, Finnish Lung Association, Helsinki, Finland. 77 Department
of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul UniversityCerrahpasa, Istambul, Turkey. 78 Department of Pulmonary Diseases, Faculty
of Medicine, Celal Bayar University, Manisa, Turkey. 79 Division of Infection,
Immunity and Respiratory Medicine, Royal Manchester Children’s Hospital,
University of Manchester, Manchester, UK. 80 Allergy Department, 2nd
Pediatric Clinic, Athens General Children’s Hospital “P&A Kyriakou”, University
of Athens, Athens, Greece. 81 Department of Otorhinolaryngology, University
of Crete School of Medicine, Heraklion, Greece. 82 Health Planning Unit,
Department of Social Medicine, Faculty of Medicine, University of Crete, Crete,
Greece. 83 University of Sydney and Woolcock Emphysema Centre and Local
Health District, Woolcock Institute of Medical Research, Glebe, NSW, Australia.
84
Department of Allergy, Immunology and Respiratory Medicine, Alfred
Hospital and Central Clinical School, Monash University, Melbourne, VIC,
Australia. 85 Department of Immunology, Monash University, Melbourne, VIC,
Australia. 86 Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos
Aires, Argentina. 87 Director of Center of Allergy, Immunology and Respiratory
Diseases, Santa Fe, Argentina Center for Allergy and Immunology, Santa Fe,
Argentina. 88 Universidad Católica de Córdoba, Córdoba, Argentina.
89
Department of Clinical Science and Education, Södersjukhuset, Karolinska
Institutet, Stockholm, Sweden. 90 Sachs’ Children and Youth Hospital,
Södersjukhuset, Stockholm and Institute of Environmental Medicine,
Karolinska Institutet, Stockholm, Sweden. 91 Centre for Clinical Research
Sörmland, Uppsala University, Eskilstuna, Sweden. 92 Upper Airways Research
Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium. 93 Depart‑
ment of Otorhinolaryngology, Univ Hospitals Leuven, Louvain, Belgium.
94
Academic Medical Center, Univ of Amsterdam, Amsterdam, The Nether‑
lands. 95 Department of Respiratory Medicine, Ghent University Hospital,
Ghent, Belgium. 96 EFA European Federation of Allergy and Airways Diseases
Patients’ Associations, Brussels, Belgium. 97 Department of Dermatology
and Allergy Centre, Odense University Hospital, Odense Research Center
for Anaphylaxis (ORCA), Odense, Denmark. 98 Department of Medicine, Clinical
Immunology and Allergy, McMaster University, Hamilton, ON, Canada.
99
Quebec Heart and Lung Institute, Laval University, Québec City, QC, Canada.
100
Clinical Medecine, Laval’s University, Quebec City, Canada. 101 Medecine
Department, Hôpital de la Malbaie, Quebec, Canada. 102 Department of Health
Research Methods, Evidence and Impact, Division of Immunology and Allergy,
McMaster University, Hamilton, ON, Canada. 103 Department of Respiratory
Medicine, University Hospital Olomouc, Olomouc, Czech Republic. 104 Peer‑
code BV, Geldermalsen, The Netherlands. 105 Faculty of Medicine, Transylvania
University, Brasov, Romania. 106 Department of Allergy and Immunology,
Hospital Quirón Bizkaia, Erandio, Spain. 107 iQ4U Consultants Ltd, London, UK.
108
Division of Allergy/Immunology, University of South Florida, Tampa, USA.
109
Section of Allergy and Immunology, Saint Louis University School
of Medicine, Saint Louis, MO, USA. 110 Clinical Reserch Center for Allergy
and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.
111
Medical Communications Consultant, MedScript Ltd (Ireland & New
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Zealand), Dundalk, Ireland. 112 Honorary Research Fellow, OPC, Cambridge, UK.
113
Johns Hopkins School of Medicine, Baltimore, MD, USA. 114 Department
of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan. 115 Nova
Southeastern University, Fort Lauderdale, FL, USA.
Acknowledgements
Practice presented during the Steering Group on Promotion and Prevention
marketplace workshop on “digitally-enabled, integrated, person-centred care”
best practices on 12–13 December 2018 in the premises of the Joint Research
Centre in Ispra, Italy.
Mask Study Group
ellings4, W Aberer5, I A
gache6, CA A
kdis7, M A
kdis7, MR
J Bousquet1-3, PW H
Aliberti8, R Almeida9, F Amat10, R A
ngles11, I Annesi-Maesano12, IJ A
nsotegui13,
JM Anto14-17, S A
rnavielle18, E A
sayag19, A A
sarnoj20, H A
rshad21, F A
volio22, E
Bacci23, C Bachert24, I Baiardini25, C B
arbara26, M B
arbagallo27, I B
aroni28, BA
Barreto29, X Basagana14, ED B
ateman30, M Bedolla-Barajas31, A B
edbrook2, M
Bewick32, B Beghé33, EH Bel34, KC B
ergmann35, KS B
ennoor36, M B
enson37, L
Bertorello23, AZ Białoszewski38, T Bieber39, S B
ialek40, C Bindslev-Jensen41 , L
Bjermer42, H Blain43,44, F Blasi45, A B
lua46, M Bochenska M
arciniak47, I BogusBuczynska47, AL Boner48, M B
onini49, S B
onini50, CS Bosnic-Anticevich51, I
Bosse52, J B
ouchard53, LP B
oulet54, R B
ourret55, PJ B
ousquet12, F B
raido25,
V Briedis56, CE B
rightling57, J B
rozek58, C B
ucca59, R B
uhl60, R B
uonaiuto61,
C Panaitescu62, MT Burguete Cabañas63 , E B
urte3, A B
ush64, F CaballeroFonseca65, D C
aillaud67, D C
aimmi68, MA C
alderon69, PAM C
amargos70, T
Camuzat71, G Canfora72, GW C
anonica25, V Cardona73, KH C
arlsen74, P CarreiroMartins75, AM Carriazo76, W Carr77, C C
artier78, T Casale79, G C
astellano80, L
Cecchi81, AM Cepeda82, NH C
havannes83, Y Chen84, R C
hiron68, T Chivato85, E
Chkhartishvili86, AG C
huchalin87, KF C
hung88, MM C
iaravolo89, A C
iceran90, C
Cingi91, G C
iprandi92, AC Carvalho C
oehlo93, L C
olas94, E C
olgan95, J C
oll96, D
Conforti97, J Correia de S ousa98, RM Cortés-Grimaldo99, F C
orti100, E C
osta101,
MC Costa-Dominguez102, AL C
ourbis103, L C
ox104, M C
rescenzo105, AA Cruz106,
A Custovic107, W Czarlewski108, SE D
ahlen109, G D’Amato381, C D
ario110, J da
Silva111, Y Dauvilliers112, U Darsow113, F De B
lay114, G De C
arlo115, T Dedeu116, M
de Fátima Emerson117, G De Feo118, G De Vries119, B De Martino120, NP Motta
Rubina121, D D
eleanu122, P D
emoly12,68, JA D
enburg123, P D
evillier124, S Di
Capua Ercolano125, N Di C
arluccio66, A D
idier126, D D
okic127, MG DominguezSilva128, H Douagui129, G D
ray103, R D
ubakiene130, SR D
urham131, G Du Toit132,
MS Dykewicz133, Y El-Gamal134, P E klund135, E E ller41, R E muzyte136, J Farrell95,
A Farsi81, J Ferreira de Mello Jr137, J F errero138, A Fink-Wagner139, A F iocchi140,
WJ Fokkens141, JA F onseca142, JF F ontaine143, S F orti97, JM Fuentes-Perez144, JL
Gálvez-Romero145, A Gamkrelidze146, J Garcia-Aymerich14, CY García-Cobas147,
MH Garcia-Cruz148, B Gemicioğlu149, S G
enova150, G C
hristoff151, JE G
ereda152,
R Gerth van Wijk153, RM Gomez154, J Gómez-Vera155, S González D
iaz156,
M Gotua157, I Grisle158, M G
uidacci159, NA G
uldemond160, Z G
utter161, MA
Guzmán162, T Haahtela163, J H
ajjam164, L Hernández165, JO’B H
ourihane166, YR
Huerta-Villalobos167, M Humbert168, G Iaccarino169, M Illario170 , Z Ispayeva380,
JC Ivancevich171, EJ J ares172, E J assem173, SL J ohnston174, G J oos175, KS Jung176,
J Just 10, M Jutel177, I Kaidashev178, O K alayci179, AF K alyoncu180, J K arjalainen181,
P Kardas182, T Keil183, PK Keith184, M K haitov185, N K haltaev186, J Kleine-Tebbe187,
L Klimek188, ML Kowalski189, M K uitunen190, I K ull191, P K una47, M K upczyk47,
V Kvedariene192, E Krzych-Fałta193, P L acwik47, D Larenas-Linnemann194, D
Laune18, D L auri195, J L avrut196, LTT L e197, M L essa198, G L evato199, J L i200, P
Lieberman201, A Lipiec193, B L ipworth202, KC Lodrup C
arlsen203, R L ouis204,
O Lourenço205, JA Luna-Pech206, A M
agnan94, B M
ahboub207, D M
aier208, A
Mair209, I Majer210, J M
alva211, E M
andajieva212, P M
anning213, E De Manuel
Keenoy214, GD M
arshall215, MR M
asjedi216, JF M
aspero217, EMathieu-Dupas18,
JJ Matta Campos218, AL Matos219, M M
aurer220, S Mavale-Manuel221, O
Mayora97, MA Medina-Avalos222, E Melén223, E Melo-Gomes26, EO M
eltzer224,
E Menditto225, J M
ercier226, N M
iculinic227, F M
ihaltan228, B M
ilenkovic229,
G Moda230, MD Mogica-Martinez231, Y Mohammad232, I M
omas233,234, S
Montefort235, R Monti236, D Mora B
ogado237, M Morais-Almeida238, FF
Morato-Castro239, R Mösges240, A Mota-Pinto241, P Moura S anto242, J Mullol243,
L Münter244, A Muraro245, R M
urray246, R N
aclerio247, R N
adif3, M N
alin28, L
Napoli248, L Namazova-Baranova249, H N
effen250, V Niedeberger251, K Nekam252,
A Neou253, A Nieto254, L Nogueira-Silva255, M N
ogues2,256, E N
ovellino257,
TD Nyembue258, RE O’Hehir259, C O
dzhakova260, K O
hta261, Y Okamoto262, K
Okubo263, GL Onorato2, M Ortega Cisneros264, S O
uedraogo265, I Pali-Schöll266,
S Palkonen115, P Panzner267, NG P
apadopoulos268, HS P
ark269, A P
api270, G
Passalacqua271, E Paulino272, R P
awankar273, S P
edersen274, JL Pépin275, AM
Page 12 of 19
Pereira276, M Persico277, O Pfaar278, J Phillips280, R Picard281, B Pigearias282, I
Pin283, C Pitsios284, D Plavec285, W Pohl286, TA Popov287, F Portejoie2, P Potter288,
AC Pozzi289, D Price290, EP Prokopakis291, R Puy259, B Pugin292, RE Pulido
Ross293, M Przemecka47, KF Rabe294, F Raciborski193, R Rajabian-Soderlund295,
S Reitsma141, I Ribeirinho296, J Rimmer297, D Rivero-Yeverino298, JA Rizzo299,
MC Rizzo300, C Robalo-Cordeiro301, F Rodenas302, X Rodo14, M Rodriguez
Gonzalez303, L Rodriguez-Mañas304, C Rolland305, S Rodrigues Valle306, M
Roman Rodriguez307, A Romano308, E Rodriguez-Zagal309, G Rolla310, RE RollerWirnsberger311, M Romano28, J Rosado-Pinto312, N. Rosario313, M Rottem314,
D Ryan315, H Sagara316, J Salimäki317, B Samolinski193, M Sanchez-Borges318,
J Sastre-Dominguez319, GK Scadding320, HJ Schunemann58, N Scichilone321,
P Schmid-Grendelmeier322, FS Serpa323, S Shamai240, A Sheikh324, M Sierra96,
FER Simons325, V Siroux326, JC Sisul327, I Skrindo378, D Solé328, D Somekh329, M
Sondermann330, T Sooronbaev331, M Sova332, M Sorensen333, M Sorlini334, O
Spranger139, C Stellato118, R Stelmach335, R Stukas336, J Sunyer14–17, J Strozek193,
A Szylling193, JN Tebyriçá337, M Thibaudon338, T To339, A Todo-Bom340, PV
Tomazic341, S Toppila-Salmi163, U Trama342, M Triggiani118, C Suppli Ulrik343, M
Urrutia-Pereira344, R Valenta345, A Valero346, A Valiulis347, E Valovirta348, M van
Eerd119, E van Ganse349, M van Hague350, O Vandenplas351, MT Ventura352, G
Vezzani353, T Vasankari354, A Vatrella118, MT Verissimo211, F Viart78, G Viegi355,
D Vicheva356, T Vontetsianos357, M Wagenmann358, S Walker359, D Wallace360,
DY Wang361, S Waserman362, T Werfel363, M Westman364, M Wickman191,
DM Williams365, S Williams366, N Wilson379, J Wright367, P Wroczynski40, P
Yakovliev368, BP Yawn369, PK Yiallouros370, A Yorgancioglu371, OM Yusuf372,
HJ Zar373, L Zhang374, N Zhong200, ME Zernotti375, I Zhanat380, M Zidarn376, T
Zuberbier35, C Zubrinich259, A Zurkuhlen377
1
University Hospital, Montpellier, France. 2MACVIA-France, Fondation
partenariale FMC VIA-LR, Montpellier, France. 3VIMA. INSERM U 1168, VIMA:
Ageing and chronic diseases Epidemiological and public health approaches,
Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le
Bretonneux, France and Euforea, Brussels, Belgium. 4Laboratory of Clinical
Immunology, Department of Microbiology and Immunology, KU Leuven,
Leuven, Belgium. 5Department of Dermatology, Medical University of Graz,
Graz, Austria. 6Transylvania University Brasov, Brasov, Romania. 7Swiss Institute
of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzer‑
land. 8Project Manager, Chairman of the Council of Municipality of Salerno,
Italy. 9Center for Health Technology and Services Research- CINTESIS,
Faculdade de Medicina, Universidade do Porto; and Medida, Lda Porto,
Portugal. 10Allergology department, Centre de l’Asthme et des Allergies
Hôpital d’Enfants Armand-Trousseau (APHP); Sorbonne Université, UPMC Univ
Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé
Publique, Equipe EPAR, Paris, France. 11Innovación y nuevas tecnologías, Salud
Sector sanitario de Barbastro, Barbastro, Spain. 12Epidemiology of Allergic and
Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and
Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine,
Paris, France. 13Department of Allergy and Immunology, Hospital Quirón
Bizkaia, Erandio, Spain. 14ISGlobAL, Centre for Research in Environmental
Epidemiology (CREAL), Barcelona, Spain.15IMIM (Hospital del Mar Research
Institute), Barcelona, Spain. 16CIBER Epidemiología y Salud Pública (CIBERESP),
Barcelona, Spain. 17Universitat Pompeu Fabra (UPF), Barcelona, Spain.
18
KYomed INNOV, Montpellier, France. 19Argentine Society of Allergy and
Immunopathology, Buenos Aires, Argentina. 20Clinical Immunology and
Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm,
and Astrid Lindgren Children’s Hospital, Department of Pediatric Pulmonology
and Allergy, Karolinska University Hospital, Stockholm, Sweden. 21David Hide
Asthma and Allergy Research Centre, Isle of Wight, United Kingdom.
22
Regionie Puglia, Bari, Italy. 23Regione Liguria, Genoa, Italy. 24Upper Airways
Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium.
25
Allergy and Respiratory Diseases, Ospedale Policlinico San Martino,
University of Genoa, Italy. 26PNDR, Portuguese National Programme for
Respiratory Diseases, Faculdade de Medicina de Lisboa, Lisbon, Portugal.
27
Director of the Geriatric Unit, Department of Internal Medicine (DIBIMIS),
University of Palermo, Italy. 28Telbios SRL, Milan, Italy. 29Universidade do Estado
do Pará, Belem, Brazil. 30Department of Medicine, University of Cape Town,
Cape Town, South Africa. 31Hospital Civil de Guadalajara Dr Juan I Menchaca,
Guadalarara, Mexico. 32iQ4U Consultants Ltd, London, UK. 33Section of
Respiratory Disease, Department of Oncology, Haematology and Respiratory
Diseases, University of Modena and Reggio Emilia, Modena, Italy. 34Depart‑
ment of Respiratory Medicine, Academic Medical Center (AMC), University of
Amsterdam, The Netherlands. 35Charité - Universitätsmedizin Berlin, corporate
member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin
Bousquet et al. Clin Transl Allergy
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Institute of Health, Comprehensive Allergy Center, Department of Dermatol‑
ogy and Allergy, Global Allergy and Asthma European Network ( GA2LEN),
Berlin, Germany. 36Dept of Respiratory Medicine, National Institute of Diseases
of the Chest and Hospital, Dhaka, Bangladesh. 37Centre for Individualized
Medicine, Department of Pediatrics, Faculty of Medicine, Linköping, Sweden.
38
Department of Prevention of Environmental Hazards and Allergology,
Medical University of Warsaw, Poland. 39BIEBER. Department of Dermatology
and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
40
Dept of Biochemistry and Clinical Chemistry, University of Pharmacy with
the Division of Laboratory Medicine, Warsaw Medical University, Warsaw,
Poland. 41Department of Dermatology and Allergy Centre, Odense University
Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
42
Department of Respiratory Medicine and Allergology, University Hospital,
Lund, Sweden. 43Department of Geriatrics, Montpellier University Hospital,
Montpellier, France. 44EA 2991, Euromov, University Montpellier, France.
45
Department of Pathophysiology and Transplantation, University of Milan,
IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy.
46
Argentine Association of Respiratory Medicine, Buenos Aires, Argentina.
47
Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital,
Medical University of Lodz, Poland. 48Pediatric Department, University of
Verona Hospital, Verona, Italy. 49UOC Pneumologia, Istituto di Medicina Interna,
F. Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy,
and National Heart and Lung Institute, Royal Brompton Hospital & Imperial
College London, UK. 50Second University of Naples and Institute of Transla‑
tional Medicine, Italian National Research Council. 51Woolcock Institute of
Medical Research, University of Sydney and Woolcock Emphysema Centre and
Local Health District, Glebe, NSW, Australia. 52Allergist, La Rochelle, France.
53
Associate Professor of Clinical medecine, Laval’s University, Quebec city,
Head of medecine department, Hôpital de la Malbaie, Quebec, Canada.
54
Quebec Heart and Lung Institute, Laval University, Québec City, Quebec,
Canada. 55Centre Hospitalier Valenciennes, France. 56Head of Department of
Clinical Pharmacy of Lithuanian University of Health Sciences, Kaunas,
Lithuania. 57Institute of Lung Health, Respiratory Biomedical Unit, University
Hospitals of Leicester NHS Trust, Leicestershire, UK; Department of Infection,
Immunity and Inflammation, University of Leicester, Leicester, UK. 58Depart‑
ment of Health Research Methods, Evidence and Impact, Division of
Immunology and Allergy, Department of Medicine, McMaster University,
Hamilton, ON, Canada. 59Chief of the University Pneumology Unit- AOU
Molinette, Hospital City of Health and Science of Torino, Italy. 60Universitäts‑
medizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany.
61
Pharmacist, Municipality Pharmacy, Sarno, Italy. 62University of Medicine and
Pharmacy Victor Babes, Timisoara, Romania. 63Instituto de Pediatria, Hospital
Zambrano Hellion Tec de Monterrey, Monterrey, Mexico. 64Imperial College
and Royal Brompton Hospital, London, UK. 65Centro Medico Docente La
Trinidad, CaRacas, Venezuela. 66Regional Director Assofarm Campania and Vice
President of the Board of Directors of Cofaser, Salerno, Italy. 67Service de
pneumologie, CHU et université d’Auvergne, Clermont-Ferrand, France.
68
Department of Respiratory Diseases, Montpellier University Hospital, France.
69
Imperial College London - National Heart and Lung Institute, Royal
Brompton Hospital NHS, London, UK. 70Federal University of Minas Gerais,
Medical School, Department of Pediatrics, Belo Horizonte, Brazil. 71Assitant
Director General, Montpellier, Région Occitanie, France. 72Mayor of Sarno and
President of Salerno Province, Director, Anesthesiology Service, Sarno “Martiri
del Villa Malta” Hospital, Italy. 73Allergy Section, Department of Internal
Medicine, Hospital Vall d’Hebron & ARADyAL Spanish Research Network,
Barcelona, Spain. 74Department of Paediatrics, Oslo University Hospital and
University of Oslo, Oslo, Norway. 75CEDOC, Integrated Pathophysiological
Mechanisms Research Group, Nova Medical School, Campo dos Martires da
Patria, Lisbon, and Serviço de Imunoalergologia, Centro Hospitalar de Lisboa
Central, EPE, Lisbon, Portugal. 76Regional Ministry of Health of Andalusia,
Seville, Spain. 77Allergy and Asthma Associates of Southern California, Mission
Viejo, CA, USA. 78ASA - Advanced Solutions Accelerator, Clapiers, France.
79
Division of Allergy/Immunology, University of South Florida, Tampa, Fla, USA.
80
Celentano pharmacy, Massa Lubrense, Italy. 81SOS Allergology and Clinical
Immunology, USL Toscana Centro, Prato, Italy. 82Allergy and Immunology
Laboratory, Metropolitan University Hospital, Branquilla, Columbia. 83Depart‑
ment of Public Health and Primary Care, Leiden University Medical Center,
Leiden, The Netherlands. 84Capital Institute of Pediatrics, Chaoyang district,
Beijing, China. 85School of Medicine, University CEU San Pablo, Madrid, Spain.
86
David Tvildiani Medical University - AIETI Highest Medical School, David
Tatishvili Medical Center Tbilisi, Georgia. 87Pulmonolory Research Institute
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FMBA, Moscow, Russia and GARD Executive Committee, Moscow, Russia.
National Heart & Lung Institute, Imperial College, London, UK. 89Specialist
social worker, Sorrento, Italy. 90Argentine Federation of Otorhinolaryngology
Societies, Buenos Aires, Argentina. 91Eskisehir Osmangazi University, Medical
Faculty, ENT Department, Eskisehir,Turkey. 92Medicine Department,
IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy. 93Universi‑
dade Federal da Bahia, Escola de Enfermagem, Brazil. 94Plateforme Transversale
d’Allergologie, Institut du Thorax, CHU de Nantes, Nantes, France. 95LANUA
International Healthcare Consultancy, Northern Ireland, UK. 96Innovación y
nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain.
97
Innovation and Research Office, Department of Health and Social Solidarity,
Autonomous Province of Trento, Italy. 98Lifeand Health Sciences Research
Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal;
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal.
99
Servicio de Allergologia, Hospital Angeles del Carmen, Guadalajara, Mexico.
100
FIMMG (Federazione Italiana Medici di Medicina Generale), Milan, Italy.
101
UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active
and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.
102
Allergologo, Mexico City, Mexico. 103IMT Mines Alès, Unversité Montpellier,
Alès, France. 104Department of Medicine, Nova Southeastern University, Davie,
University of Miami Dept of Medicine, Miami, Florida, USA. 105Regional Director
Assofarm Campania and Vice President of the Board of Directors of Cofaser,
Salerno, Italy. 106ProAR – Nucleo de Excelencia em Asma, Federal University of
Bahia, Brasil and WHO GARD Planning Group, Brazil. 107Centre for Respiratory
Medicine and Allergy, Institute of Inflammation and Repair, University of
Manchester and University Hospital of South Manchester, Manchester, UK.
108
Medical Consulting Czarlewski, Levallois, France. 109The Centre for Allergy
Research, The Institute of Environmental Medicine, Karolinska Institutet,
Stockholm, Sweden. 110Azienda Provinciale per i Servizi Sanitari di Trento
(APSS-Trento), Italy. 111Department of Internal Medicine and Allergy Clinic of
Professor Polydoro Ernani de São Thiago University Hospital, Federal University
of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil. 112Sleep Unit,
Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061,
France. 113Department of Dermatology and Allergy, Technische Universität
München, Munich, Germany; ZAUM-Center for Allergy and Environment,
Helmholtz Center Munich, Technische Universität München, Munich,
Germany. 114Allergy Division, Chest Disease Department, University Hospital of
Strasbourg, Strasbourg, France. 115EFA European Federation of Allergy and
Airways Diseases Patients’ Associations, Brussels, Belgium. 116AQuAS, Barcelna,
Spain & EUREGHA, European Regional and Local Health Association, Brussels,
Belgium. 117Policlínica Geral do Rio de Janeiro, Rio de Janeiro – Brasil.
118
Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”,
University of Salerno, Salerno, Italy. 119Peercode BV, Geldermalsen, The
Netherlands. 120Social workers oordinator, Sorrento, Italy. 121Federal University
of the State of Rio de Janeiro, School of Medicine and Surgery, Rio de Janeiro,
Brazil. 122Allergology and Immunology Discipline, “Iuliu Hatieganu” University
of Medicine and Pharmacy, Cluj-Napoca, Romania. 123Department of
Medicine, Division of Clinical Immunology and Allergy, McMaster University,
Hamilton, Ontario, Canada. 124Laboratoire de Pharmacologie Respiratoire
UPRES EA220, Hôpital Foch, Suresnes, Université Versailles Saint-Quentin,
Université Paris Saclay, France. 125Farmacie Dei Golfi Group, Massa Lubrense,
Italy. 126Rangueil-Larrey Hospital, Respiratory Diseases Department, Toulouse,
France. 127University Clinic of Pulmology and Allergy, Medical Faculty Skopje,
Republic of Macedonia. 128Allergologo, Mexico City, Mexico. 129Service de
Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algiers,
Algeria. 130Clinic of infectious, chest diseases, dermatology and allergology,
Vilnius University, Vilnius, Lithuania. 131Allergy and Clinical Immunology
National Heart and Lung Institute, Imperial College London, UK. 132Guy’s and
st Thomas’ NHS Trust, Kings College London, UK. 133Section of Allergy and
Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri,
USA. 134Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain Shams
University, Cairo, Egypt. 135Department of Computing Science, Umeå
University, Sweden and Four Computing Oy, Finland. 136Clinic of Children’s
Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. 137University
of São Paulo Medical School, Sao Paulo, Brazil. 138Andalusian Agency for
Healthcare Quality, Seville, Spain. 139Global Allergy and Asthma Platform
GAAPP, Vienna, Austria. 140Division of Allergy, Department of Pediatric
Medicine - The Bambino Gesù Children’s Research Hospital Holy see, Rome,
Italy. 141Department of Otorhinolaryngology, Academic Medical Centers,
Amsterdam, the Netherlands. 142CINTESIS, Center for Research in Health
Technologies and Information Systems, Faculdade de Medicina da
88
Bousquet et al. Clin Transl Allergy
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Universidade do Porto, Porto, Portugal and MEDIDA, Lda, Porto, Portugal.
143
Allergist, Reims, France. 144Hospital General Regional 1 “Dr Carlos Mc Gregor
Sanchez Navarro” IMSS, Mexico City, Mexico. 145Regional hospital of ISSSTE,
Puebla, Mexico. 146National Center for Disease Control and Public Health of
Georgia, Tbilisi, Georgia. 147Allergologo, Guadalajara, Mexico. 148Allergy Clinic,
National Institute of Respiratory Diseases, Mexico City, Mexico. 149Department
of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of
Medicine, Istambul,Turkey. 150Allergology unit, UHATEM “NIPirogov”, Sofia,
Bulgaria. 151Medical University, Faculty of Public Health, Sofia, Bulgaria.
152
Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru.
153
Department of Internal Medicine, section of Allergology, Erasmus MC,
Rotterdam, The Netherlands. 154Allergy & Asthma Unit, Hospital San Bernardo
Salta, Argentina. 155Allergy Clinic, Hospital Regional del ISSSTE ‘Lic. López
Mateos’, Mexico City, Mexico. 156Head and Professor, Centro Regional de
Excelencia CONACYT y WAO en Alergia, Asma e Inmunologia, Hospital
Universitario, Universidad Autónoma de Nuevo León, Monterrey NL, Mexico.
157
Center of Allergy and Immunology, Georgian Association of Allergology
and Clinical Immunology, Tbilisi, Georgia. 158Latvian Association of Allergists,
Center of Tuberculosis and Lung Diseases, Riga, Latvia. 159Federal District Base
Hospital Institute, Brasília, Brazil. 160Institute of Health Policy and Management
iBMG, Erasmus University, Rotterdam, The Netherlands. 161University Hospital
Olomouc – National eHealth Centre, Czech Republic. 162Immunology and
Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile. 163Skin
and Allergy Hospital, Helsinki University Hospital, University of Helsinki,
Helsinki, Finland. 164Centich: centre d’expertise national des technologies de
l’information et de la communication pour l’autonomie, Gérontopôle
autonomie longévité des Pays de la Loire, Conseil régional des Pays de la Loire,
Centre d’expertise Partenariat Européen d’Innovation pour un vieillissement
actif et en bonne santé, Nantes, France. 165Autonomous University of Baja
California, Ensenada, Baja California, Mexico. 166Department of Paediatrics and
Child Health, University College Cork, Cork, Ireland. 167Hospital General
Regional 1 “Dr. Carlos MacGregor Sánchez Navarro” IMSS, Mexico City, Mexico.
168
Université Paris-Sud; Service de Pneumologie, Hôpital Bicêtre; Inserm
UMR_S999, Le Kremlin Bicêtre, France. 169Dipartimento di medicina, chirurgia e
odontoiatria, università di Salerno, Italy. 170Division for Health Innovation,
Campania Region and Federico II University Hospital Naples (R&D and
DISMET) Naples, Italy. 171Servicio de Alergia e Immunologia, Clinica Santa
Isabel, Buenos Aires, Argentina. 172President, Libra Foundation, Buenos Aires,
Argentina. 173Medical University of Gdańsk, Department of Allergology,
Gdansk, Poland. 174Airway Disease Infection Section, National Heart and Lung
Institute, Imperial College; MRC & Asthma UK Centre in Allergic Mechanisms of
Asthma, London, UK. 175Dept of Respiratory Medicine, Ghent University
Hospital, Ghent, Belgium. 176Hallym University College of Medicine, Hallym
University Sacred Heart Hospital, Gyeonggi-do, South Korea. 177Department of
Clinical Immunology, Wrocław Medical University, Poland. 178Ukrainina Medical
Stomatological Academy, Poltava, Ukraine. 179Pediatric Allergy and Asthma
Unit, Hacettepe University School of Medicine, Ankara, Turkey.180Hacettepe
University, School of Medicine, Department of Chest Diseases, Immunology
and Allergy Division, Ankara, Turkey. 181Allergy Centre, Tampere University
Hospital, Tampere, Finland. 182First Department of Family Medicine, Medical
University of Lodz, Poland. 183Institute of Social Medicine, Epidemiology and
Health Economics, Charité - Universitätsmedizin Berlin, Berlin, and Institute for
Clinical Epidemiology and Biometry, University of Wuerzburg, Germany.
184
Department of Medicine, McMaster University, Health Sciences Centre
3V47, West, Hamilton, Ontario, Canada. 185National Research Center, Institute
of Immunology, Federal Medicobiological Agency, Laboratory of Molecular
immunology, Moscow, Russian Federation. 186GARD Chairman, Geneva,
Switzerland. 187Allergy & Asthma Center Westend, Berlin, Germany. 188Center
for Rhinology and Allergology, Wiesbaden, Germany. 189Department of
Immunology and Allergy, Healthy Ageing Research Center, Medical University
of Lodz, Lodz, Poland. 190Children’s Hospital and University of Helsinki, Finland.
191
Department of Clinical Science and Education, Södersjukhuset, Karolinska
Institutet, Stockholm and Sach´s Children and Youth Hospital, Södersjukhuset,
Stockholm, Sweden. 192Faculty of Medicine, Vilnius University, Vilnius,
Lithuania. 193Department of Prevention of Envinronmental Hazards and
Allergology, Medical University of Warsaw, Poland. 194Center of Excellence in
Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City,
Mexico. 195Presidente CMMC, Milano, Italy. 196Head of the Allergy Department
of Pedro de Elizalde Children’s Hospital, Buenos Aires, Argentina. 197University
of Medicine and Pharmacy, Hochiminh City, Vietnam. 198Federal University of
Bahia, Brazil. 199Sifmed, Milano, Italy. 200State Key Laboratory of Respiratory
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Diseases, Guangzhou Institute of Respiratory Disease, the First Affiliated
Hospital of Guangzhou Medical University, Guangzhou, China. 201Departments
of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology),
University of Tennessee College of Medicine, Germantown, TN, USA.
202
Scottish Centre for Respiratory Research, Cardiovascular & Diabetes
Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee,
UK. 203Oslo University Hospital, Department of Paediatrics, Oslo, and University
of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.
204
Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 research
group, Liege, Belgium. 205Faculty of Health Sciences and CICS – UBI, Health
Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
206
Department of Philosophical, Methodological and Instrumental Disciplines,
CUCS, University of Guadalajara, Guadalajara, Mexico. 207Department of
Pulmonary Medicine, Rashid Hospital, Dubai, UAE. 208Biomax Informatics AG,
Munich, Germany. 209Director General for Health and Social Care, Scottish
Government, Edinburgh, UK. 210Department of Respiratory Medicine,
University of Bratislava, Bratislava, Slovakia. 211Coimbra Institute for Clinical and
Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra,
Portugal; Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
212
Medical center Iskar Ltd Sofia, Bulgaria. 213Department of Medicine (RCSI),
Bon Secours Hospital, Glasnevin, Dublin, Ireland. 214Kronikgune, International
Centre of Excellence in Chronicity Research Barakaldo, Bizkaia, Spain.
215
Division of Clinical Immunology and Allergy, Laboratory of Behavioral
Immunology Research, The University of Mississippi Medical Center, Jackson,
Mississippi, USA. 216Tobacco Control Research Centre;Iranian Anti Tobacco
Association, Tehran, Iran. 217Argentine Association of Allergy and Clinical
Immunology, Buenos Aires, Argentina. 218Hospital de Especialidades, Centro
Medico Nacional Siglo XXI, Mexico City, Mexico. 219University of Southeast
Bahia, Brazil. 220Allergie-Centrum-Charité at the Department of Dermatology
and Allergy, Charité - Universitätsmedizin Berlin, Germany. 221Maputo Central
Hospital, Department of Paediatrics, Maputo, Mozambique. 222Allergologo,
Veracruz, Mexico. 223Sachs’ Children and Youth Hospital, Södersjukhuset,
Stockholm and Institute of Environmental Medicine, Karolinska Institutet,
Stockholm, Sweden. 224Allergy and Asthma Medical Group and Research
Center, San Diego, California, USA. 225CIRFF, Federico II University, Naples, Italy.
226
Department of Physiology, CHRU, University Montpellier, Vice President for
Research, PhyMedExp, INSERM U1046, CNRS UMR 9214, France. 227Croatian
Pulmonary Society. 228National Institute of Pneumology M Nasta, Bucharest,
Romania. 229Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of
Medicine, University of Belgrade, Serbian Association for Asthma and COPD,
Belgrade, Serbia. 230Regione Piemonte, Torino, Italy. 231Col Jardines de Sta
Monica, Tlalnepantla, Mexico. 232National Center for Research in Chronic
Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria.
233
Department of Public health and health products, Paris Descartes
University-Sorbonne Paris Cité, EA 4064 and Paris Municipal Department of
social action, childhood, and health, Paris, France. 234Paris municipal
Department of social action, childhood, and health, Paris, France. 235Lead
Respiratory Physician Mater Dei Hospital Malta, Academic Head of Dept and
Professor of Medicine University of Malta, Deputy Dean Faculty of Medicine
and Surgery University of Medicine, La Valette, Malta. 236Department of
Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino &
Mauriziano Hospital, Torino, Italy. 237Instituto de Prevision Social IPS HC, Socia
de la SPAAI, Tesorera de la SLAAI, Asuncion, Paraguay. 238Allergy Center, CUF
Descobertas Hospital, Lisbon, Portugal. 239Universidade de São Paulo, São
Paulo, Brazil. 240Institute of Medical Statistics, and Computational Biology,
Medical Faculty, University of Cologne, Germany and CRI-Clinical Research
International-Ltd, Hamburg, Germany. 241General Pathology Institute, Faculty
of Medicine, University of Coimbra, Portugal; Ageing@Coimbra EIP-AHA
Reference Site, Coimbra, Portugal. 242Federal University of Bahia, Brazil.
243
Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical &
Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of
Barcelona, Spain. 244Danish Commitee for Health Education, Copenhagen East,
Denmark. 245Food Allergy Referral Centre Veneto Region, Department of
Women and Child Health, Padua General University Hospital, Padua, Italy.
246
Director, Medical Communications Consultant, MedScript Ltd, Dundalk, Co
Louth, Ireland and New Zealand, and Honorary Research Fellow, OPC,
Cambridge, UK. 247Johns Hopkins School of Medicine, Baltimore, Maryland,
USA. 248General Manager of COFASER - Pharmacy Services Consortium,
Salerno, Italy. 249Scientific Centre of Children’s Health under the MoH, Moscow,
Russian National Research Medical University named Pirogov, Moscow, Russia.
250
Director of Center of Allergy, Immunology and Respiratory Diseases, Santa
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Fe, Argentina Center for Allergy and Immunology, Santa Fe, Argentina. 251Dept
of Otorhinolaryngology, Medical University of Vienna, AKH, Vienna, Austria.
252
Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary. 253Die
Hautambulanz and Rothhaar study center, Berlin, Germany. 254Neumología y
Alergología Infantil, Hospital La Fe, Valencia, Spain. 255Center for Health
Technology and Services Research - CINTESIS and Department of Internal
Medicine, Centro Hospitalar Sao Joao, Porto, Portugal. 256Caisse d’assurance
retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR),
Montpellier, France. 257Director of Department of Pharmacy of University of
Naples Federico II, Naples, Italy. 258ENT Department, University Hospital of
Kinshasa, Kinshasa, Congo. 259Department of Allergy, Immunology and
Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash
University, Melbourne, Victoria,Australia; Department of Immunology, Monash
University, Melbourne, Victoria, Australia. 260Medical center “Research expert”,
Varna, Bulgaria. 261National Hospital Organization, Tokyo National Hospital,
Tokyo, Japan. 262Dept of Otorhinolaryngology, Chiba University Hospital,
Chiba, Japan. 263Dept of Otolaryngology, Nippon Medical School, Tokyo,
Japan. 264Allergologo, Jalisco, Guadalajara, Mexico. 265Centre Hospitalier
Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso.
266
Dept of Comparative Medicine; Messerli Research Institute of the University
of Veterinary Medicine and Medical University, Vienna, Austria. 267Department
of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in
Pilsen, Charles University in Prague, Pilsen, Czech Republic. 268Division of
Infection, Immunity & Respiratory Medicine, Royal Manchester Children’s
Hospital, University of Manchester, Manchester, UK, and Allergy Department,
2nd Pediatric Clinic, Athens General Children’s Hospital “P&A Kyriakou,”
University of Athens, Athens, Greece. 269Department of Allergy and Clinical
Immunology, Ajou University School of Medicine, Suwon, South Korea.
270
Respiratory Medicine, Department of Medical Sciences, University of Ferrara,
Ferrara, Italy. 271Allergy and Respiratory Diseases, Ospedale Policlino San
Martino -University of Genoa, Italy. 272Farmacias Holon, Lisbon, Portugal.
273
Department of Pediatrics, Nippon Medical School, Tokyo, Japan. 274Univer‑
sity of Southern Denmark, Kolding, Denmark. 275Université Grenoble Alpes,
Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, France.
276
Allergy Unit, CUF-Porto Hospital and Institute; Center for Research in Health
Technologies and information systems CINTESIS, Universidade do Porto,
Portugal. 277Sociologist, municipality area n33, Sorrento, Italy. 278Center for
Rhinology and Allergology, Wiesbaden, Germany. 279Department of
Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim,
Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
280
Centre for empowering people and communites, Dublin, UK. 281Conseil
Général de l’Economie Ministère de l’Economie, de l’Industrie et du
Numérique, Paris, France. 282Société de Pneumologie de Langue Française,
Espace francophone de Pneumologie, Paris, France. 283Département de
pédiatrie, CHU de Grenoble, Grenoble France. 284Medical School, University of
Cyprus, Nicosia, Cyprus. 285Children’s Hospital Srebrnjak, Zagreb, School of
Medicine, University J.J. Strossmayer, Osijek, Croatia. 286Karl Landsteiner
Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Vienna,
Austria. 287University Hospital ‘Sv. Ivan Rilski’”, Sofia, Bulgaria. 288Allergy
Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute,
Cape Town, South Africa. 289Vice-Presidente of IML, Milano, Italy. 290Centre of
Academic Primary Care, Division of Applied Health Sciences, University of
Aberdeen, Aberdeen, United Kingdom; Observational and Pragmatic Research
Institute, Singapore, Singapore. 291Department of Otorhinolaryngology
University of Crete School of Medicine, Heraklion, Greece. 292European Forum
for Research and Education in Allergy and Airway Diseases (EUFOREA),
Brussels, Belgium. 293Allergologo, cancun quintana roo, Mexico. 294Lungen‑
Clinic Grosshansdorf, Airway Research Center North, Member of the German
Center for Lung Research (DZL), Grosshansdorf, Germany Department of
Medicine, Christian Albrechts University, Airway Research Center North,
Member of the German Center for Lung Research (DZL), Kiel, Germany.
295
Department of Nephrology and Endocrinology, Karolinska University
Hospital, Stockholm, Sweden. 296Farmácia São Paio, Vila Nova de Gaia, Porto,
Portugal. 297St Vincent’s Hospital and University of Sydney, Sydney, New South
Wales, Australia. 298Allergologo, Mexico City, Mexico. 299Serviço de Pneumolo‑
gia-Hosp das Clinicas UFPE-EBSERH, Recife, Brazil. 300Universidade Federal de
São Paulo, São Paulo, Brazil. 301Centre of Pneumology, Coimbra University
Hospital, Portugal. 302Polibienestar Research Institute, University of Valencia,
Valencia, Spain. 303Pediatric Allergy and Clinical Immunology, Hospital Angeles
Pedregal, Mexico City, Mexico. 304Getafe University Hospital Department of
Geriatrics, Madrid, Spain. 305Association Asthme et Allergie, Paris, France.
Page 15 of 19
306
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. 307Primary
Care Respiratory Research Unit Institutode Investigación Sanitaria de Palma
IdisPa, Palma de Mallorca, Spain. 308Allergy Unit, Presidio Columbus, Rome,
Catholic University of Sacred Heart, Rome and IRCCS Oasi Maria SS, Troina,
Italy. 309Hospital General, Mexico City, Mexico. 310Regione Piemonte, Torino,
Italy. 311Medical University of Graz, Department of Internal Medicine, Graz,
Austria. 312Serviço de Imunoalergologia Hospital da Luz, Lisboa, Portugal.
313
Hospital de Clinicas, University of Parana, Brazil. 314Division of Allergy
Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel.
315
Honorary Clinical Research Fellow, Allergy and Respiratory Research Group,
The University of Edinburgh, Edinburgh, UK. 316Showa University School of
Medicine, Tokyo, Japan. 317Association of Finnish Pharmacies, Helsinki, Finland.
318
Allergy and Clinical Immunology Department, Centro Médico-Docente la,
Trinidad and Clínica El Avila, Caracas, Venezuela. 319Faculty of Medicine,
Autnonous University of Madrid, Spain. 320The Royal National TNE Hospital,
University College London, UK. 321DIBIMIS, University of Palermo, Italy.
322
Allergy Unit, Department of Dermatology, University Hospital of Zurich,
Zürich, Switzerland. 323Asthma Reference Center, Escola Superior de Ciencias
da Santa Casa de Misericordia de Vitoria - Esperito Santo, Brazil. 324The Usher
Institute of Population Health Sciences and Informatics, The University of
Edinburgh, Edinburgh, UK. 325Department of Pediatrics & Child Health,
Department of Immunology, Faculty of Medicine, University of Manitoba,
Winnipeg, Manitoba, Canada. 326INSERM, Université Grenoble Alpes, IAB, U
1209, Team of Environmental Epidemiology applied to Reproduction and
Respiratory Health, Université Joseph Fourier, Grenoble, France. 327Sociedad
Paraguaya de Alergia Asma e Inmunologı´a, Paraguay. 328Division of Allergy,
Clinical Immunology and Rheumatology, Department of Pediatrics, Federal
University of São Paulo, São Paulo, Brazil. 329European Health Futures Forum
(EHFF), Dromahair, Ireland. 330ENT, Aachen, Germany. 331Kyrgyzstan National
Centre of Cardiology and Internal medicine, Euro-Asian respiratory Society,
Bishkek, Kyrgyzstan. 332University Hospital Olomouc, Czech Republic.
333
Department of Paediatric and Adolescent medicine, University Hospital of
North Norway, Tromsø, Paediatric Research Group, Deptarment of Clinical
Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway,
Tromsø, Norway. 334Presidente, IML (Lombardy Medical Initiative), Bergamo,
Italy. 335Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da
Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
336
Public Health Institute of Vilnius University, Vilnius, Lithuania. 337Universi‑
dade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. 338RNSA
(Réseau National de Surveillance Aérobiologique), Brussieu, France. 339The
Hospital for Sick Children, Dalla Lana School of Public Health, University of
Toronto, Canada. 340Imunoalergologia, Centro Hospitalar Universitário de
Coimbra and Faculty of Medicine, University of Coimbra, Portugal. 341Depart‑
ment of ENT, Medical University of Graz, Austria. 342Campania Region, Division
on Pharmacy and devices policy, Naples, Italy. 343Department of Respiratory
Medicine, Hvidovre Hospital & University of Copenhagen, Denmark.
344
Universidade Federal dos Pampas, Uruguaiana, Brazil. 345Division
ofImmunopathology, Department of Pathophysiology and Allergy Research,
Center for Pathophysiology, Infectiology and Immunology, Medical University
of Vienna, Vienna, Austria. 346Pneumology and Allergy Department CIBERES
and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of
Barcelona, Spain. 347Vilnius University Institute of Clinical Medicine, Clinic of
Children’s Diseases, and Institute of Health Sciences, Department of Public
Health, Vilnius, Lithuania; European Academy of Paediatrics (EAP/UEMS-SP),
Brussels, Belgium. 348Department of Lung Diseases and Clinical Immunology
Allergology, University of Turku and Terveystalo allergy clinic, Turku, Finland.
349
PELyon; HESPER 7425, Health Services and Performance Resarch - Université
Claude Bernard Lyon, France. 350Immunology and Allergy Unit, Department of
Medicine Solna, Karolinska Institutet and University Hospital, Stockholm.
351
Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur,
Université Catholique de Louvain, Yvoir, Belgium. 352University of Bari Medical
School, Unit of Geriatric Immunoallergology, Bari, Italy. 353Pulmonary Unit,
Department of Medical Specialties, Arcispedale SMaria Nuova/IRCCS, AUSL di
Reggio Emilia, Italy. 354FILHA, Finnish Lung Association, Helsinki, Finland.
355
Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical
Physiology, Pisa, Italy; and CNR Institute of Biomedicine and Molecular
Immunology “A Monroy”, Palermo, Italy. 356Medical University, Plovdiv, Bulgaria,
Department of Otorhinolaryngology, Plovdiv, Bulgaria. 357Sotiria Hospital,
Athens, Greece. 358Dept of Otorhinolaryngology, Universitätsklinikum
Düsseldorf, Germany. 359Asthma UK, Mansell street, London, UK. 360Nova
Southeastern University, Fort Lauderdale, Florida, USA. 361Department of
Bousquet et al. Clin Transl Allergy
(2019) 9:16
Otolaryngology, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore. 362Department of Medicine, Clinical
Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
363
Division of Immunodermatology and Allergy Research, Department of
Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
364
Department of Medicine Solna, Immunology and Allergy Unit, Karolinska
Institutet and Department of ENT diseases, Karolinska University Hospital,
Stockholm, Sweden. 365Eshelman School of Pharmacy, University of North
Carolina, Chapel Hill, NC, USA. 366International Primary Care Respiratory Group
IPCRG, Aberdeen, Scotland. 367Bradford Institute for Health Research, Bradford
Royal Infirmary, Bradford, UK. 368Allergologyst - Medical College of Medical
Faculty, Thracian University, Stara Zagora, Bulgaria. 369Department of Research,
Olmsted Medical Center, Rochester, Minnesota, USA. 370Cyprus International
Institute for Environmental & Public Health in Association with Harvard School
of Public Health, Cyprus University of Technology, Limassol, Cyprus;
Department of Pediatrics, Hospital “Archbishop Makarios III”, Nicosia, Cyprus.
371
Celal Bayar University Department of Pulmonology, Manisa, Turkey. 372The
Allergy and Asthma Institute, Islamabad, Pakistan. 373Department of
Paediatrics and Child Health, Red Cross Children’s Hospital, and MRC Unit on
Child & Adolescent Health, University of Cape Town, Cape Town, South Africa.
374
Department of Otolaryngology Head and Neck Surgery, Beijing TongRen
Hospital and Beijing Institute of Otolaryngology, Beijing, China. 375Universidad
Católica de Córdoba, Córdoba, Argentina. 376University Clinic of Respiratory
and Allergic Diseases, Golnik, Slovenia. 377Gesundheitsregion KölnBonn - HRCB
Projekt GmbH, Kohln, Germany. 378Akershus University Hospital, Department
of Otorhinolaryngology, Akershus, Norway. 379Chief of Staff, the Northern
Health Science Alliance (NHSA) and Director and Founder of Northern Health
Matters Ltd, Manchester, UK. 380President of Kazakhstan Association of
Allergology and Clinical Immunology, Department of Allergology and Clinical
Immunology of the Kazakh National Medical University, Kazakhstan.
381
Division of Respiratory and Allergic Diseases,Hospital ‘A Cardarelli’, University
of Naples Federico II, Naples, Italy.
Competing interests
Dr. Ansotegui reports personal fees from Mundipharma, Roxall, Sanofi, MSD,
Faes Farma, Hikma, UCB, Astra Zeneca, outside the submitted work. Dr. BosnicAnticevich reports grants from TEVA, personal fees from TEVA, Boehringer
Ingelheim, AstraZeneca, Sanofi, Mylan, outside the submitted work. Dr
Bousquet reports personal fees and others from Chiesi, Cipla, Hikma, Menarini,
Mundipharma, Mylan, Novartis, Sanofi-Aventis, Takeda, Teva, Uriach, others
from Kyomed, outside the submitted work. Dr. Boulet reports and Disclosure
of potential conflicts of interest—last 3 years research grants for participa‑
tion to multicentre studies, AstraZeneca, Boston Scientific, GlaxoSmithKline,
Hoffman La Roche, Novartis, Ono Pharma, Sanofi, Takeda.Support for research
projects introduced by the investigator AstraZeneca, Boehringer-Ingelheim,
GlaxoSmithKline, Merck, Takeda. Consulting and advisory boards Astra Zeneca,
Novartis, Methapharm. Royalties Co-author of “Up-To-Date” (occupational
asthma). Nonprofit grants for production of educational materials Astra‑
Zeneca, Boehringer-Ingelheim, GlaxoSmithKline, Merck Frosst, Novartis.
Conference fees AstraZeneca, GlaxoSmithKline, Merck, Novartis. Support for
participation in conferences and meetings Novartis, Takeda. Other participa‑
tions Past president and Member of the Canadian Thoracic Society Respiratory
Guidelines Committee; Chair of the Board of Directors of the Global Initiative
for Asthma (GINA). Chair of Global Initiative for Asthma (GINA) Guidelines Dis‑
semination and Implementation Committee; Laval University Chair on Knowl‑
edge Transfer, Prevention and Education in Respiratory and Cardiovascular
Health; Member of scientific committees for the American College of Chest
Physicians, American Thoracic Society, European Respiratory Society and the
World Allergy Organization;1st Vice-President of the Global Asthma Organiza‑
tion “InterAsma”. Dr. Casale reports grants and non-financial support from Stall‑
ergenes, outside the submitted work. Dr. Cruz reports grants and personal fees
from GlaxoSmithKline, personal fees from Boehrinher Ingelheim, AstraZeneca,
Novartis, Merk, Sharp & Dohme, MEDA Pharma, EUROFARMA, Sanofi Aventis,
outside the submitted work. Dr. Ebisawa reports personal fees from DBV
Technologies, Mylan EPD maruho, Shionogi & CO., Ltd., Kyorin Pharmaceuti‑
cal Co., Ltd., Thermofisher Diagnostics, Pfizer, Beyer, Nippon Chemifar, Takeda
Pharmaceutical Co., Ltd., MSD, outside the submitted work. Dr. Ivancevich
reports personal fees from Euro Farma Argentina, Faes Farma, non-financial
support from Laboratorios Casasco, outside the submitted work. Dr. Haahtela
reports personal fees from Mundipharma, Novartis, and Orion Pharma, outside
Page 16 of 19
the submitted work. Dr. Klimek reports grants and personal fees from ALK
Abelló, Denmark, Novartis, Switzerland, Allergopharma, Germany, Bionorica,
Germany, GSK, Great Britain, Lofarma, Italy, personal fees from MEDA,
Sweden, Boehringer Ingelheim, Germany, grants from Biomay, Austria, HAL,
Netherlands, LETI, Spain, Roxall, Germany, Bencard, Great Britain, outside the
submitted work. V.KV has received payment for consultancy from GSK and for
lectures from StallergensGreer, Berlin-CHemie and sponsorship from MYLAN
for in the following proffesional training: ARIA masterclass in allergic rhinitis
participation. Dr. Larenas Linnemann reports personal fees from GSK, Astra‑
zeneca, MEDA, Boehringer Ingelheim, Novartis, Grunenthal, UCB, Amstrong,
Siegfried, DBV Technologies, MSD, Pfizer., grants from Sanofi, Astrazeneca,
Novartis, UCB, GSK, TEVA, Chiesi, Boehringer Ingelheim, outside the submitted
work. Dr. Mösges reports personal fees from ALK, grants from ASIT biotech,
Leti, BitopAG, Hulka, Ursapharm, Optima; personal fees from allergopharma,
Nuvo, Meda, Friulchem, Hexal, Servier, Bayer, Johnson&Johnson, Klosterfrau,
GSK, MSD, FAES, Stada, UCB, Allergy Therapeutics; grants and personal fees
from Bencard, Stallergenes; grants, personal fees and non-financial support
from Lofarma; non-financial support from Roxall, Atmos, Bionorica, Otonomy,
Ferrero; personal fees and non-financial support from Novartis; Dr. Okamoto
reports personal fees from Eizai Co., Ltd., Shionogi Co., Ltd., Torii Co., Ltd., GSK,
MSD, Kyowa Co., Ltd., grants and personal fees from Kyorin Co., Ltd., Tiho Co.,
Ltd., grants from Yakuruto Co., Ltd., Yamada Bee Farm, outside the submitted
work. Dr. Papadopoulos reports grants from Gerolymatos, personal fees from
Hal Allergy B.V., Novartis Pharma AG, Menarini, Hal Allergy B.V., outside the
submitted work. Dr. Pépin reports grants from AIR LIQUIDE FOUNDATION,
AGIR à dom, ASTRA ZENECA, FISHER & PAYKEL, MUTUALIA, PHILIPS, RESMED,
VITALAIRE, other from AGIR à dom, ASTRA ZENECA, BOEHRINGER INGEL‑
HEIM, JAZZ PHARMACEUTICAL, NIGHT BALANCE, PHILIPS, RESMED, SEFAM,
outside the submitted work. Dr. Pfaar reports grants and personal fees from
ALK-Abelló, Allergopharma Stallergenes Greer, HAL Allergy Holding B.V./HAL
Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, grants
from Biomay, ASIT Biotech Tools S.A, Laboratorios LETI/LETI Pharma, Anergis
S.A., grants from Nuvo, Circassia, Glaxo Smith Kline, personal fees from Novartis
Pharma, MEDA Pharma, Mobile Chamber Experts (a GA2LEN Partner), PohlBoskamp, Indoor Biotechnologies, grants from, outside the submitted work.
Dr. Todo-Bom reports grants and personal fees from Novartis, Mundipharma,
GSK Teva Pharma, personal fees from AstraZeneca, grants from Leti, outside
the submitted work. Dr. Tsiligianni reports advisory boards from Boehringer
Ingelheim and Novartis and a grant from GSK, outside the submitted work. Dr.
Wallace reports and Indicates that she is the co-chair of the Joint Task Force on
Practice Parameters, a task force composed of 12 members of the American
Academy of Allergy, Asthma, and Immunology and the American College
of Allergy, Asthma, and Immunology. Dr. Waserman reports other from CSL
Behring, Shire, AstraZeneca,Teva, Meda, Merck, outside the submitted work.
Dr. Zuberbier reports and Organizational affiliations: Commitee member:
WHO-Initiative “Allergic Rhinitis and Its Impact on Asthma” (ARIA). Member of
the Board: German Society for Allergy and Clinical Immunology (DGAKI). Head:
European Centre for Allergy Research Foundation (ECARF) Secretary General:
Global Allergy and Asthma European Network (GA2LEN). Member: Committee
on Allergy Diagnosis and Molecular Allergology, World Allergy Organization
(WAO).
Availability of data and materials
Not applicable.
Consent for publication
Not applicable.
Ethics approval and consent to participate
Not applicable.
Funding
FMC VIA LR.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in pub‑
lished maps and institutional affiliations.
Received: 11 January 2019 Accepted: 4 February 2019
Bousquet et al. Clin Transl Allergy
(2019) 9:16
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