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National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 Aug.
External Review and Comment Overview
In response to a recommendation by the National Asthma Education and Prevention Program (NAEPP) Coordinating Committee, an Expert Panel was convened by the National Heart, Lung, and Blood Institute (NHLBI) to update the asthma guidelines.
Several measures were taken in the development of these asthma guidelines to enhance transparency of the evidence review process and to better manage any potential or perceived conflict of interest. In addition to using a methodologist to guide preparation of the Evidence Tables, several layers of external content review were also embedded into the guidelines development process. Expert Panel members and consultant reviewers completed financial disclosure forms that are summarized below. In addition to review by consultants, an early draft of the guidelines was circulated to a panel of guidelines end-users (the Guidelines Implementation Panel) appointed specifically for their review and feedback on ways to enhance guidelines utilization by primary care clinicians, health care delivery organizations, and third-party payors. Finally, a draft of the guidelines was posted on the NHLBI Web Site for review and comment by the NAEPP Coordinating Committee and to allow opportunity for public review and comment before the guidelines were finalized and released.
NAEPP COORDINATING COMMITTEE
Agency for Healthcare Research and Quality
Denise Dougherty, Ph.D.
Allergy and Asthma Network Mothers of Asthmatics
Nancy Sander
American Academy of Allergy, Asthma, and Immunology
Michael Schatz, M.D., M.S.
American Academy of Family Physicians
Kurtis S. Elward, M.D., M.P.H., F.A.A.F.P.
American Academy of Pediatrics
Gary S. Rachelefsky, M.D.
American Academy of Physician Assistants
Tera Crisalida, P.A.-C., M.P.A.S.
American Association for Respiratory Care
Thomas J. Kallstrom, R.R.T., F.A.A.R.C., AE-C
American College of Allergy, Asthma, and Immunology
William Storms, M.D.
American College of Chest Physicians
John Mitchell, M.D., F.A.C.P.
American College of Emergency Physicians
Richard M. Nowak, M.D., M.B.A., F.A.C.E.P.
American Lung Association
Noreen M. Clark, Ph.D.
American Medical Association
Paul V. Williams, M.D.
American Nurses Association
Karen Huss, D.N.Sc., R.N., A.P.R.N.B.C., F.A.A.N., F.A.A.A.A.I.
American Pharmacists Association
Dennis M. Williams, Pharm.D.
American Public Health Association
Pamela J. Luna, Dr.P.H., M.Ed.
American School Health Association
Lani S. M. Wheeler, M.D., F.A.A.P., F.A.S.H.A.
American Society of Health-System Pharmacists
Kathryn V. Blake, Pharm.D.
American Thoracic Society
Stephen C. Lazarus, M.D.
Asthma and Allergy Foundation of America
Mo Mayrides
Council of State and Territorial Epidemiologists
Sarah Lyon-Callo, M.A., M.S.
National Association of School Nurses
Donna Mazyck, R.N., M.S., N.C.S.N.
National Black Nurses Association, Inc.
Susan B. Clark, R.N., M.N.
National Center for Chronic Disease Prevention, Centers for Disease Control and Prevention (CDC)
Sarah Merkle, M.P.H.
National Center for Environmental Health, CDC
Paul M. Garbe, M.D.
National Center for Health Statistics, CDC
Lara Akinbami, M.D.
National Institute for Occupational Safety and Health, CDC
Margaret Filios, S.M., R.N.
National Heart, Lung, and Blood Institute
National Institutes of Health (NIH)
Elizabeth Nabel, M.D.
National Heart, Lung, and Blood Institute
NIH, Ad Hoc Committee on Minority Populations
Ruth I. Quartey, Ph.D.
National Institute of Allergy and Infectious Diseases (NIAID), NIH
Peter J. Gergen, M.D., M.P.H.
National Institute of Environmental Health Sciences, NIH
Charles A. Wells, Ph.D.
National Medical Association
Michael Lenoir, M.D.
National Respiratory Training Center
Pamela Steele, M.S.N., C.P.N.P., AE-C
Society for Academic Emergency Medicine
Rita Cydulka, M.D., M.S.
Society for Public Health Education
Judith C. Taylor-Fishwick, M.Sc., AE-C
U.S. Department of Education
Dana Carr
U.S. Environmental Protection Agency Indoor Environments Division
David Rowson, M.S.
U.S. Environmental Protection Agency Office of Research and Development
Hillel S. Koren, Ph.D.
U.S. Food and Drug Administration
Robert J. Meyer, M.D.
THIRD EXPERT PANEL ON THE DIAGNOSIS AND MANAGEMENT OF ASTHMA
William W. Busse, M.D., Chair
University of Wisconsin Medical School
Madison, Wisconsin
Homer A. Boushey, M.D.
University of California–San Francisco
San Francisco, California
Carlos A. Camargo, Jr., M.D., Dr.P.H.
Massachusetts General Hospital
Boston, Massachusetts
David Evans, Ph.D., A.E.-C,
Columbia University
New York, New York
Michael B. Foggs, M.D.
Advocate Health Centers
Chicago, Illinois
Susan L. Janson, D.N.Sc., R.N., A.N.P., F.A.A.N.
University of California–San Francisco
San Francisco, California
H. William Kelly, Pharm.D.
University of New Mexico Health Sciences Center
Albuquerque, New Mexico
Robert F. Lemanske, M.D.
University of Wisconsin Hospital and Clinics
Madison, Wisconsin
Fernando D. Martinez, M.D.
University of Arizona Medical Center
Tucson, Arizona
Robert J. Meyer, M.D.
U.S. Food and Drug Administration
Silver Spring, Maryland
Harold S. Nelson, M.D.
National Jewish Medical and Research Center
Denver, Colorado
Thomas A. E. Platts-Mills, M.D., Ph.D.
University of Virginia School of Medicine
Charlottesville, Virginia
Michael Schatz, M.D., M.S.
Kaiser-Permanente–San Diego
San Diego, California
Gail Shapiro, M.D.†
University of Washington
Seattle, Washington
Stuart Stoloff, M.D.
University of Nevada School of Medicine
Carson City, Nevada
Stanley J. Szefler, M.D.
National Jewish Medical and Research Center
Denver, Colorado
Scott T. Weiss, M.D., M.S.
Brigham and Women's Hospital
Boston, Massachusetts
Barbara P. Yawn, M.D., M.Sc.
Olmstead Medical Center
Rochester, Minnesota
Development of the resource document and the guidelines report was funded by the NHLBI, NIH. Expert Panel members completed financial disclosure forms, and the Expert Panel members disclosed relevant financial interests to each other prior to their discussions. Expert Panel members participated as volunteers and were compensated only for travel expenses related to the Expert Panel meetings. Financial disclosure information covering the 3-year period during which the guidelines were developed is provided for each Panel member below.
Dr. Busse has served on the Speakers' Bureaus of GlaxoSmithKline, Merck, Novartis, and Pfizer; and on the Advisory Boards of Altana, Centocor, Dynavax, Genentech/Novartis, GlaxoSmithKline, Isis, Merck, Pfizer, Schering, and Wyeth. He has received funding/grant support for research projects from Astellas, AstraZeneca, Centocor, Dynavax, GlaxoSmithKline, Novartis, and Wyeth. Dr. Busse also has research support from the NIH.
Dr. Boushey has served as a consultant for Altana, Protein Design Lab, and Sumitomo. He has received honoraria from (Boehringer-Ingelheim, Genentech, Merck, Novartis, and Sanofi-Aventis, and funding/grant support for research projects from the NIH.
Dr. Camargo has served on the Speakers' Bureaus of AstraZeneca, GlaxoSmithKline, Merck, and Schering-Plough; and as a consultant for AstraZeneca, Critical Therapeutics, Dey Laboratories, GlaxoSmithKline, MedImmune, Merck, Norvartis, Praxair, Respironics, Schering-Plough, Sepracor, and TEVA. He has received funding/grant support for research projects from a variety of Government agencies and not-for-profit foundations, as well as AstraZeneca, Dey Laboratories, GlaxoSmithKline, MedImmune, Merck, Novartis, and Respironics.
Dr. Evans has received funding/grant support for research projects from the NHLBI.
Dr. Foggs has served on the Speakers' Bureaus of GlaxoSmithKline, Merck, Pfizer, Sepracor, and UCB Pharma; on the Advisory Boards of Alcon, Altana, AstraZeneca, Critical Therapeutics, Genentech, GlaxoSmithKline, and IVAX; and as consultant for Merck and Sepracor. He has received funding/grant support for research projects from GlaxoSmithKline.
Dr. Janson has served on the Advisory Board of Altana, and as a consultant for Merck. She has received funding/grant support for research projects from the NHLBI.
Dr. Kelly has served on the Speakers' Bureaus of AstraZeneca and GlaxoSmithKline; and on the Advisory Boards of AstraZeneca, MAP Pharmaceuticals, Merck, Novartis, and Sepracor.
Dr. Lemanske has served on the Speakers' Bureaus of GlaxoSmithKline and Merck, and as a consultant for AstraZeneca, Aventis, GlaxoSmithKline, Merck, and Novartis. He has received honoraria from Altana, and funding/grant support for research projects from the NHLBI and NIAID.
Dr. Martinez has served on the Advisory Board of Merck and as a consultant for Genentech, GlaxaSmithKline, and Pfizer. He has received honoraria from Merck.
Dr. Meyer has no relevant financial interests.
Dr. Nelson has served on the Speakers' Bureaus of AstraZeneca, GlaxoSmithKline, Pfizer, and Schering-Plough; and as a consultant for Abbott Laboratories, Air Pharma, Altana Pharma US, Astellas, AstraZeneca, Curalogic, Dey Laboratories, Dynavax Technologies, Genentech/Novartis, GlaxoSmithKline, Inflazyme Pharmaceuticals, MediciNova, Protein Design Laboratories, Sanofi-Aventis, Schering-Plough, and Wyeth Pharmaceuticals. He has received funding/grant support for research projects from Altana, Astellas, AstraZeneca, Behringer, Critical Therapeutics, Dey Laboratories, Epigenesis, Genentech, GlaxoSmithKline, Hoffman LaRoche, IVAX, Medicinova, Novartis, Sanofi-Aventis, Schering-Plough, Sepracor, TEVA, and Wyeth.
Dr. Platts-Mills has served on the Advisory Committee of Indoor Biotechnologies. He has received funding/grant support for a research project from Pharmacia Diagnostics.
Dr. Schatz has served on the Speakers' Bureaus of AstraZeneca, Genentech, GlaxoSmithKline, and Merck; and as a consultant for GlaxoSmithKline on an unbranded asthma initiative. He has received honoraria from AstraZeneca, Genentech, GlaxoSmithKline and Merck. He has received funding/grant support for research projects from GlaxoSmithKline and Merck and Sanofi-Adventis.
Dr. Shapiro† served on the Speakers' Bureaus of AstraZeneca, Genentech, GlaxoSmithKline, IVAX Laboratories, Key Pharmaceuticals, Merck, Pfizer Pharmaceuticals, Schering Corporation, UCB Pharma, and 3M; and as a consultant for Altana, AstraZeneca, Dey Laboratories, Genentech/Novartis, GlaxoSmithKline, ICOS, IVAX Laboratories, Merck, Sanofi-Aventis, and Sepracor. She received funding/grant support for research projects from Abbott, AstraZeneca, Boehringer Ingelheim, Bristol-Myers-Squibb, Dey Laboratories, Fujisawa Pharmaceuticals, Genentech, GlaxoSmithKline, Immunex, Key, Lederle, Lilly Research, MedPointe Pharmaceuticals, Medtronic Emergency Response Systems, Merck, Novartis, Pfizer, Pharmaxis, Purdue Frederick, Sanofi-Aventis, Schering, Sepracor, 3M Pharmaceuticals, UCB Pharma, and Upjohn Laboratories.
Dr. Stoloff has served on the Speakers' Bureaus of Alcon, Altana, AstraZeneca, Genentech, GlaxoSmithKline, Novartis, Pfizer, Sanofi-Aventis, and Schering; and as a consultant for Alcon, Altana, AstraZeneca, Dey, Genentech, GlaxoSmithKline, Merck, Novartis, Pfizer, Sanofi-Aventis, and Schering.
Dr. Szefler has served on the Advisory Boards of Altana, AstraZeneca, Genentech, GlaxoSmithKline, Merck, Novartis, and Sanofi-Aventis; and as a consultant for Altana, AstraZeneca, Genentech, GlaxoSmithKline, Merck, Novartis, and Sanofi-Aventis. He has received funding/grant support for a research project from Ross.
Dr. Weiss has served on the Advisory Board of Genentech, and as a consultant for Genentech and GlaxoSmithKline. He has received funding/grant support for research projects from GlaxoSmithKline.
Dr. Yawn has served on the Advisory Boards of Altana, AstraZeneca, Merck, Sanofi-Aventis, and Schering-Plough. She has received honoraria from Pfizer and Schering-Plough, and funding/grant support for research projects from the Agency for Healthcare Research and Quality, the CDC, the NHLBI, Merck, and Schering-Plough.
CONSULTANT REVIEWERS
The Expert Panel acknowledges the following consultants for their review of an early draft of the report. Financial disclosure information covering a 12-month period prior to the review of the guidelines is provided below for each consultant.
Andrea J. Apter, M.D., M.Sc.
University of Pennsylvania Medical Center
Philadelphia, Pennsylvania
Noreen M. Clark, Ph.D.
University of Michigan School of Public Health
Ann Arbor, Michigan
Anne Fuhlbrigge, M.D., M.S.
Brigham and Women's Hospital
Boston, Massachusetts
Elliott Israel, M.D.
Brigham and Women's Hospital
Boston, Massachusetts
Meyer Kattan, M.D.
Mount Sinai Medical Center
New York, New York
Jerry A. Krishnan. M.D., Ph.D.
The Johns Hopkins School of Medicine
Baltimore, Maryland
James T. Li, M.D., Ph.D., F.A.A.A.A.I.
Mayo Clinic
Rochester, Minnesota
Dennis R. Ownby, M.D.
Medical College of Georgia
Augusta, Georgia
Gary S. Rachelefshy, M.D.
University of California–Los Angeles, School of Medicine
Los Angeles, California
Brian H. Rowe, M.D., M.Sc., C.C.F.P. (E.M.), F.C.C.P.
University of Alberta Hospital
Edmonton, Alberta, Canada
E. Rand Sutherland, M.D., M.P.H.
National Jewish Medical and Research Center
Denver, Colorado
Sandra R. Wilson, Ph.D.
Palo Alto Medical Foundation
Palo Alto, California
Robert A. Wood, M.D.
The Johns Hopkins School of Medicine
Baltimore, Maryland
Robert Zeiger, M.D.
Kaiser Permanente Medical Center
San Diego, California
Dr. Apter owns stock in Johnson & Johnson. She has received funding/grant support for research projects from the NHLBI.
Dr. Clark has no relevant financial interests.
Dr. Fulhlbrigge has served on the Speakers' Bureau of GlaxoSmithKline, the Advisory Boards of GlaxoSmithKline and Merck, the Data Systems Monitoring Board for a clinical trial sponsored by Sepracor, and as a consultant for GlaxoSmithKline. She has received honoraria from GlaxoSmithKline and Merck, and funding/grant support for a research project from Boehringer Ingelheim.
Dr. Israel has served on the Speakers' Bureau of Genentech and Merck, and as a consultant for Asthmatx, Critical Therapeutics, Genentech, Merck, Novartis Pharmaceuticals, Protein Design Labs, Schering-Plough Company, and Wyeth. He has received funding/grant support for research projects from Asthmatx, Boehringer Ingelheim, Centocor, Genentech, GlaxoSmithKline, and Merck.
Dr. Kattan has served on the Speakers' Bureau of AstraZeneca.
Dr. Krishnan has received funding/grant support for a research project from Hill-Rom, Inc.
Dr. Li has received funding/grant support for research projects from the American Lung Association, GlaxoSmithKline, Pharming, and ZLB Behring.
Dr. Ownby has none.
Dr. Rachelefsky has served on the Speakers' Bureaus of AstraZeneca, GlaxoSmithKline, IVAX, Medpointe, Merck, and Schering-Plough. He has received honoraria from AstraZeneca, GlaxoSmithKline, IVAX, Medpointe, Merck, and Schering-Plough.
Dr. Rowe has served on the Advisory Boards of Abbott, AstraZeneca, Boehringer Ingelheim, and GlaxoSmithKline. He has received honoraria from Abbott, AstraZeneca, Boehringer Ingelheim, and GlaxoSmithKline. He has received funding/grant support for research projects from Abbott, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Trudell.
Dr. Sutherland has served on the Speakers' Bureau of Novartis/Genentech and the Advisory Board of Dey Laboratories. He has received honoraria from IVAX and funding/grant support for research projects from GlaxoSmithKline and the NIH.
Dr. Wilson has served as a consultant for the Department of Urology, University of California, San Francisco (UCSF); Asthmatx, Inc.; and the Stanford-UCSF Evidence-Based Practice Center. She has received funding/grant support for research projects from the NHLBI and from a subcontract to Stanford University from Blue Shield Foundation.
Dr. Wood has served on the Speakers' Bureaus of Dey Laboratories, GlaxoSmithKline, and Merck; on the Advisory Board of Dey Laboratories; and as a consultant to Dey Laboratories. He has received honoraria from Dey Laboratories, GlaxoSmithKline, and Merck, and funding/grant support for a research project from Genentech.
Dr. Zeiger has served on the Data Monitoring Board of Genentech, Advisory Board of GlaxoSmithKline, and as a consultant for Aerocrine, AstraZeneca, and Genentech. He has received honoraria from AstraZeneca and funding/grant support for a research project from Sanofi-Aventis.
National Heart, Lung, and Blood Institute Staff
Robinson (Rob) Fulwood, Ph.D., M.S.P.H.
Chief, Enhanced Dissemination and Utilization Branch
Division for the Application of Research Discoveries
James P. Kiley, Ph.D.
Director
Division of Lung Diseases
Gregory J. Morosco, Ph.D., M.P.H.
Associate Director for Prevention, Education, and Control
Director
Division for the Application of Research Discoveries
Diana K. Schmidt, M.P.H.
Coordinator
National Asthma Education and Prevention Program
Division for the Application of Research Discoveries
Virginia S. Taggart, M.P.H.
Program Director
Division of Lung Diseases
American Institutes for Research Staff
Heather Banks, M.A., M.A.T.
Senior Editor
Patti Louthian
Senior Desktop Publisher
Karen L. Soeken, Ph.D.
Methodologist
Mary Tierney, M.D.
Project Manager
Footnotes
- †
Deceased
- Acknowledgments and Financial Disclosures - Expert Panel Report 3: Guidelines fo...Acknowledgments and Financial Disclosures - Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma
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