As Neil Barnes points out in his review of outcome measures in asthma,1 the selection of appropriate outcomes plays a key role in shaping clinical and research agendas. He relates widely used outcome measures to the aims of management as stated in current asthma guidelines, particularly in terms of parameters of long term asthma control such as prevention of symptoms, minimal requirement for reliever medication, normalisation of lung function, and prevention of exacerbations. These parameters correspond to the aims of asthma management in the BTS2 and the GINA guidelines.3 The importance of looking at a number of different outcomes and of recognising the different time scales over which these outcomes need to be measured is now widely recognised in the evaluation of medical interventions in asthma.

It could be argued, however, that even the wide range of parameters considered in the review fails to capture all the aims of asthma management, and particularly may miss those outcomes determined by the patients themselves. It is becoming …