Article Text

Monitoring asthma in children: what does BATMAN tell us?
  1. Louise Fleming1,2
  1. 1National Heart and Lung Institute, Imperial College, London, UK
  2. 2Royal Brompton and Harefield NHS Foundation Trust, London, UK
  1. Correspondence to Dr Louise Fleming, Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; l.fleming{at}

Statistics from

The importance of monitoring asthma and adjusting treatment according to control is a fundamental part of asthma management and many studies have demonstrated the benefits of achieving good control. Numerous tools can be used, including spirometry, inflammometry, airway hyper-responsiveness and validated questionnaires of asthma control and asthma-related quality of life. In practice, the clinician uses a combination of some (or none!) of these. However, the evidence of the utility of most of these is lacking, particularly in children. Studies that have been carried out are hampered by a number of constraints: first, there is no gold standard for asthma control. The Global Initiative for Asthma (GINA) definition of controlled, partially controlled or uncontrolled is often used.1 This is a composite measure, including symptoms, exacerbations and lung function, which was developed for adults and has not been validated in children. It is not universally used to assess the usefulness of monitoring strategies and a variety of end points, including exacerbations, symptom-free days (SFD), inhaled corticosteroid (ICS) dose and FEV1, have been reported. Second, studies tend to evaluate each measure in isolation: lung function or measurement of exhaled nitric oxide (FeNO) versus standard care and so on and there is limited evidence as to how the various components of control should be integrated. Third, the term ‘standard care’ is also open to much interpretation. The BATMAN …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Paediatric lung disease
    Sandra Voorend-van Bergen Anja A Vaessen-Verberne Hein J Brackel Anneke M Landstra Norbert J van den Berg Wim C Hop Johan C de Jongste Peter J Merkus Mariëlle W Pijnenburg
  • Airwaves
    Andrew Bush Ian Pavord