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We appreciated Professor Woodcock’s comments and practical suggestion of the 6P rule as a quick and simple method for assessing asthma severity. We consider that the crucial issue in considering assessment tools is whether their use results in an appropriate therapeutic response. This can be achieved if assessment tools are directly linked to guidelines for management, which is the approach recommended in the British Thoracic Society algorithm (see fig 3). In this way, management is dictated by the results of the assessments made. Thus while the 6P rule is certainly quick and easy to remember, an appropriate decision will still need to be made, and the British Thoracic Society algorithm represents an ideal system to achieve this outcome.
Competing interests: None.