6.1
Given the scarcity of robust research comparing inhaler devices (including spacers) in older children, decision-making is likely to be substantially improved by adequately powered RCT equivalence studies. Ideally, these would include:
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treatment of a full spectrum of chronic asthma severity in generalisable clinical settings
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qualitative assessment of children's experience of devices and factors influencing adherence
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examination of clinically relevant outcome measures (e.g. symptoms, activities, time away from school) rather than short-term measures of lung function
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examination of differences in resource use
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epidemiological investigation of the determinants (e.g. social factors) of adherence, effectiveness and cost effectiveness of treatment.