Discussion/Conclusion
With our Systematic Review, we expected to find a great number of observational studies focusing the proportion of asthma control in European children, something that, in fact, didn’t happen. However, the articles found lead us to some interesting but controversial results about the proportion of asthma control in children among the European countries.
Initially, with our Systematic Review, we expected that the articles directly related to our research question and aims would tell us that most asthmatic children in Europe had this disease controlled, but many others didn’t [7], [8], so that the need to promote and inform the population about this control was moderate and continuous, but not extremely urgent. Moreover, we thought that the differences of the results encountered between different regions in Europe wouldn’t be very accentuated, since all the European countries are considered developed countries that cooperate to find the best way to guarantee a good quality of life of the European children (which includes an efficient vigilance and care about their health).
However, after analyzing the results of the different European countries, we realized that these were quite different from our expectations - in particular, the expected result of homogeneity is not checked, since there are countries with a high proportion of asthma control and others with a low one and even in the same country, there is account for different values of proportion.
Asthma control can, at least in one of the studies found [13], vary according with the age stratum, namely in Germany and Switzerland.
Ergo, it might be interesting to widen the spectrum of studies in this area, given the low number of relevant results.
Anyway, some explanations for poorly controlled asthma may be inadequate parents’ perception of asthma control; the dynamic process of asthma; too little step-up of asthma treatment by the paediatrician; too little instruction on a proper inhaler technique.
Limitations
While performing this Systematic Review we have encountered various problems in the different phases of our project. The fact that we had to re-do the whole review from scratch just when we had already the final articles is an example of such matters.
Although we had some problems with the queries, which were clearly the reason why our numbers were so discrepant, we solved this by creating new and more effective ones. Such effectiveness is reflected on the more coherent results obtained afterwards.
When it comes down to the conclusions, there is a difficulty in generalizing asthma proportion in European children, since the data collected are very few and different for each country found and even controversial within some countries.
Furthermore, we did prepare for the eventuality of the number of final articles being too low or their results being contradictory by saving the articles which did not have full-text available and by writing an e-mail to be sent to the authors. Yet, we did not send it.
This is justified by a number of reasons. Firstly the time we had saved for this part of the project was totally consumed by the resolution of other problems, previously mentioned. Secondly, comparing the tittles of the saved articles with the ones that we excluded after reading the full-text, we realized that the point of focus might have been similar and, for that fact, the probability of exclusion rose higher. Finally, in order not to neglect the work that needed to be done, we decided that not committing to more articles would be in the best interest of our project.