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Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)

Clinical and Translational Allergy volume 6, Article number: 29 (2016) Cite this article

An Erratum to this article was published on 20 February 2017

Abstract

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

Background

Health and care services in Europe are undergoing changes to adapt systems to the growing demands caused by the expansion of chronic diseases and ageing. This restructuring involves the development and testing of innovative solutions as well as the implementation of the most successful pilots. The multitude of good practices developed throughout the European Union favours a comprehensive and multi-dimensional scaling-up strategy at European level [1].

The European Commission DG Santé (Directorate General for Health and Food Safety) and DG CNECT (Directorate General for Communications Networks, Content and Technology) launched the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) to enhance European Union competitiveness and to tackle societal challenges through research and innovation (Table 1) [2].

Table 1 Priority areas and action plans of the EIP on AHA
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Chronic respiratory diseases are the pilot for chronic diseases of the EIP on AHA Action Plan B3 [3, 4]. Several effective plans exist in Europe for chronic respiratory diseases, but they are rarely deployed to other regions or countries. There is an urgent need for scaling up strategies in order to (1) avoid fragmentation, (2) improve health care delivery across Europe, (3) speed up the implementation of good practices using existing cost-effective success stories and (4) meet the triple win of the EIP on AHA:

  • Enabling European citizens to lead healthy, active and independent lives while ageing.

  • Improving the sustainability and efficiency of social and health care systems.

  • Boosting and improving the competitiveness of the markets for innovative products and services, responding to the ageing challenge and creating new opportunities for businesses.

This paper presents the scaling up strategy for chronic respiratory diseases strictly following the five-step framework scaling up strategy of the EIP on AHA. It may be used as a model for scaling up activities in other areas of the EIP on AHA and other chronic diseases.

AIRWAYS ICPs, the pilot for chronic diseases of the EIP on AHA

Chronic respiratory diseases include a variety of diseases such as airway diseases (allergic and non-allergic asthma, rhinitis, rhinosinusitis and COPD), occupational lung diseases, sleep apnoea syndrome, interstitial diseases, pulmonary vascular diseases and genetic diseases such as cystic fibrosis [5, 6]. Over 1 billion people in the world suffer from chronic respiratory diseases. They represent one of the priorities of the European Union (3053rd and 3131st Conclusions of the European Union Council, 2010 and 2011) [7, 8], World Health Organization (WHO 2013–2020 Noncommunicable Disease Action Plan) and the United Nations (High Level meeting on Non-Communicable Diseases, 2011) [9]. The 2011 Polish Presidency of the European Union Council made the prevention, early diagnosis and treatment of asthma and allergic diseases a priority for the European Union’s public health policy in order to reduce health inequalities [7]. The early determinants of chronic respiratory diseases were reinforced during the Cyprus Presidency of the European Union Council [10]. The 2014 Italian Presidency of the European Union Council has prioritized chronic respiratory diseases. Chronic respiratory diseases represent a model of chronic diseases due to their prevalence, burden (e.g. 3 million annual deaths due to COPD), and comorbidities with other chronic diseases [11].

The initiative AIRWAYS ICPs (Integrated care pathways for airway diseases) [3] has been approved by the EIP on AHA as the model of chronic diseases of the B3 Action Plan. It is a GARD (Global Alliance against Chronic Respiratory Diseases, World Health Organization) Research Demonstration Project [5]. It was launched by NHS England (National Health Service, Newcastle, February 2014) [12] and has been endorsed by the EIP on AHA Reference Site Network.

The objectives of AIRWAYS ICPs are to launch a collaboration to develop practical multisectoral care pathways (ICPs) to reduce chronic respiratory disease burden, mortality and multimorbidity. AIRWAYS-ICPs proposes a feasible, achievable and manageable project from science to guidelines and policies using existing networks and stakeholders committed to the Action Plan B3 of the EIP on AHA and GARD [5]. It is implemented and scaled up in Europe by the EIP on AHA and globally with GARD.

AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and the World Health Organization Noncommunicable Diseases Action Plan (2013–2020). It adds value to existing public health knowledge (Table 2).

Table 2 List of activities implemented by AIRWAYS ICPs
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Five-step framework scaling up strategy of the EIP on AHA

Scaling up is often considered as a continuous process of change and adaptation that can take different forms [38]. The EIP on AHA has proposed a 5-step framework for developing an individual scaling up strategy. Area 5 has already used all these steps (Table 3). The scaling up process of AIRWAYS ICPs has already been initiated, during an Action Plan B3 meeting in Brussels (March 2014).

Table 3 The 5-step framework of EIP on AHA scaling up strategy
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In order to achieve a successful outcome for scaling up of innovative practice, the workforce should be appropriately educated in disease management, the necessary skills (e.g. spirometry, inhaler technique) should be present, and sufficient capacity made available both for training and the extra time necessary in consultation with the individual patient. These were critical factors in achieving success in the Finnish asthma and COPD ten year plans [39]. Clinical recording systems need to be integrated to facilitate audit and appropriate sharing of clinical records.

Application of the EIP on AHA scaling up strategy to chronic respiratory diseases

Good practices in chronic respiratory diseases

AIRWAYS ICPs

Six commitments for action were submitted to the EIP on AHA to support AIRWAYS ICPs. Their good practices are complementary for the scaling up strategy (Table 4).

Table 4 Good practices of the EIP on AHA Commitments for Action on chronic respiratory diseases
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  • AIRWAYS ICPs study groups exist in all but 2 European Union countries (Luxembourg, Malta). They follow the GARD model deployed in Turkey [46, 47] and Italy [13, 48].

  • Governments of countries (e.g. Lithuania, Poland, Portugal, Turkey) or regions (e.g. Emilia-Romagna) are involved in AIRWAYS ICPs. One of the commitments for action (Norway) is a joint action between the Ministry of Health of Finland and Norway [43].

Other international, national or regional projects

Many guidelines, ICPs and national plans exist for the most common chronic respiratory diseases (asthma, COPD, rhinitis).

  • The Finnish plans for asthma [40], allergy [41] and COPD [39], considered to be the prototypes of national plans for chronic respiratory diseases [42]. Polastma (Poland) is, in particular, derived from the asthma plan [35]. A review on the European asthma plans based on the Finnish Asthma Plan is available [42].

  • The Portuguese National Programme for Respiratory Diseases (PNDR), the first national programme including all respiratory diseases [45].

  • In the Netherlands, the SMART-formulated collaborative National Action programme against Chronic Lung Diseases (NACL) aims to improve the cost-effectiveness of respiratory prescribing, while reducing hospitalisation days, productivity loss, adolescent smoking, and mortality due to asthma and COPD. Both the Ministry of Health and the collective Health Insurers Netherlands are funding the programme [13].

  • Several national or regional plans on asthma, COPD, other chronic respiratory diseases and allergy.

  • Guidelines or strategies for asthma [49–52], COPD [53], rhinitis [21], rhinosinusitis [54] or severe asthma [55] (Table 5).

    Table 5 An example of scaling up strategy: ARIA (Allergic Rhinitis and its Impact on Asthma) [21, 26]
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  • Care pathways provided by national institutions (e.g. NICE in the UK, National Institute for Health and Care Excellence or the Haute Autorité de Santé in France, ICP for acute asthma in children in Northern Ireland).

  • The World Health Organization guidelines for asthma and COPD in low-income settings (WHO PEN) [14].

  • Management plans already successfully tested in low and middle-income countries [15].

  • A common approach to severe asthma and allergic diseases [17, 19].

  • In Spain, Polibienestar Research Institute is developing a Multi-Agent Simulator for people requiring prolonged mechanical ventilation based on the validated LTCMAS [64] and following the Canadian model [65], which is easily replicable and transferrable to other healthcare systems and to other diseases. Moreover, this tool offers great possibilities for scaling-up and for supporting the decision-making process of health professionals and policy-makers.

  • Multimorbidity guidelines for chronic respiratory diseases do not exist, except for rhinitis and asthma [21].

  • The risk for developing a COPD has only been studied in Italy and represents a chart risk applicable to the entire Europe.

  • Palliative approaches to care in chronic respiratory disease, and planning end-of-life decisions and care/advanced care.

  • Guidelines with a specific target on old age adults do not exist. A Delphi process is ongoing.

Guidance documents for primary care

Some guidance documents are specifically directed to primary care—where most patients with chronic respiratory diseases are managed—such as COPD-Australia (Lung Foundation Australia with Thoracic Society of Australia and New Zealand) and Asthma Management in Australia (National Asthma Council Australia). IPCRG (International Primary Care Respiratory Group) has undertaken a mapping on national guidelines used by primary care for COPD, asthma, rhinitis, obstructive sleep apnea and stop smoking (https://www.theipcrg.org/display/ResMapping).

Database

A centralized repository of evidence is developed to preserve data throughout the lifecycle of the project. The repository is under development by the Commission.

Assessment of viability of the scaling up of good practices

The members of AIRWAYS ICPs, ARIA and GARD [6, 13, 48] have experience in working together and have already scaled up several chronic respiratory disease good practices. Scaling up for ARIA and GARD follows the 7 key characteristics of the CORRECT features: Credible, Observable, Relevant, Relative advantage, Easy and Compatible [66, 67]. The success of the scaling up strategy and its long-term viability (over 15 years for ARIA and 8 years in GARD) has been demonstrated. GARD has been scaled up in several countries at governmental levels [13, 46–48].

Members of 13 EIP on AHA Reference Sites have agreed on the AIRWAYS ICPs concept and are co-authors of the paper [3]. A meeting of all EIP on AHA Reference Sites was co-organised by the Région LR, North England and the EIP on AHA Reference Site Collaborative Network to scale up AIRWAYS ICPs in all Reference Sites (October 21, 2014).

The viability of ARIA and GARD has been demonstrated. The viability of AIRWAYS ICPs will be analysed according to the set of parameters provided by the Commission in the near future. The analysis will be carried out within 6 months by an AIRWAYS ICPs expert panel and revised by an independent expert panel (6 additional months). The meeting for the analysis of the viability took place in Lisbon (Directorate General of Health of Portugal), July 1-2, 2015 in collaboration with the World Health Organization GARD [68].

Classification of good practices for replication

Feasibility has been reviewed for the Finnish Asthma Plan (Table 6). It is expected that AIRWAYS ICPs following the expertise raised in ARIA and GARD will have a similar feasibility.

Table 6 Classification of good practices for replication: the example of the Finnish Asthma Plan [40]
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Facilitating partnership for scaling up

Collaborator’s role

The ARIA programme includes over 300 members and AIRWAYS ICPs includes 445 members. The paper describing the AIRWAYS ICPs proposal is co-authored by 250 members (all stakeholders: health care professionals, social carers, patients, government officers, methodologists, etc.) [3]. All of the members are very committed to the implementation of AIRWAYS ICPs. National and regional groups have been initiated in all but 2 European Union countries. In countries where health care is regionalised [59], many regional groups are in place.

Role of scientific societies

AIRWAYS ICPs is in line with the mission and vision of scientific societies which aim to (1) promote research, (2) collect, assess and diffuse scientific information, (3) represent a scientific reference body for other scientific, health and political organisations and an advocate towards political organisation and the general public, (4) encourage and provide training, continuous education and professional development and (5) collaborate with patients and lay organisations in the area of their field in order to lead the way towards better understanding, prevention, management and eventual cure of diseases. The European Academy of Allergy and Clinical Immunology (EAACI), the European Respiratory Society (ERS), the European Rhinology Society (ERS), the European Union Geriatric Medicine Society (EUGMS), the International Academy of Pediatrics and the International Primary Care Respiratory Group (IPCRG) are the major societies in Europe of their respective field and are all members of AIRWAYS ICPs. A recent meeting on precision medicine in airways and allergic diseases was held at the European Union Parliament with these societies [77, 78]. The activities of IPCRG are summarized in Additional file 1.

Role of patient’s organisations

The goal and rationale of patient involvement in medical decisions is patient empowerment. Empowered patients know their disease. Patient empowerment commences with the initial consultations at the primary care level encompassing discussions about the patient’s ideas, concerns and expectations coupled with patient education about the specific disease process, what can be done to ameliorate the disease and ultimately self-management. Patients have the skills and motivation to take good care in their everyday life, to adjust their treatment, and are prepared for new or potentially exacerbating situations. They are able to detect side-effects, contact healthcare professionals when necessary and they adhere to the treatment regime. Many tools support empowerment, shared decision making models and patient education. Patient empowerment should be included in the health care professional’s curriculum. For an optimal dissemination of good practices, there is a need for patient involvement and empowerment.

There are recommendations to secure patient organization/patient involvement at national (e.g. The Netherlands ZonMW) and also at European Union level [79, 80].

EFA (European Federation of Allergy and airways diseases patient’s association), the major patient’s organisation for respiratory and allergic diseases in Europe, has been very active for AIRWAYS ICPs [77, 78].

Diffusion of good practices

All European Union countries should be included.

The European Geriatric Medicine, the official organ of the European Union Geriatric Medicine Society (EUGMS), has initiated a column of the EIP on AHA to publish important activities of the EIP on AHA in order to inform the medical community [2]. Several papers have already been published [2, 29, 44, 81–85].

  • Reference Site Network: The Reference Site Network is already committed to AIRWAYS-ICPs (decision taken during the Montpellier meeting).

  • Action Groups: Area 5 of Action Group B3 is leading AIRWAYS ICPs.

  • Event and dedicated scaling up/twinning sessions: Several events have already taken place (Table 7).

    Table 7 AIRWAYS ICPs 2014 events
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  • Network of excellence centres in respiratory and allergic diseases: It includes the Commitments for Action (EIP on AHA action Plan B3), Reference Sites of the EIP AHA, the Global Allergy and Asthma European Network (GA2LEN) and members of AIRWAYS ICPs. GA2LEN, a Sixth European Union Framework Programme for Research and Technological Development (FP6) Network of Excellence, was created in 2005 as a vehicle to ensure excellence in research bringing together research and clinical institutions to combat fragmentation in the European research area and to tackle allergy in its globality [89]. The GA2LEN network has benefited greatly from the voluntary efforts of researchers who are strongly committed to this model of pan-European collaboration. The network was organized in order to increase networking for scientific and clinical projects in allergy and asthma around Europe.

Implementation, key success factors and lessons learnt

Planning and initiating the service

  • Needs for AIRWAYS ICPs, in particular in elderly adults and co-morbid diseases, are clear. AIRWAYS ICPs was developed following the research priorities set by the World Health Organization on chronic respiratory diseases [90].

  • The strategy, the road map and the first implementation results have been published [4].

  • ICPs for asthma have been shown to be highly cost-effective in different settings [15, 35]. Studies in developed and developing countries have shown a cost-effective reduction of hospitalisations and mortality.

Setting up a system for change

  • Good understanding: The members of ARIA, GARD and AIRWAYS ICPs have perceived the need for innovation, and consider it beneficial and congruent with central ideas and concepts. Deployment has been made to all stakeholders including patients and citizens. The results of the ARIA and GARD initiatives are clear [13, 46, 91–98]. Since the same methodology is used for AIRWAYS ICPs enhanced by the EIP on AHA scaling up strategy, there is no reason for a lack of understanding. The present paper is co-authored by over 450 authors from 72 countries in order to enhance understanding for different cultures, settings, health systems and languages.

  • Implementation of emerging technologies for predictive and personalised medicine. Systems medicine is an emerging discipline [18, 77, 78, 99]. It combines high-throughput analyses of all human genes and their products with computational, functional and clinical studies. The aim is to gain detailed understanding of disease mechanisms, and how they vary between different patient groups. This understanding can be exploited for predictive and personalised medicine, according to guidelines proposed by the European Commission (https://www.casym.eu). The first implementations may reach the clinic within the next five years for serious diseases that require costly treatments [100].

  • Political endorsement: Several meetings have been organised by the European Union. In particular, the Polish Priority of the Council [7, 8] which “WELCOMES existing networks and alliances, such as the Global Allergy and Asthma European Network (GA2LEN) and Global Alliance against Respiratory Diseases (GARD)”. There are recommendation: (i) to give appropriate consideration to prevention, early diagnosis and treatment, (ii) to strengthen cooperation with relevant stakeholders, (iii)to exchange best practices, (iv) to support national centres and existing international research networks (v) to find cost-effective procedures by using health technology assessment, (vi) to improve health care system standards relating to chronic respiratory diseases, (vii) to consider the use of e-Health tools and innovative technologies for prevention, early diagnosis and treatment of chronic respiratory diseases, and finally (viii) to support Member States by the “Commission developing and implementing effective policies, improving networking among institutions responsible for the implementation of programmes.”

A meeting at the European Union Parliament under the leadership of the Cyprus Presidency of the European Union Council [10] and a GARD meeting at the Italian Ministry of Health during the Presidency of the Council both reinforced the importance of chronic respiratory diseases for their early detection and management to improve AHA. The present document was presented at a meeting in Lisbon, Portugal (July 1–2, 2015) organised by the Reference Site Network of the EIP on AHA in collaboration with European Union regions and the Directorate General of Health.

MACVIA-LR is supported by a strong political endorsement at the regional level. ARIA has been adopted by several governmental policies. AIRWAYS ICPs has been launched in collaboration with NHS England, Scotland, Northern Ireland, the Ministry of Health of Portugal, Poland and Lithuania and several governments of regions (e.g. Emilia Romagna, Basque Country).

  • Engagement of relevant stakeholders: In ARIA, GARD and AIRWAYS ICPs, all relevant stakeholders have been included and are highly motivated: health care professionals (physicians, pharmacists, nurses, physiotherapists and others), social workers, policy makers. A special effort has been made for patient empowerment. A European Union Parliament session led by EFA, the largest European patients’ organisation in asthma and airway diseases, has been organised in collaboration with MeDALL (Mechanisms of the Development of Allergy, FP7 project) [36, 37], in May 2015. Professional societies and groups should be enlisted as active collaborators in order to enhance and even drive uptake at the country level.

  • Financial viability and business model: It has been shown that the implementation of the Finnish national plans, ARIA and GARD does not require large resources. However, AIRWAYS ICPs will require arrangements for the reimbursement of the services.

Organisational process and design choices

  • Investing in human capital: Training and reskilling the work force is an essential and fundamental component of AIRWAYS ICPs. This may require initial and continuing investment to ensure that the workforce possesses the appropriate knowledge, skills and equipment to fulfil its roles, as show by some very successful ARIA and GARD initiatives. AIRWAYS ICPs should shall go a step further, however, and be fully implemented countrywide. The EIP on AHA Reference Site Network has offered its help. The present paper has been co-authored by many professional leaders from over 70 countries to build a global momentum.

  • Integrating ICT solutions: Telemedicine represents a possible specific advanced tool of ICT in chronic respiratory disease management and secondary prevention. ICT solutions are integrated to support AIRWAYS ICPs implementation and the MACVIA–ARIA Sentinel NetworK has been launched in Copenhagen (June 9, 2014). A clinical decision support system (CDSS) is being built and should be available at the end of the year. This system may form the prototype for a more complex one for asthma, COPD, other chronic respiratory diseases and co-morbidities.

  • Organisational changes: Currently under discussion but will require flexibility in order to adapt to the needs of different areas.

Monitoring, evaluation and dissemination

These activities have been initiated by ARIA and GARD at the international level, but they are also part of the national and regional plans for chronic respiratory diseases. The Area 5 programme on chronic respiratory diseases will benefit from previous expertise, successes and failures to propose refined and updated activities.

  • Assessment indicators: In asthma and COPD, hospitalisation rates and mortality are two indicators of interest and are responsive to change within 2–3 years. In rhinitis, these indicators cannot be used. Control is applicable to asthma, COPD and/or rhinitis and quality of life is applicable to all 3 diseases. An economic evaluation was found to be effective in asthma in many countries [40, 74].

  • Mutual learning: Learning Networks for learning and sharing best practices are in place for chronic respiratory diseases. Scientific societies and patient’s organisations are of importance in the process.

  • Dissemination activities: One of the strengths of ARIA and GARD, and also already AIRWAYS ICPs, is the great ability to disseminate information and guidelines in countries of the European Union and globally.

  • Scaling up of the new good practices: Another strength of ARIA and GARD is the capacity to scale up good practices in countries of the European Union and elsewhere.

Conclusions

The scaling up strategy of AIRWAYS ICPs confirms that the proposed strategy of the EIP on AHA is simple and easy to follow. It may be used as a model for the scaling up strategies of other projects of the EIP on AHA.

Abbreviations

AIRWAYS ICPs:

integrated care pathways for airway diseases

ARIA:

Allergic Rhinitis and its Impact on Asthma

COPD:

chronic obstructive pulmonary disease

DG:

Directorate General

EIP on AHA:

European Innovation Partnership on Active and Healthy Ageing

GA2LEN:

Global Allergy and Asthma European Network (FP6)

GARD:

WHO Global Alliance against Chronic Respiratory Diseases

ICP:

integrated care pathway

IPCRG:

International Primary Care Respiratory Group

MACVIA-LR:

Contre les MAladies Chroniques pour un VIeillissement Actif (Fighting chronic diseases for active and healthy ageing)

MASK:

MACVIA–ARIA Sentinel NetworK

NHS:

National Health Service

WHO:

World Health Organization

VAS:

visual analogue scale

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Authors’ contributions

All the authors participated in scaling up strategy of AIRWAYS ICPs. All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests, except: Bousquet, Calverley, Carr, Custovic, De Carlo, Demoly, Fonseca, Gemicioglu, Howarth, Just, Klimek, Koppelman, MacNee, Mullol, Naclerio, Papadopoulos, Papi, Pedersen, Pin, Plavec, Pohl, Rosario, Siafakas, Similowski, Sterk, Valenta, VanHage, Vogelmeier, Yawn.

Author information

Authors and Affiliations

  1. CHRU, University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France

    J. Bousquet

  2. MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France

    J. Bousquet, A. Bedbrook, D. J. Costa, D. Heve, C. Jeandel & F. Portejoie

  3. INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France

    J. Bousquet & J. Ankri

  4. UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France

    J. Bousquet & J. Ankri

  5. Department of Health, Social Services and Public Safety, Belfast, UK

    J. Farrell

  6. EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK

    G. Crooks & D. Henderson

  7. Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium

    P. Hellings

  8. European Academy of Allergy and Clinical Immunology, Zurich, Switzerland

    P. Hellings & A. Muraro

  9. Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, Netherlands

    E. H. Bel

  10. European Respiratory Society, Lausanne, Switzerland

    E. H. Bel

  11. iQ4U Consultants Ltd, London, UK

    M. Bewick

  12. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands

    N. H. Chavannes & D. J. Costa

  13. Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa

    N. H. Chavannes, A. A. Cruz, N. Khaltaev & A. Yorgancioglu

  14. International Primary Care Respiratory Group, Westhill, UK

    N. H. Chavannes & S. Williams

  15. Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga, Portugal

    J. Correia de Sousa

  16. ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil

    A. A. Cruz

  17. GARD Executive Committee, Bahia, Brazil

    A. A. Cruz & A. G. Chuchalin

  18. EIP on AHA Commitment for Action, Lisbon, Portugal

    T. Haahtela & A. Yorgancioglu

  19. Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland

    T. Haahtela, M. J. Makela & S. Reitamo

  20. Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium

    G. Joos

  21. Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    J. Malva

  22. Ageing@Coimbra Reference Site, Coimbra, Portugal

    J. Malva

  23. Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy

    A. Muraro

  24. Caisse Assurance Retraite et Santé Au Travail Languedoc-Roussillon (CARSAT-LR), 34000, Montpellier, France

    M. Nogues

  25. EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium

    S. Palkonen & G. De Carlo

  26. University of Southern Denmark, Kolding, Denmark

    S. Pedersen

  27. Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal

    C. Robalo-Cordeiro

  28. Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland

    B. Samolinski & F. Raciborski

  29. Helsinki University, Helsinki University Hospital, Helsinki, Finland

    T. Strandberg

  30. Center for Life Course Health Research, University of Oulu, Oulu, Finland

    T. Strandberg

  31. European Union GeriatricMedicine Society, EUGMS, Oslo, Norway

    T. Strandberg & J. P. Michel

  32. Center of Quality of Life Research, Vilnius University Clinic of Children’s Diseases, Vilnius University Public Health Institute, Vilnius, Lithuania

    A. Valiulis

  33. European Association of Pediatrics (EAP/UEMS-SP), Brussels, Belgium

    A. Valiulis

  34. Department of Pulmonology, Celal Bayar University, Manisa, Turkey

    A. Yorgancioglu

  35. Turkish Thoracic Society, Antalya, Turkey

    A. Yorgancioglu

  36. Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany

    T. Zuberbier, K. C. Bergmann & A. Neou

  37. Secretary General of the Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany

    T. Zuberbier, K. C. Bergmann & A. Neou

  38. Department of Dermatology, Medical University of Graz, Graz, Austria

    W. Aberer

  39. Department of Clinical Research Center, International University of Health and Welfare/Sanno Hospital, Tokyo, Japan

    M. Adachi

  40. Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain

    A. Agusti, A. Alonso & J. Roca

  41. CIBER Enfermedades Respiratorias, Barcelona, Spain

    A. Agusti & A. Alonso

  42. Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland

    C. A. Akdis & M. Akdis

  43. EPAR U707 INSERM, Paris, France

    I. Annesi-Maesano, P. J. Bousquet & P. Demoly

  44. Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain

    I. J. Ansotegui

  45. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain

    J. M. Anto, J. Garcia-Aymerich & J. Sunyer

  46. Hospital del Mar Research Institute (IMIM), Barcelona, Spain

    J. M. Anto, J. Garcia-Aymerich & J. Sunyer

  47. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    J. M. Anto, J. Garcia-Aymerich & J. Sunyer

  48. Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain

    J. M. Anto, J. Garcia-Aymerich & J. Sunyer

  49. Digi Health, Montpellier, France

    S. Arnavielhe & D. Laune

  50. David Hide Asthma and Allergy Research Centre, Isle of Wight, UK

    H. Arshad

  51. Shanghai Respiratory Research Institute, Vice President of Respiratory Society, Chinese Medical Association, China and Chinese Alliance Against Lung Cancer, Shanghai, China

    C. Bai

  52. Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy

    I. Baiardini, F. Braido, G. W. Canonica & G. Passalacqua

  53. Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium

    C. Bachert

  54. EuroAsian Respiratory Society, Astana City, Kazakhstan

    A. K. Baigenzhin

  55. Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal

    C. Barbara

  56. Department of Medicine, University of Cape Town, Cape Town, South Africa

    E. D. Bateman

  57. Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy

    B. Beghé

  58. Service de pneumologie IV, hôpital Abderrahman Mami, Ariana, 2080, Tunis, Tunisia

    A. Ben Kheder

  59. Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh

    K. S. Bennoor

  60. Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, LInköping University, Linköping, Sweden

    M. Benson

  61. Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany

    T. Bieber

  62. Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark

    C. Bindslev-Jensen & R. Dahl

  63. Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden

    L. Bjermer

  64. Department of Geriatrics, Montpellier University Hospital, Montpellier, France

    H. Blain & C. Jeandel

  65. EA 2991, Euromov, University Montpellier, Montpellier, France

    H. Blain

  66. Department of Pathophysiology and Transplantation, IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, Milan, Italy

    F. Blasi

  67. Pediatric Department, University of Verona Hospital, Verona, Italy

    A. L. Boner

  68. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

    M. Bonini

  69. Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy

    S. Bonini

  70. Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia

    S. Bosnic-Anticevitch

  71. Quebec Heart and Lung Institute, Laval University, Québec City, QC, Canada

    L. P. Boulet

  72. Directeur Général Adjoint, Montpellier University Hospital, Montpellier, France

    R. Bourret

  73. Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK

    A. H. Briggs

  74. Respiratory Biomedical Unit, Institute of Lung Health, University Hospitals of Leicester NHS Trust, Leicestershire, UK

    C. E. Brightling

  75. Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK

    C. E. Brightling

  76. Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC Room 2C16, 1280 Main Street West Hamilton, Hamilton, Canada

    J. Brozek & H. J. Schunemann

  77. Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany

    R. Buhl

  78. National Heart and Lung Institute, Imperial College, London, London, UK

    P. G. Burney

  79. Wellcome Centre for Global Health, Imperial College, London, London, UK

    P. G. Burney

  80. MRC-PHE Centre for Environment and Health, Imperial College, London, London, UK

    P. G. Burney

  81. Imperial College and Royal Brompton Hospital, London, UK

    A. Bush

  82. Centro Medico Docente La Trinidad, Caracas, Venezuela

    F. Caballero-Fonseca

  83. Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France

    D. Caimmi, R. Chiron & P. Demoly

  84. National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital NHS, London, UK

    M. A. Calderon

  85. Institute of Ageing and Chronic Disease, University of Liverpool and University Hospital Aintree, Liverpool, UK

    P. M. Calverley

  86. Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil

    P. A. M. Camargos

  87. Région Languedoc Roussillon, Montpellier, France

    T. Camuzat

  88. Department of Paediatrics, Oslo University Hospital and University of Oslo, Oslo, Norway

    K. H. Carlsen

  89. Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA

    W. Carr

  90. Regional Ministry of Equality, Health and Social Policies of Andalusia, Seville, Spain

    A. Carriazo

  91. Division of Allergy/Immunology, University of South Florida, Tampa, FL, USA

    T. Casale

  92. Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia

    A. M. Cepeda Sarabia

  93. Asma e Immunologia, SLaai, Sociedad Latinoamericana de Allergia, Barranquilla, Colombia

    A. M. Cepeda Sarabia

  94. Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion, 71003, Crete, Greece

    L. Chatzi

  95. National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, China

    Y. Z. Chen

  96. Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia

    E. Chkhartishvili

  97. Pulmonolory Research Institute FMBA, Moscow, Russia

    A. G. Chuchalin

  98. National Heart and Lung Institute, Imperial College, London, London, UK

    K. F. Chung

  99. Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy

    G. Ciprandi

  100. Latvian Allergy Association, Riga, Latvia

    I. Cirule

  101. Department of Medicine, Nova Southeastern University, Davie, FL, USA

    L. Cox

  102. Department of Paediatrics, Imperial College London, London, UK

    A. Custovic

  103. The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    S. E. Dahlen

  104. Department of Dermatology and Allergy, Technische Universität München, Munich, Germany

    U. Darsow

  105. ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany

    U. Darsow

  106. Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France

    F. De Blay

  107. EUREGHA, European Regional and Local Health Association, Brussels, Belgium

    T. Dedeu

  108. University of Edinburgh, Edinburgh, UK

    T. Dedeu

  109. Allergology and Immunology Discipline, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    D. Deleanu

  110. Kronikgune, Bilbao, Basque Region, Spain

    E. De Manuel Keenoy

  111. Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada

    J. A. Denburg

  112. Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, Suresnes, France

    P. Devillier

  113. Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France

    A. Didier

  114. Service de physiologie respiratoire, Hôpital Cochin, Université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France

    A. T. Dinh-Xuan

  115. NIHR Southampton Respiratory Biomedical Research Unit, Faculty of Medicine, University Southampton, Southampton, UK

    R. Djukanovic

  116. Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Macedonia

    D. Dokic

  117. Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria

    H. Douagui

  118. Ecole des Mines, Alès, France

    G. Dray

  119. Medical Faculty, Vilnius University, Vilnius, Lithuania

    R. Dubakiene

  120. Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK

    S. R. Durham

  121. Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA

    M. S. Dykewicz

  122. Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt

    Y. El-Gamal

  123. Clinic of Children’s Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania

    R. Emuzyte

  124. Modena University, Modena, Italy

    L. M. Fabbri

  125. Education for Health, Warwick, UK

    M. Fletcher

  126. Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children’s Research Hospital Holy See, Rome, Italy

    A. Fiocchi

  127. Global Allergy and Asthma Platform (GAAPP), Altgasse 8-10, 1130, Vienna, Austria

    A. Fink Wagner & O. Spranger

  128. Center for Health Technology and Services Research - CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal

    J. Fonseca

  129. Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal

    J. Fonseca

  130. Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands

    W. J. Fokkens

  131. Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy

    F. Forastiere

  132. Repatriation General Hospital, Adelaide, SOUTH AUSTRALIA, Australia

    P. Frith

  133. Athens Chest Hospital, Athens, Greece

    M. Gaga

  134. National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia

    A. Gamkrelidze

  135. Polibienestar Research Institute, University of Valencia, Valencia, Spain

    J. Garces, F. Rodenas & E. Valia

  136. Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey

    B. Gemicioğlu

  137. Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru

    J. E. Gereda

  138. Universidad Autónoma de Nuevo León, San Nicolás De La Garza, Mexico

    S. González Diaz

  139. Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia

    M. Gotua

  140. Latvian Association of Allergists, Center of Tuberculosis and Lung Diseases, Riga, Latvia

    I. Grisle

  141. Faculty of the Department of Neurology, University of Washington School of Medicine, St. Louis, MO, USA

    L. Grouse

  142. University Hospital Olomouc – National eHealth Centre, Olomouc, Czech Republic

    Z. Gutter

  143. Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile

    M. A. Guzmán

  144. Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK

    L. G. Heaney

  145. Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark

    B. Hellquist-Dahl

  146. NHS Scotland, Edinburgh, UK

    A. Hendry

  147. Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany

    J. Heinrich

  148. Agence Régionale de Santé, 34067, Montpellier Cedex 2, France

    D. Heve

  149. Vienna Challenge Chamber, Vienna, Austria

    F. Horak

  150. Department of Paediatrics and Child Health, University College Cork, Cork, Ireland

    J. O’. B. Hourihane

  151. University of Southampton Faculty of Medicine, University Hospital Southampton, Southampton, UK

    P. Howarth

  152. Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Université Paris-Sud, Le Kremlin Bicêtre, France

    M. Humbert

  153. School of Psychology, Plymouth University, Plymouth, UK

    M. E. Hyland

  154. Federico II University Hospital/Campania RS, Naples, Italy

    M. Illario

  155. Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina

    J. C. Ivancevich

  156. Universidade Federal de Sao Paulo, São Paulo, Brazil

    J. R. Jardim

  157. Libra Foundation, Buenos Aires, Argentina

    E. J. Jares

  158. The George Institute for Global Health, The University of Sydney, Camperdown, Australia

    C. Jenkins

  159. Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, London, UK

    S. L. Johnston

  160. MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK

    S. L. Johnston

  161. Medical Commission, Montpellier University Hospital, Montpellier, France

    O. Jonquet

  162. Children’s Clinic of Tartu University Hospital, Tartu, Estonia

    K. Julge

  163. Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-Do, South Korea

    K. S. Jung

  164. Allergology Department, Centre de l’Asthme et des Allergies, Hôpital d’Enfants Armand-Trousseau (APHP), Paris, France

    J. Just

  165. Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe EPAR, 75013, Paris, France

    J. Just

  166. Ukrainian Medical Stomatological Academy, Poltava, Ukraine

    I. Kaidashev

  167. Federal Medicobiological Agency, Laboratory of Molecular Immunology, Institute of Immunology, National Research Center, Moscow, Russia

    M. R. Kaitov

  168. Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey

    O. Kalayci

  169. Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey

    A. F. Kalyoncu

  170. Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany

    T. Keil

  171. Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany

    T. Keil

  172. Department of Medicine, McMaster University, Health Sciences Centre 3V47, 1280 Main Street West, Hamilton, Canada

    P. K. Keith

  173. Center for Rhinology and Allergology, Wiesbaden, Germany

    L. Klimek

  174. Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France

    B. Koffi N’Goran & B. Pigearias

  175. Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic

    V. Kolek

  176. GRIACResearch Institute, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands

    G. H. Koppelman

  177. Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, and HARC, Lodz, Poland

    M. L. Kowalski

  178. Sachs’ Children’s Hospital, Stockholm, Sweden

    I. Kull & J. Mullol

  179. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    I. Kull & J. Mullol

  180. Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland

    P. Kuna

  181. Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania

    V. Kvedariene

  182. VIB Inflammation Research Center, Ghent University, Ghent, Belgium

    B. Lambrecht

  183. Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany

    S. Lau

  184. Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, Ciudad De México, Mexico

    D. Larenas-Linnemann

  185. University of Medicine and Pharmacy, Hochiminh City, Vietnam

    L. T. T. Le

  186. Divisions of Allergy and Immunology, Departments of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Germantown, TN, USA

    P. Lieberman

  187. Scottish Centre for Respiratory Research, Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK

    B. Lipworth

  188. State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China

    J. Li & N. Zhong

  189. Department of Paediatrics, Oslo University Hospital, Oslo, Norway

    K. Lodrup Carlsen & I. Skrindo

  190. Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    K. Lodrup Carlsen & I. Skrindo

  191. Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium

    R. Louis

  192. Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK

    W. MacNee

  193. Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France

    Y. Magard

  194. Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l’institut du thorax, University of Nantes, Nantes, France

    A. Magnan

  195. Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE

    B. Mahboub

  196. Scottish Government Health Department, eHealth and Pharmaceuticals, Edinburgh, UK

    A. Mair

  197. Department of Respiratory Medicine, University of Bratislava, Bratislava, Slovakia

    I. Majer

  198. Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland

    P. Manning

  199. Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, Turin, Italy

    S. Mara

  200. Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS, USA

    G. D. Marshall

  201. Respiratory Medicine Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    M. R. Masjedi

  202. VingCard Elsafe, Moss, Norway

    P. Matignon

  203. Allergie-Centrum-Charité at the Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany

    M. Maurer

  204. Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique

    S. Mavale-Manuel

  205. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    E. Melén & M. Wickman

  206. PNDR/Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal

    E. Melo-Gomes

  207. Allergy and Asthma Medical Group and Research Center, San Diego, CA, USA

    E. O. Meltzer

  208. Royal Brompton Hospital, London, UK

    A. Menzies-Gow

  209. Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Germany

    H. Merk

  210. Croatian Pulmonary Society, Zagreb, Croatia

    N. Miculinic

  211. National Institute of Pneumology M. Nasta, Bucharest, Romania

    F. Mihaltan

  212. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    B. Milenkovic

  213. Serbian Association for Asthma and COPD, Belgrade, Serbia

    B. Milenkovic

  214. National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria

    G. M. Y. Mohammad

  215. Département de Pharmacologie, CHU de Bordeaux, Universite Bordeaux, INSERM U657, Bordeaux Cedex, France

    M. Molimard

  216. Department of Public Health and Biostatistics, EA 4064, Paris Descartes University, Paris, France

    I. Momas

  217. Paris Municipal Department of Social Action, Childhood, and Health, Paris, France

    I. Momas

  218. Aura Andalucia, Andalucía, Spain

    A. Montilla-Santana

  219. Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisbon, Portugal

    M. Morais-Almeida

  220. National Clinical Director for Respiratory Services, NHS England, Leeds, UK

    M. Morgan

  221. Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany

    R. Mösges

  222. Unitat de Rinologia i Clínica de l’Olfacte, Servei d’ORL, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain

    J. Mullol

  223. Mustapha Hospital, Algers, Algeria

    S. Nafti

  224. Scientific Centre of Children’s Health Under the Russian Academy of Medical Sciences, Moscow, Russia

    L. Namazova-Baranova

  225. Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA

    R. Naclerio

  226. Hospital de Niños Orlando Alassia, Santa Fe, Argentina

    H. Neffen

  227. Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary

    K. Nekam

  228. Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany

    B. Niggemann & U. Wahn

  229. EA4556 Epsylon, Université Montpellier 1, Montpellier, France

    G. Ninot

  230. ENT Department, University Hospital of Kinshasa, Kinshasa, Congo

    T. D. Nyembue

  231. Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia

    R. E. O’Hehir

  232. Department of Immunology, Monash University, Melbourne, VIC, Australia

    R. E. O’Hehir

  233. National Hospital Organization, Tokyo National Hospital, Tokyo, Japan

    K. Ohta

  234. Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan

    Y. Okamoto

  235. Department of Otolaryngology, Nippon Medical School, Tokyo, Japan

    K. Okubo

  236. Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso

    S. Ouedraogo

  237. Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy

    P. Paggiaro

  238. Department of Comparative Medicine, Messerli, Research Institute of the University of Veterinary Medicine and Medical University, Vienna, Austria

    I. Pali-Schöll

  239. Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic

    P. Panzner

  240. Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children’s Hospital, University of Manchester, Manchester, M13 9WL, UK

    N. Papadopoulos

  241. Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital “P&A Kyriakou”, University of Athens, Athens, 11527, Greece

    N. Papadopoulos

  242. Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy

    A. Papi

  243. Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

    H. S. Park

  244. Nuffield Department of Medicine, University of Oxford, Oxford, UK

    I. Pavord

  245. Department of Pediatrics, Nippon Medical School, Tokyo, Japan

    R. Pawankar

  246. Department of Health, Social Services and Public Safety, Belfast, UK

    R. Pengelly

  247. Center for Rhinology and Allergology, Wiesbaden, Germany

    O. Pfaar

  248. Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    O. Pfaar

  249. Conseil Général de l’Economie. Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France

    R. Picard

  250. Département de pédiatrie, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 9, France

    I. Pin

  251. Children’s Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia

    D. Plavec

  252. Im GerontoLab Europe - Europäische Vereinigung für Vitalität und Aktives Altern (eVAA) e.V., Leipzig, Germany

    D. Poethig

  253. Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Wolkersbergenstraße 1, 1130, Vienna, Austria

    W. Pohl

  254. Clinic of Allergy and Asthma, Medical University Sofia, 1Sv. Georgi Sofiyski St., 1431, Sofia, Bulgaria

    T. A. Popov

  255. Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa

    P. Potter

  256. Department of Pulmonary Medicine and Tuberculosis, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, Netherlands

    D. Postma

  257. Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK

    D. Price

  258. Research in Real-Life, Cambridge, UK

    D. Price

  259. LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany

    K. F. Rabe

  260. Department of Medicine, Christian Albrechts University, Airway Research Center North, Member of the German Center for Lung Research (DZL), Kiel, Germany

    K. F. Rabe

  261. Conseil Départemental de l’Ordre des Pharmaciens, Maison des Professions Libérales, 34000, Montpellier, France

    F. Radier Pontal

  262. SLAAI, Barranquilla, Colombia

    S. Repka-Ramirez

  263. Division of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska Medical Center, Omaha, NE, USA

    S. Rennard

  264. Salford, Royal NHS Foundation Trust and NHS England North, London, UK

    J. Roberts

  265. Hospital Universitario de Getafe-Servicio Madrileño de Salud, Madrid, Spain

    L. Rodriguez Mañas

  266. Association Asthme et Allergie, Paris, France

    C. Rolland

  267. Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma De Mallorca, Spain

    M. Roman Rodriguez

  268. Allergy Unit, Complesso integrato Columbus, Rome, Italy

    A. Romano

  269. Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal

    J. Rosado-Pinto

  270. Hospital de Clinicas, University of Parana, Curitiba, PR, Brazil

    N. Rosario

  271. Department of Allergy, Asthma, and Immunology, Children’s Mercy Hospitals and Clinics and Pediatrics, Medicine University of Misouri-Kansas City School of Medicine, Kansas City, MO, USA

    L. Rosenwasser

  272. Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel

    M. Rottem

  273. Woodbrook Medical Centre, Loughborough, UK

    D. Ryan

  274. Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK

    D. Ryan

  275. Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, 6a transversal Urb, Altamira, piso 8, consultorio 803, Caracas, 1060, Venezuela

    M. Sanchez-Borges

  276. The Royal National TNE Hospital, University College London, London, UK

    G. K. Scadding

  277. Otolaryngology and Head and Neck Surgery, CHU Rangueil-Larrey, Toulouse, France

    E. Serrano

  278. Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland

    P. Schmid-Grendelmeier

  279. Helmholtz Zentrum München/Institute of Epidemiology I, Neuherberg, Germany

    H. Schulz

  280. Allergy and Respiratory Research Group, Centre for Population Health Sciences, Medical School, The University of Edinburgh, Edinburgh, UK

    A. Sheikh

  281. Child Health, Queen’s University Belfast and Royal Belfast Hospital for Sick Children, Belfast, UK

    M. Shields

  282. Department of Thoracic Medicine, University Hospital of Heraklion, Crete, Greece

    N. Siafakas

  283. University Hospital of Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium

    Y. Sibille

  284. Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France

    T. Similowski

  285. INSERM, UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France

    T. Similowski

  286. Department R3S, AP-HP, Groupe, Paris, France

    T. Similowski

  287. Department of Pediatrics and Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada

    F. E. R. Simons

  288. Sociedad Paraguaya de Alergia Asma e Inmunología, Asunción, Paraguay

    J. C. Sisul

  289. Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, Netherlands

    H. A. Smit

  290. Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil

    D. Solé

  291. Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan

    T. Sooronbaev

  292. Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil

    R. Stelmach

  293. Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands

    P. J. Sterk

  294. Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, Netherlands

    C. Thijs

  295. Sidkkids hospitala and Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada

    T. To

  296. Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    A. Todo-Bom

  297. Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy

    M. Triggiani

  298. Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria

    R. Valenta

  299. Pneumology and Allergy Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain

    A. L. Valero

  300. Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland

    E. Valovirta

  301. Unité de Pharmacoépidémiologie, CHU-Lyon - UR 5558 CNRS, Université Claude Bernard, Lyon, Villeurbanne, France

    E. Van Ganse

  302. Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden

    M. van Hage

  303. Department of Chest Medicine, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain, Yvoir, Belgium

    O. Vandenplas

  304. FILHA, Finnish Lung Association, Helsinki, Finland

    T. Vasankari

  305. Gérontopôle, CHU Toulouse, Toulouse, France

    B. Vellas

  306. Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK

    J. Vestbo

  307. University Hospital of South Manchester, Manchester NHS Foundation Trust, Manchester, UK

    J. Vestbo

  308. Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy

    G. Vezzani

  309. Regional Agency for Health and Social Care, Reggio Emilia, Italy

    G. Vezzani

  310. Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, 10700, Thailand

    P. Vichyanond

  311. Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Via Trieste 41, 56126, Pisa, Italy

    G. Viegi

  312. CNR Institute of Biomedicine and Molecular Immunology “A. Monroy”, Via U. La Malfa 153, 90146, Palermo, Italy

    G. Viegi

  313. Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Marburg, Germany

    C. Vogelmeier

  314. Sotiria Hospital, Athens, Greece

    T. Vontetsianos

  315. Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

    M. Wagenmann

  316. Hôpital Albert Calmette, CHRU, Lille, France

    B. Wallaert

  317. Asthma UK, Mansell Street, London, UK

    S. Walker

  318. Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    D. Y. Wang

  319. Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA

    D. M. Williams

  320. Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK

    J. Wright

  321. Department of Research, Olmsted Medical Center, Rochester, MN, USA

    B. P. Yawn

  322. Cyprus International Institute for Environmental and Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus

    P. K. Yiallouros

  323. Department of Pediatrics, Hospital “Archbishop Makarios III”, Nicosia, Cyprus

    P. K. Yiallouros

  324. The Allergy and Asthma Institute, Lahore, Pakistan

    O. M. Yusuf

  325. Social Sciences, University of Southampton, Southampton, UK

    A. Zaidi

  326. Department of Paediatrics and Child Health, Red Cross Children’s Hospital, and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa

    H. J. Zar

  327. Universidad Católica de Córdoba, Córdoba, Argentina

    M. E. Zernotti

  328. Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China

    L. Zhang

  329. University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia

    M. Zidarn

  330. Department of Physiology, CHRU and Vice President for Research, University Montpellier, Montpellier, France

    J. Mercier

  331. EPAR UMR-S UPMC, Paris VI, Paris, France

    I. Annesi-Maesano

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