Asthma Treatment Guidelines Meet the Real World

Asthma is a common reason for seeking medical care; it is the most frequent medical handicap among children. Because it is so common, most patients with asthma are treated by generalists and family physicians. Guidelines for treating asthma are built on results from randomized, tightly controlled trials. The patients enrolled in these trials make up a small and selected fraction of the real-world population with asthma.1 In this issue of the Journal, Price et al. report on two “pragmatic trials” in which a much larger fraction of patients with asthma were enrolled than is the case in randomized, controlled trials; . . .