Abstract Background Asthma is a lifelong disease that significantly impairs quality of life, with poorly controlled childhood asthma often leading to irreversible declines in lung function. Many adults have childhood-onset disease, with persistence linked to severity, bronchial hyperresponsiveness, and atopy. As management evolves, including biologic therapies targeting type 2 inflammation to reduce exacerbations and minimize oral corticosteroid (OCS) use, Pulmonologists and Allergists/Immunologists require ongoing, case-based education to align with evidence, improve phenotyping, and optimize treatment decisions. Methods This intervention used a virtual patient simulation (VPS) platform featuring two patient cases with moderate to severe asthma. Participants ordered diagnostic tests, made assessments, and prescribed treatments reflective of practice. After each decision, they received tailored clinical guidance (CG) based on current evidence and expert consensus, then had the opportunity to modify decisions. Post-CG and pre-CG responses were compared to assess improvement. Statistical analysis used McNemar’s test at a 10% significance level (P .001). Data were collected from September 2024-September 2025. Results Significant relative improvements were observed among Pulmonologists (n = 53) and Allergists/Immunologists (n = 67) after CG for ordering relevant tests to determine asthma phenotype, adjustment of treatment according to guidelines, and referrals to asthma specialists. Clinical Decisions and Relative Changes • Order: Complete Blood Count (CBC) w/ Differential o Pulmonologists: 11% relative change (82% pre-CG → 91% post-CG; P .01) o Allergists/Immunologists: 19% relative change (78% pre-CG → 93% post-CG; P .001) • Order: FeNO o Pulmonologists: 13% relative change (75% pre-CG → 85% post-CG; P .01) o Allergists/Immunologists: 17% relative change (75% pre-CG → 88% post-CG; P .001) • Diagnosing asthma phenotype based on clinical presentation o Pulmonologists: 100% relative change (12% pre-CG → 24% post-CG; P .001) o Allergists/Immunologists: 59% relative change (17% pre-CG → 27% post-CG; P .001) • Guideline-based treatment recommendations based on clinical phenotype o Pulmonologists: 200% relative change (8% pre-CG → 24% post-CG; P .001) o Allergists/Immunologists: 153% relative change (15% pre-CG → 38% post-CG; P .001) Conclusion Targeted, interactive VPS education improved evidence-based decision-making among Pulmonologists and Allergists/Immunologists. It enhanced testing, phenotyping, and treatment alignment with guidelines. Gaps remain in biomarker use, phenotype classification, and biologic optimization—areas vital to advancing precision medicine and reducing OCS dependence. As therapies expand, immersive, data-driven education remains essential to translating evidence into practice and improving outcomes for patients with asthma. This abstract is funded by: Regeneron
Thorpe et al. (Fri,) studied this question.