You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial
Abstract 1:
Objective To determine whether mobile phone based monitoring improves asthma control compared with st and ard paper based monitoring strategies . Design Multicentre r and omised controlled trial with cost effectiveness analysis . Setting UK primary care . Participants 288 adolescents and adults with poorly controlled asthma ( asthma control question naire ( ACQ ) score ≥1.5 ) from 32 practice s. Intervention Participants were central ly r and omised to twice daily recording and mobile phone based transmission of symptoms , drug use , and peak flow with immediate feedback prompting action according to an agreed plan or paper based monitoring . Main outcome measures Changes in scores on asthma control question naire and self efficacy ( knowledge , attitude , and self efficacy asthma question naire ( KASE-AQ ) ) at six months after r and omisation . Assessment of outcomes was blinded . Analysis was on an intention to treat basis . Results There was no significant difference in the change in asthma control or self efficacy between the two groups ( ACQ : mean change 0.75 in mobile group v 0.73 in paper group , mean difference in change −0.02 ( 95 % confidence interval −0.23 to 0.19 ) ; KASE-AQ score : mean change −4.4 v −2.4 , mean difference 2.0 ( −0.3 to 4.2 ) ) . The numbers of patients who had acute exacerbations , steroid courses , and unscheduled consultations were similar in both groups , with similar healthcare costs . Overall , the mobile phone service was more expensive because of the expenses of telemonitoring . Conclusions Mobile technology does not improve asthma control or increase self efficacy compared with paper based monitoring when both groups received clinical care to guidelines st and ards . The mobile technology was not cost effective . Trial registration Clinical Trials NCT00512837


Title 2:
A mobile telephone-based interactive self-care system improves asthma control
Abstract 2:
The self-management of asthma can improve clinical outcomes . Recently , mobile telephones have been widely used as an efficient , instant personal communication tool . This study investigated whether a self-care system will achieve better asthma control through a mobile telephone-based interactive programme . This was a prospect i ve , controlled study in outpatient clinics . From 120 consecutive patients with moderate-to-severe persistent asthma , 89 were eventually recruited for the study , with 43 in the mobile telephone group ( with a mobile telephone-based interactive asthma self-care system )  . In the mobile telephone group , mean±sem peak expiratory flow rate significantly increased at 4 ( 378.2±9.3 L·min−1 ; n = 43 ; p = 0.020 ) , 5 ( 378.2±9.2 L·min−1 ; n = 43 ; p = 0.008 ) and 6 months ( 382.7±8.6 L·min−1 ; n = 43 ; p = 0.001 ) compared to the control group . Mean±sem forced expiratory volume in 1 s significantly increased at 6 months ( 65.2±3.2 % predicted ; n = 43 ; p<0.05 ) . Patients in the mobile telephone group had better quality of life after 3 months , as determined using the Short Form-12 ® physical component score , and fewer episodes of exacerbation and unscheduled visits than the control group . Patients in the mobile telephone group significantly increased their mean daily dose of either systemic or inhaled corticosteroids compared with the control group . The mobile telephone-based interactive self-care system provides a convenient and practical self-monitoring and -management of asthma , and improves asthma control


Title 3:
Development and cross-sectional validation of the Childhood Asthma Control Test.
Abstract 3:
BACKGROUND For children younger than 12 years old with asthma , there are several quality -of-life instruments , clinical diaries , and question naires assessing symptoms ; however , a vali date d tool for assessing asthma control is currently lacking . OBJECTIVE To develop and vali date the  Childhood Asthma Control Test  ( C-ACT ) , a self-administered tool for identifying children aged 4 - 11 years whose asthma is inadequately controlled . METHODS A 21-item question naire was administered to 343 patients with asthma and their caregivers , r and omly assigning 75 % ( n = 257 ) for development and cross-sectional validation of the tool and 25 % ( n = 86 ) to a confirmatory sample . Stepwise logistic regression was used to reduce the 21 items to those best able to discriminate control as defined by the specialist 's rating of asthma control . RESULTS Seven items were selected from regression analyses of the development sample to comprise the C-ACT . The scores of each item were summed for a total score ( 0 - 27 ) , with lower scores indicating poorer control . Summed scores discriminated between groups of patients differing in the specialists ' rating of asthma control ( F = 36.89 ; P < .0001 ) , the need for change in patients ' therapy ( F = 20.07 ; P < .0001 ) , and % predicted FEV(1 ) ( F = 2.66 ; P = .0494 ) . A score of 19 indicated inadequately controlled asthma ( specificity 74 % , sensitivity 68 % ) . These analyses were confirmed in the confirmatory sample . CONCLUSION The C-ACT is a vali date d tool to assess asthma control and identify children with inadequately controlled asthma . CLINICAL IMPLICATION S The C-ACT can be valuable in clinical practice and research based on its validation , ease of use , input from the child and caregiver , and alignment with asthma guidelines
Conclusions No apps for people with asthma combined reliable , comprehensive information about the condition with supportive tools for self-management .
There remains much to be done if apps are to find broad use in clinical practice ; clinicians can not recommend tools that are inaccurate , unsafe or lack an evidence base