Hargreave and Nair (PRO) argue the boutique technique is underrated and underused, citing trials showing improvement in severe asthma outcomes when sputum eosinophils are used to guide therapy (1, 2, and studies on IL-5 blockers). Peters (CON) questions the findings of those trials, doubts eosinophil count adds to clinical measures of asthma control, and compares maintaining the infrastructure for sputum eosinophil measurement to "a house at the beach" -- whose benefits aren't worth the expense. CHEST 2011;139:1270-1275.