Background The prevalence, Medicaid use and mortality risk associated with low forced expiratory volume in 1 s (FEV1) among young adults aged 20–35 years are not well understood, despite its potential implications for the development of chronic pulmonary disease and overall prognosis. Methods A retrospective cohort study was conducted among young adults aged 20–35 years old, using data from the National Health and Nutrition Examination Survey, National Death Index and Centers for Medicare & Medicaid Services. Participants were categorised into a low FEV1 group (pre-bronchodilator FEV1%pred <80%) and a normal FEV1 group (FEV1%pred ≥80%). Weighted logistic regression analysis was employed to identify the risk factors associated with low FEV1, while Cox proportional hazard models were used to calculate the hazard ratio (HR) for Medicaid use and the all-cause mortality between the two groups. Results A total of 5346 participants aged 20–35 were included in the study, with 329 in the low FEV1 group and 5017 in the normal group. The weighted prevalence of low FEV1 among young adults was 7.1% (95% CI 6.0 to 8.2). Low body mass index (OR=3.06, 95% CI 1.79 to 5.24), doctor-diagnosed asthma (OR=2.25, 1.28 to 3.93), and wheezing or whistling (OR=1.57, 1.06 to 2.33) were identified as independent risk factors for low FEV1. Over a 15-year follow-up, individuals in the low FEV1 group exhibited a higher likelihood of Medicaid use compared with those in the normal group (HR=1.73, 1.07 to 2.79). However, there was no statistically significant increase in the risk of all-cause mortality over a 30-year follow-up period (HR=1.48, 1.00 to 2.19). Conclusions A considerable portion of young adults demonstrated low FEV1 levels, a characteristic that was associated with a higher risk of Medicaid use over a long-term follow-up, yet not linked to an augmented risk of all-cause mortality. Data sharing is not applicable because no new dataset was generated and the data used in this study were originally from publicly available databases.
{"title":"Prevalence, Medicaid use and mortality risk of low FEV1 in adults aged 20–35 years old in the USA: evidence from a population-based retrospective cohort study","authors":"Zihui Wang, Yun Li, Lunfang Tan, Shuyi Liu, Zhufeng Wang, Qing Zhang, Junfeng Lin, Jinhai Huang, Lina Liang, Yi Gao, Nanshan Zhong, Jinping Zheng","doi":"10.1136/bmjresp-2023-001918","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-001918","url":null,"abstract":"Background The prevalence, Medicaid use and mortality risk associated with low forced expiratory volume in 1 s (FEV1) among young adults aged 20–35 years are not well understood, despite its potential implications for the development of chronic pulmonary disease and overall prognosis. Methods A retrospective cohort study was conducted among young adults aged 20–35 years old, using data from the National Health and Nutrition Examination Survey, National Death Index and Centers for Medicare & Medicaid Services. Participants were categorised into a low FEV1 group (pre-bronchodilator FEV1%pred <80%) and a normal FEV1 group (FEV1%pred ≥80%). Weighted logistic regression analysis was employed to identify the risk factors associated with low FEV1, while Cox proportional hazard models were used to calculate the hazard ratio (HR) for Medicaid use and the all-cause mortality between the two groups. Results A total of 5346 participants aged 20–35 were included in the study, with 329 in the low FEV1 group and 5017 in the normal group. The weighted prevalence of low FEV1 among young adults was 7.1% (95% CI 6.0 to 8.2). Low body mass index (OR=3.06, 95% CI 1.79 to 5.24), doctor-diagnosed asthma (OR=2.25, 1.28 to 3.93), and wheezing or whistling (OR=1.57, 1.06 to 2.33) were identified as independent risk factors for low FEV1. Over a 15-year follow-up, individuals in the low FEV1 group exhibited a higher likelihood of Medicaid use compared with those in the normal group (HR=1.73, 1.07 to 2.79). However, there was no statistically significant increase in the risk of all-cause mortality over a 30-year follow-up period (HR=1.48, 1.00 to 2.19). Conclusions A considerable portion of young adults demonstrated low FEV1 levels, a characteristic that was associated with a higher risk of Medicaid use over a long-term follow-up, yet not linked to an augmented risk of all-cause mortality. Data sharing is not applicable because no new dataset was generated and the data used in this study were originally from publicly available databases.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"19 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140925451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Multidrug-resistant tuberculosis is a type of tuberculosis that is resistant to at least the first-line antituberculosis drugs namely, rifampicin and isoniazid. However, most of these studies were limited only to a single hospital. Therefore, this study aimed to identify the determinants of multidrug-resistant tuberculosis among adults undergoing treatment for tuberculosis in the Tigray region of Ethiopia. Methods Hospital-based unmatched case–control study was conducted from 1 April 2019 to 30 June 2019. A simple random sampling method was used to select the required sample size. Variables at a p value less than 0.25 in bivariate analysis were entered into a multivariable analysis to identify the determinant factors of multidrug-resistant tuberculosis. Finally, the level of significance was declared at p<0.05. Results Rural residence (adjusted OR (AOR) 2.54; 95% CI 1.34 to 4.83), HIV (AOR 4.5; 95% CI 1.4 to 14.2), relapse (AOR 3.86; 95% CI 1.98 to 7.5), return after lost follow-up (AOR 6.29; 95% CI 1.64 to 24.2), treatment failure (AOR 5.87; 95% CI 1.39 to 24.8) were among the determinants of multidrug-resistant tuberculosis. Conclusion Rural residence, HIV, relapses, return after lost follow-up and treatment failure were the identified determinant factors of multidrug-resistance tuberculosis. Data are available in a public, open access repository.
背景 耐多药结核病是一种至少对一线抗结核药物（即利福平和异烟肼）具有耐药性的结核病。然而，这些研究大多仅限于一家医院。因此，本研究旨在确定埃塞俄比亚提格雷地区接受结核病治疗的成年人中耐多药结核病的决定因素。方法 从 2019 年 4 月 1 日至 2019 年 6 月 30 日开展了基于医院的非匹配病例对照研究。研究采用简单随机抽样法选取所需的样本量。将二变量分析中 P 值小于 0.25 的变量纳入多变量分析，以确定耐多药结核病的决定因素。最后，以 P<0.05 为显著性水平。结果 农村居住地（调整 OR (AOR) 2.54；95% CI 1.34 至 4.83）、HIV（AOR 4.5；95% CI 1.4 至 14.2）、复发（AOR 3.86；95% CI 1.98 至 7.5）、失去随访后返回（AOR 6.29；95% CI 1.64 至 24.2）、治疗失败（AOR 5.87；95% CI 1.39 至 24.8）是耐多药结核病的决定因素。结论 农村居民、艾滋病病毒感染者、复发、失去随访后返回以及治疗失败是耐多药结核病的决定因素。数据可在公开、开放的资料库中查阅。
{"title":"Determinants of multidrug-resistant tuberculosis among adults undergoing treatment for tuberculosis in Tigray Region, Ethiopia: a case–control study","authors":"Kidane Zereabruk, Tensay Kahsay, Hiyab Teklemichael, Woldu Aberhe, Abrha Hailay, Guesh Mebrahtom, Gebrewahd Bezabh","doi":"10.1136/bmjresp-2023-001999","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-001999","url":null,"abstract":"Background Multidrug-resistant tuberculosis is a type of tuberculosis that is resistant to at least the first-line antituberculosis drugs namely, rifampicin and isoniazid. However, most of these studies were limited only to a single hospital. Therefore, this study aimed to identify the determinants of multidrug-resistant tuberculosis among adults undergoing treatment for tuberculosis in the Tigray region of Ethiopia. Methods Hospital-based unmatched case–control study was conducted from 1 April 2019 to 30 June 2019. A simple random sampling method was used to select the required sample size. Variables at a p value less than 0.25 in bivariate analysis were entered into a multivariable analysis to identify the determinant factors of multidrug-resistant tuberculosis. Finally, the level of significance was declared at p<0.05. Results Rural residence (adjusted OR (AOR) 2.54; 95% CI 1.34 to 4.83), HIV (AOR 4.5; 95% CI 1.4 to 14.2), relapse (AOR 3.86; 95% CI 1.98 to 7.5), return after lost follow-up (AOR 6.29; 95% CI 1.64 to 24.2), treatment failure (AOR 5.87; 95% CI 1.39 to 24.8) were among the determinants of multidrug-resistant tuberculosis. Conclusion Rural residence, HIV, relapses, return after lost follow-up and treatment failure were the identified determinant factors of multidrug-resistance tuberculosis. Data are available in a public, open access repository.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"247 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140840170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjresp-2023-002238
Myriam Drysdale, Evgeniy R Galimov, Marcus James Yarwood, Vishal Patel, Bethany Levick, Daniel C Gibbons, Jonathan D Watkins, Sophie Young, Benjamin F Pierce, Emily J Lloyd, William Kerr, Helen J Birch, Tahereh Kamalati, Stephen J Brett
Background We assessed the effectiveness of sotrovimab vs no early COVID-19 treatment in highest-risk COVID-19 patients during Omicron predominance. Methods Retrospective cohort study using the Discover dataset in North West London. Included patients were non-hospitalised, aged ≥12 years and met ≥1 National Health Service highest-risk criterion for sotrovimab treatment. We used Cox proportional hazards models to compare HRs of 28-day COVID-19-related hospitalisation/death between highest-risk sotrovimab-treated and untreated patients. Age, renal disease and Omicron subvariant subgroup analyses were performed. Results We included 599 sotrovimab-treated patients and 5191 untreated patients. Compared with untreated patients, the risk of COVID-19 hospitalisation/death (HR 0.50, 95% CI 0.24, 1.06; p=0.07) and the risk of COVID-19 hospitalisation (HR 0.43, 95% CI 0.18, 1.00; p=0.051) were both lower in the sotrovimab-treated group; however, statistical significance was not reached. In the ≥65 years and renal disease subgroups, sotrovimab was associated with a significantly reduced risk of COVID-19 hospitalisation, by 89% (HR 0.11, 95% CI 0.02, 0.82; p=0.03) and 82% (HR 0.18, 95% CI 0.05, 0.62; p=0.007), respectively. Conclusions Risk of COVID-19 hospitalisation in sotrovimab-treated patients aged ≥65 years and with renal disease was significantly lower compared with untreated patients. Overall, risk of hospitalisation was also lower for sotrovimab-treated patients, but statistical significance was not reached. Data are available upon reasonable request. The Discover data that support the findings of this study are available from Imperial College Health Partners via approval from the Discover Data Research Access Group (DRAG) under certain restrictions.
背景 我们评估了索托维单抗与不进行早期 COVID-19 治疗的效果，索托维单抗适用于 Omicron 优势期的高风险 COVID-19 患者。方法 使用伦敦西北部的发现数据集进行回顾性队列研究。纳入的患者均未住院，年龄≥12 岁，且符合≥1 项国家卫生服务局索托维单抗治疗最高风险标准。我们使用 Cox 比例危险模型比较了最高风险索托维单抗治疗患者和未治疗患者 28 天 COVID-19 相关住院/死亡的 HRs。还进行了年龄、肾病和 Omicron 亚变量亚组分析。结果 我们纳入了 599 例索托维单抗治疗患者和 5191 例未治疗患者。与未经治疗的患者相比，索托维单抗治疗组的COVID-19住院/死亡风险（HR 0.50，95% CI 0.24，1.06；P=0.07）和COVID-19住院风险（HR 0.43，95% CI 0.18，1.00；P=0.051）均较低，但未达到统计学意义。在≥65岁和肾脏疾病亚组中，索托维单抗与COVID-19住院风险显著降低相关，分别降低了89%（HR 0.11，95% CI 0.02，0.82；P=0.03）和82%（HR 0.18，95% CI 0.05，0.62；P=0.007）。结论 与未接受治疗的患者相比，年龄≥65岁且患有肾病的索托维单抗治疗患者的COVID-19住院风险显著降低。总体而言，索托维单抗治疗患者的住院风险也较低，但未达到统计学意义。如有合理要求，可提供相关数据。在某些限制条件下，经发现数据研究访问组 (DRAG) 批准，可从帝国理工学院健康合作伙伴处获得支持本研究结果的发现数据。
{"title":"Comparative effectiveness of sotrovimab versus no treatment in non-hospitalised high-risk COVID-19 patients in north west London: a retrospective cohort study","authors":"Myriam Drysdale, Evgeniy R Galimov, Marcus James Yarwood, Vishal Patel, Bethany Levick, Daniel C Gibbons, Jonathan D Watkins, Sophie Young, Benjamin F Pierce, Emily J Lloyd, William Kerr, Helen J Birch, Tahereh Kamalati, Stephen J Brett","doi":"10.1136/bmjresp-2023-002238","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-002238","url":null,"abstract":"Background We assessed the effectiveness of sotrovimab vs no early COVID-19 treatment in highest-risk COVID-19 patients during Omicron predominance. Methods Retrospective cohort study using the Discover dataset in North West London. Included patients were non-hospitalised, aged ≥12 years and met ≥1 National Health Service highest-risk criterion for sotrovimab treatment. We used Cox proportional hazards models to compare HRs of 28-day COVID-19-related hospitalisation/death between highest-risk sotrovimab-treated and untreated patients. Age, renal disease and Omicron subvariant subgroup analyses were performed. Results We included 599 sotrovimab-treated patients and 5191 untreated patients. Compared with untreated patients, the risk of COVID-19 hospitalisation/death (HR 0.50, 95% CI 0.24, 1.06; p=0.07) and the risk of COVID-19 hospitalisation (HR 0.43, 95% CI 0.18, 1.00; p=0.051) were both lower in the sotrovimab-treated group; however, statistical significance was not reached. In the ≥65 years and renal disease subgroups, sotrovimab was associated with a significantly reduced risk of COVID-19 hospitalisation, by 89% (HR 0.11, 95% CI 0.02, 0.82; p=0.03) and 82% (HR 0.18, 95% CI 0.05, 0.62; p=0.007), respectively. Conclusions Risk of COVID-19 hospitalisation in sotrovimab-treated patients aged ≥65 years and with renal disease was significantly lower compared with untreated patients. Overall, risk of hospitalisation was also lower for sotrovimab-treated patients, but statistical significance was not reached. Data are available upon reasonable request. The Discover data that support the findings of this study are available from Imperial College Health Partners via approval from the Discover Data Research Access Group (DRAG) under certain restrictions.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"240 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjresp-2023-001804
Wang Chun Kwok, Chung Ki Tsui, Sze Him Isaac Leung, Chun Ka Emmanuel Wong, Terence Chi Chun Tam, James Chung-man Ho
Background Although bronchiectasis is reported to be associated with cardiovascular disease, evidence for an association with cardiovascular events (CVEs) is lacking. Methods A territory-wide retrospective cohort study was conducted in Hong Kong involving all patients who had bronchiectasis diagnosed in public hospitals and clinics between 1 January 1993 and 31 December 2017 were included. Patients were allocated to be exacerbator or non-exacerbator group based on hospitalzied bronchiecsis history and CVEs over the next 5 years determined. Propensity score matching was used to balance baseline characteristics. Results 10 714 bronchiectasis patients (mean age 69.6±14.4 years, 38.9% men), including 1230 in exacerbator group and 9484 in non-exacerbator group, were analysed. At 5 years, 113 (9.2%) subjects in the exacerbator group and 87 (7.1%) in the non-exacerbator group developed composite CVEs. After adjustment for age, sex, smoking and risk factors for cardiovascular disease, bronchiectasis exacerbation was associated with increased risks for acute myocardial infarction (AMI), congestive heart failure (CHF) and CVE compared with those in the non-exacerbator group with adjusted HR of 1.602 (95% CI 1.006–2.552, p value=0.047), 1.371 (95% CI 1.016–1.851, p value=0.039) and 1.238 (95% CI 1.001–1.532, p=0.049) in the whole cohort. Findings were similar for the propensity score-matched cohort for AMI and CVE. Conclusion Patients who were hospitalised for exacerbation of bronchiectasis were at significantly increased risk of AMI, CHF and CVE over a 5-year follow-up period. All data relevant to the study are included in the article or uploaded as supplementary information.
背景 虽然有报道称支气管扩张与心血管疾病有关，但缺乏证据表明支气管扩张与心血管事件（CVEs）有关。方法 在香港进行了一项回顾性队列研究，纳入了 1993 年 1 月 1 日至 2017 年 12 月 31 日期间在公立医院和诊所确诊的所有支气管扩张症患者。根据患者的住院支气管扩张病史和未来5年的CVE情况，将患者分配到恶化组和非恶化组。采用倾向评分匹配法平衡基线特征。结果 对10 714名支气管扩张患者（平均年龄为69.6±14.4岁，38.9%为男性）进行了分析，其中恶化组1230人，非恶化组9484人。5年后，病情加重组中有113人（9.2%）和非病情加重组中有87人（7.1%）出现复合CVE。在对年龄、性别、吸烟和心血管疾病风险因素进行调整后，支气管扩张症加重与急性心肌梗死（AMI）、充血性心力衰竭（CHF）和CVE的风险增加有关，与非加重组相比，调整后的HR为1.602（95% CI 1.006-2.552，P值=0.047）、1.371（95% CI 1.016-1.851，P值=0.039）和1.238（95% CI 1.001-1.532，P值=0.049）。倾向得分匹配队列中的 AMI 和 CVE 结果相似。结论 因支气管扩张加重而住院的患者在5年随访期内发生AMI、CHF和CVE的风险显著增加。与该研究相关的所有数据均包含在文章中或作为补充信息上传。
{"title":"Cardiovascular outcomes following hospitalisation for exacerbation of bronchiectasis: a territory-wide study","authors":"Wang Chun Kwok, Chung Ki Tsui, Sze Him Isaac Leung, Chun Ka Emmanuel Wong, Terence Chi Chun Tam, James Chung-man Ho","doi":"10.1136/bmjresp-2023-001804","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-001804","url":null,"abstract":"Background Although bronchiectasis is reported to be associated with cardiovascular disease, evidence for an association with cardiovascular events (CVEs) is lacking. Methods A territory-wide retrospective cohort study was conducted in Hong Kong involving all patients who had bronchiectasis diagnosed in public hospitals and clinics between 1 January 1993 and 31 December 2017 were included. Patients were allocated to be exacerbator or non-exacerbator group based on hospitalzied bronchiecsis history and CVEs over the next 5 years determined. Propensity score matching was used to balance baseline characteristics. Results 10 714 bronchiectasis patients (mean age 69.6±14.4 years, 38.9% men), including 1230 in exacerbator group and 9484 in non-exacerbator group, were analysed. At 5 years, 113 (9.2%) subjects in the exacerbator group and 87 (7.1%) in the non-exacerbator group developed composite CVEs. After adjustment for age, sex, smoking and risk factors for cardiovascular disease, bronchiectasis exacerbation was associated with increased risks for acute myocardial infarction (AMI), congestive heart failure (CHF) and CVE compared with those in the non-exacerbator group with adjusted HR of 1.602 (95% CI 1.006–2.552, p value=0.047), 1.371 (95% CI 1.016–1.851, p value=0.039) and 1.238 (95% CI 1.001–1.532, p=0.049) in the whole cohort. Findings were similar for the propensity score-matched cohort for AMI and CVE. Conclusion Patients who were hospitalised for exacerbation of bronchiectasis were at significantly increased risk of AMI, CHF and CVE over a 5-year follow-up period. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"22 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140625993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjresp-2023-001944
Huan Zhang, Tan Xiaojiao, Junjun Chen, Zheng Zhang, Chenxi Wang, Haiqing Shi, Yao Li, Jianbo Li, Yan Kang, Xiaodong Jin, Xuelian Liao
Background In China, both nirmatrelvir-ritonavir (Paxlovid) and azvudine have been granted approval to treat adult SARS-CoV-2-infected patients with moderate symptoms. Information about the clinical effect of the two available agents among inpatients with severe or critical COVID-19 is scarce. Purpose To compare the clinical outcomes of Paxlovid and azvudine among adult inpatients with severe or critical COVID-19. Method We conducted a retrospective cohort study in two large medical centres after the epidemic control measures were lifted in China. A new propensity score matched-inverse probability of treatment weighting cohort was constructed to evaluate the in-hospital all-cause mortality, hospital length of stay, Sequential Organ Failure Assessment (SOFA) score and safety. Results A total of 955 individuals were in the cohort. The antiviral therapy strategies were decided by the senior physician and the supplies of the pharmacy. A total of 451 patients were in the Paxlovid group, and 504 patients were in the azvudine group. Compared with Paxlovid, the effects of azvudine on in-hospital all-cause mortality were not significantly different, and the OR (95% CI) was 1.084 (0.822 to 1.430), and the average hospital length of stay of patients discharged alive was also similar in the azvudine group, and the difference (day) and (95% CI) was 0.530 (−0.334 to 1.393). After 7 days of therapy, the degree of decline in the SOFA score was greater in the Paxlovid group than in the azvudine group (p<0.001). The change in glomerular filtration rate was not significantly different (p=0.824). Conclusion Paxlovid and azvudine had similar effectiveness on in-hospital all-cause mortality and hospital length of stay. Compared with the azvudine group, after 7 days of therapy, the degree of decline in SOFA score was significantly higher in the Paxlovid group. These findings need to be verified in larger prospective studies or randomised controlled trials. Data are available upon reasonable request.
{"title":"Effectiveness of nirmatrelvir-ritonavir versus azvudine for adult inpatients with severe or critical COVID-19","authors":"Huan Zhang, Tan Xiaojiao, Junjun Chen, Zheng Zhang, Chenxi Wang, Haiqing Shi, Yao Li, Jianbo Li, Yan Kang, Xiaodong Jin, Xuelian Liao","doi":"10.1136/bmjresp-2023-001944","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-001944","url":null,"abstract":"Background In China, both nirmatrelvir-ritonavir (Paxlovid) and azvudine have been granted approval to treat adult SARS-CoV-2-infected patients with moderate symptoms. Information about the clinical effect of the two available agents among inpatients with severe or critical COVID-19 is scarce. Purpose To compare the clinical outcomes of Paxlovid and azvudine among adult inpatients with severe or critical COVID-19. Method We conducted a retrospective cohort study in two large medical centres after the epidemic control measures were lifted in China. A new propensity score matched-inverse probability of treatment weighting cohort was constructed to evaluate the in-hospital all-cause mortality, hospital length of stay, Sequential Organ Failure Assessment (SOFA) score and safety. Results A total of 955 individuals were in the cohort. The antiviral therapy strategies were decided by the senior physician and the supplies of the pharmacy. A total of 451 patients were in the Paxlovid group, and 504 patients were in the azvudine group. Compared with Paxlovid, the effects of azvudine on in-hospital all-cause mortality were not significantly different, and the OR (95% CI) was 1.084 (0.822 to 1.430), and the average hospital length of stay of patients discharged alive was also similar in the azvudine group, and the difference (day) and (95% CI) was 0.530 (−0.334 to 1.393). After 7 days of therapy, the degree of decline in the SOFA score was greater in the Paxlovid group than in the azvudine group (p<0.001). The change in glomerular filtration rate was not significantly different (p=0.824). Conclusion Paxlovid and azvudine had similar effectiveness on in-hospital all-cause mortality and hospital length of stay. Compared with the azvudine group, after 7 days of therapy, the degree of decline in SOFA score was significantly higher in the Paxlovid group. These findings need to be verified in larger prospective studies or randomised controlled trials. Data are available upon reasonable request.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"183 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjresp-2023-002211
David M G Halpin, Donald A Mahler
Background Errors using inhaled delivery systems for COPD are common and it is assumed that these lead to worse clinical outcomes. Previous systematic reviews have included patients with both asthma and COPD and much of the evidence related to asthma. More studies in COPD have now been published. Through systematic review, the relationship between errors using inhalers and clinical outcomes in COPD, including the importance of specific errors, was assessed.Methods Electronic databases were searched on 27 October 2023 to identify cohort, case–control or randomised controlled studies, which included patients with COPD, an objective assessment of inhaler errors and data on at least one outcome of interest (forced expiratory volume in 1 s, (FEV1), dyspnoea, health status and exacerbations). Study quality was assessed using the Newcastle and Ottawa scales. A narrative synthesis of the results was performed as there was insufficient detail in the publications to allow quantitative synthesis. There was no funding for the review. Results 19 publications were included (7 cohort and 12 case–control) reporting outcomes on 6487 patients. 15 were considered low quality, and most were confounded by the absence of adherence data. There was weak evidence that lower error rates are associated with better FEV1, symptoms and health status and fewer exacerbations. Only one considered the effects of individual errors and found that only some were related to worse outcomes. Conclusion Evidence about the importance of specific errors using inhalers and outcomes would optimise the education and training of patients with COPD. Prospective studies, including objective monitoring of inhalation technique and adherence, are needed. PROSPERO registration number CRD42023393120. No data are available.
{"title":"Systematic review of the effects of patient errors using inhaled delivery systems on clinical outcomes in COPD","authors":"David M G Halpin, Donald A Mahler","doi":"10.1136/bmjresp-2023-002211","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-002211","url":null,"abstract":"Background Errors using inhaled delivery systems for COPD are common and it is assumed that these lead to worse clinical outcomes. Previous systematic reviews have included patients with both asthma and COPD and much of the evidence related to asthma. More studies in COPD have now been published. Through systematic review, the relationship between errors using inhalers and clinical outcomes in COPD, including the importance of specific errors, was assessed.Methods Electronic databases were searched on 27 October 2023 to identify cohort, case–control or randomised controlled studies, which included patients with COPD, an objective assessment of inhaler errors and data on at least one outcome of interest (forced expiratory volume in 1 s, (FEV1), dyspnoea, health status and exacerbations). Study quality was assessed using the Newcastle and Ottawa scales. A narrative synthesis of the results was performed as there was insufficient detail in the publications to allow quantitative synthesis. There was no funding for the review. Results 19 publications were included (7 cohort and 12 case–control) reporting outcomes on 6487 patients. 15 were considered low quality, and most were confounded by the absence of adherence data. There was weak evidence that lower error rates are associated with better FEV1, symptoms and health status and fewer exacerbations. Only one considered the effects of individual errors and found that only some were related to worse outcomes. Conclusion Evidence about the importance of specific errors using inhalers and outcomes would optimise the education and training of patients with COPD. Prospective studies, including objective monitoring of inhalation technique and adherence, are needed. PROSPERO registration number CRD42023393120. No data are available.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"34 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140612133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjresp-2023-002089
Xingyu Rao, Zicheng Lei, Huifang Zhu, Kaiyuan Luo, Chaohua Hu
Background Asthma is a chronic disease affecting the lower respiratory tract, which can lead to death in severe cases. The cause of asthma is not fully known, so exploring its potential mechanism is necessary for the targeted therapy of asthma. Method Asthma mouse model was established with ovalbumin (OVA). H&E staining, immunohistochemistry and ELISA were used to detect the inflammatory response in asthma. Transcriptome sequencing was performed to screen differentially expressed genes (DEGs). The role of KIF23 silencing in cell viability, proliferation and apoptosis was explored by cell counting kit-8, EdU assay and flow cytometry. Effects of KIF23 knockdown on inflammation, oxidative stress and pyroptosis were detected by ELISA and western blot. After screening KIF23-related signalling pathways, the effect of KIF23 on p53 signalling pathway was explored by western blot. Results In the asthma model, the levels of caspase-3, IgG in serum and inflammatory factors (interleukin (IL)-1β, KC and tumour necrosis factor (TNF)-α) in serum and bronchoalveolar lavage fluid were increased. Transcriptome sequencing showed that there were 352 DEGs in the asthma model, and 7 hub genes including KIF23 were identified. Knockdown of KIF23 increased cell proliferation and inhibited apoptosis, inflammation and pyroptosis of BEAS-2B cells induced by IL-13 in vitro. In vivo experiments verified that knockdown of KIF23 inhibited oxidative stress, inflammation and pyroptosis to alleviate OVA-induced asthma mice. In addition, p53 signalling pathway was suppressed by KIF23 knockdown. Conclusion Knockdown of KIF23 alleviated the progression of asthma by suppressing pyroptosis and inhibited p53 signalling pathway. Data are available in a public, open access repository. The datasets used and/or analysed during the current study have been uploaded to NCBI SRA database ().
{"title":"Knockdown of KIF23 alleviates the progression of asthma by inhibiting pyroptosis","authors":"Xingyu Rao, Zicheng Lei, Huifang Zhu, Kaiyuan Luo, Chaohua Hu","doi":"10.1136/bmjresp-2023-002089","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-002089","url":null,"abstract":"Background Asthma is a chronic disease affecting the lower respiratory tract, which can lead to death in severe cases. The cause of asthma is not fully known, so exploring its potential mechanism is necessary for the targeted therapy of asthma. Method Asthma mouse model was established with ovalbumin (OVA). H&E staining, immunohistochemistry and ELISA were used to detect the inflammatory response in asthma. Transcriptome sequencing was performed to screen differentially expressed genes (DEGs). The role of KIF23 silencing in cell viability, proliferation and apoptosis was explored by cell counting kit-8, EdU assay and flow cytometry. Effects of KIF23 knockdown on inflammation, oxidative stress and pyroptosis were detected by ELISA and western blot. After screening KIF23-related signalling pathways, the effect of KIF23 on p53 signalling pathway was explored by western blot. Results In the asthma model, the levels of caspase-3, IgG in serum and inflammatory factors (interleukin (IL)-1β, KC and tumour necrosis factor (TNF)-α) in serum and bronchoalveolar lavage fluid were increased. Transcriptome sequencing showed that there were 352 DEGs in the asthma model, and 7 hub genes including KIF23 were identified. Knockdown of KIF23 increased cell proliferation and inhibited apoptosis, inflammation and pyroptosis of BEAS-2B cells induced by IL-13 in vitro. In vivo experiments verified that knockdown of KIF23 inhibited oxidative stress, inflammation and pyroptosis to alleviate OVA-induced asthma mice. In addition, p53 signalling pathway was suppressed by KIF23 knockdown. Conclusion Knockdown of KIF23 alleviated the progression of asthma by suppressing pyroptosis and inhibited p53 signalling pathway. Data are available in a public, open access repository. The datasets used and/or analysed during the current study have been uploaded to NCBI SRA database (<https://www.ncbi.nlm.nih.gov/sra/PRJNA1019821>).","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjresp-2024-002318
Mark Youssef, Marina Boutros Salama, Nadia Rehman, Christina Hanna, Mary Rose Waniss, Lawrence Mbuagbaw
Introduction People living with HIV (PLHIV) have a higher risk of developing pulmonary hypertension (PH) with subsequent poorer prognosis. This review aimed to determine the (1) survival outcomes and (2) proportion of emergency department (ED) visits and hospitalisations of PLHIV and PH. Methods We conducted a systematic review and meta-analysis of observational studies reporting survival outcomes for PLHIV and PH. Electronic databases (Medline, EMBASE, PubMed, Web of Science, Global Index Medicus and Cochrane Library), trial registries and conference proceedings were searched until 22 July 2023. We pooled similar measures of effect, assessed apriori subgroups and used meta-regression to determine mortality and associated variables. Results 5248 studies were identified; 28 studies were included with a total of 5459 PLHIV and PH. The mean survival (95% CI) of PLHIV and PH was 37.4 months (29.9 to 44.8). Participants alive at 1, 2 and 3 years were 85.8% (74.1% to 95.0%), 75.2% (61.9% to 86.7%) and 61.9% (51.8% to 71.6%), respectively. ED visits and hospitalisation rates were 73.3% (32.5% to 99.9%) and 71.2% (42.4% to 94.2%), respectively. More severe disease, measured by echocardiogram, was associated with poorer prognosis (β −0.01, 95% CI −0.02 to 0.00, p=0.009). Survival was higher in high-income countries compared with lower-income countries (β 0.50, 95% CI 0.28 to 0.73, p<0.001) and in Europe compared with the America (β 0.56, 95% CI 0.37 to 0.75, p<0.001). Conclusion Our study confirms poor prognosis and high healthcare utilisation for PLHIV and PH. Prognosis is associated with country income level, geographic region and PH severity. This highlights the importance of screening in this population. PROSPERO registration number CRD42023395023. Data are available upon reasonable request.
导言 HIV 感染者（PLHIV）罹患肺动脉高压（PH）的风险较高，预后较差。本综述旨在确定 (1) 肺动脉高压患者的生存结果和 (2) 急诊科就诊和住院比例。方法 我们对报告 PLHIV 和 PH 存活结果的观察性研究进行了系统回顾和荟萃分析。我们检索了电子数据库（Medline、EMBASE、PubMed、Web of Science、Global Index Medicus 和 Cochrane Library）、试验登记册和会议论文集，检索截止日期为 2023 年 7 月 22 日。我们汇集了相似的效果测量指标，评估了先验亚组，并使用元回归确定死亡率和相关变量。结果 共发现了 5248 项研究；其中 28 项研究共纳入了 5459 名 PLHIV 和 PH 患者。PLHIV和PH的平均生存期（95% CI）为37.4个月（29.9至44.8个月）。1年、2年和3年的存活率分别为85.8%（74.1%至95.0%）、75.2%（61.9%至86.7%）和61.9%（51.8%至71.6%）。急诊室就诊率和住院率分别为 73.3%（32.5% 至 99.9%）和 71.2%（42.4% 至 94.2%）。根据超声心动图测量，病情越严重，预后越差（β -0.01，95% CI -0.02至0.00，P=0.009）。高收入国家的存活率高于低收入国家（β 0.50，95% CI 0.28 至 0.73，p<0.001），欧洲的存活率高于美洲（β 0.56，95% CI 0.37 至 0.75，p<0.001）。结论 我们的研究证实，PLHIV 和 PH 的预后较差，医疗保健利用率较高。预后与国家收入水平、地理区域和 PH 严重程度有关。这凸显了对这一人群进行筛查的重要性。PROSPERO 注册号为 CRD42023395023。如有合理要求，可提供相关数据。
{"title":"Pulmonary hypertension survival and hospitalisations in people living with HIV: a systematic review and meta-analysis","authors":"Mark Youssef, Marina Boutros Salama, Nadia Rehman, Christina Hanna, Mary Rose Waniss, Lawrence Mbuagbaw","doi":"10.1136/bmjresp-2024-002318","DOIUrl":"https://doi.org/10.1136/bmjresp-2024-002318","url":null,"abstract":"Introduction People living with HIV (PLHIV) have a higher risk of developing pulmonary hypertension (PH) with subsequent poorer prognosis. This review aimed to determine the (1) survival outcomes and (2) proportion of emergency department (ED) visits and hospitalisations of PLHIV and PH. Methods We conducted a systematic review and meta-analysis of observational studies reporting survival outcomes for PLHIV and PH. Electronic databases (Medline, EMBASE, PubMed, Web of Science, Global Index Medicus and Cochrane Library), trial registries and conference proceedings were searched until 22 July 2023. We pooled similar measures of effect, assessed apriori subgroups and used meta-regression to determine mortality and associated variables. Results 5248 studies were identified; 28 studies were included with a total of 5459 PLHIV and PH. The mean survival (95% CI) of PLHIV and PH was 37.4 months (29.9 to 44.8). Participants alive at 1, 2 and 3 years were 85.8% (74.1% to 95.0%), 75.2% (61.9% to 86.7%) and 61.9% (51.8% to 71.6%), respectively. ED visits and hospitalisation rates were 73.3% (32.5% to 99.9%) and 71.2% (42.4% to 94.2%), respectively. More severe disease, measured by echocardiogram, was associated with poorer prognosis (β −0.01, 95% CI −0.02 to 0.00, p=0.009). Survival was higher in high-income countries compared with lower-income countries (β 0.50, 95% CI 0.28 to 0.73, p<0.001) and in Europe compared with the America (β 0.56, 95% CI 0.37 to 0.75, p<0.001). Conclusion Our study confirms poor prognosis and high healthcare utilisation for PLHIV and PH. Prognosis is associated with country income level, geographic region and PH severity. This highlights the importance of screening in this population. PROSPERO registration number CRD42023395023. Data are available upon reasonable request.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"38 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Despite substantial progress in reducing the global burden of chronic obstructive pulmonary disease (COPD), traditional methods to promote understanding and management of COPD are insufficient. We developed an innovative model based on the internet of things (IoT) for screening and management of COPD in primary healthcare (PHC). Methods Electronic questionnaire and IoT-based spirometer were used to screen residents. We defined individuals with a questionnaire score of 16 or higher as high-risk population, COPD was diagnosed according to 2021 Global Initiative for COPD (Global Initiative for Chronic Obstructive Lung Disease) criteria. High-risk individuals and COPD identified through the screening were included in the COPD PHC cohort study, which is a prospective, longitudinal observational study. We provide an overall description of the study’s design framework and baseline data of participants. Results Between November 2021 and March 2023, 162 263 individuals aged over 18 from 18 cities in China were screened, of those 43 279 high-risk individuals and 6902 patients with COPD were enrolled in the cohort study. In the high-risk population, the proportion of smokers was higher than that in the screened population (57.6% vs 31.4%), the proportion of males was higher than females (71.1% vs 28.9%) and in people underweight than normal weight (57.1% vs 32.0%). The number of high-risk individuals increased with age, particularly after 50 years old (χ2=37 239.9, p<0.001). Female patients are more common exposed to household biofuels (χ2=72.684, p<0.05). The majority of patients have severe respiratory symptoms, indicated by a CAT score of ≥10 (85.8%) or an Modified Medical Research Council Dyspnoea Scale score of ≥2 (65.5%). Conclusion Strategy based on IoT model help improve the detection rate of COPD in PHC. This cohort study has established a large clinical database that encompasses a wide range of demographic and relevant data of COPD and will provide invaluable resources for future research. No data are available. Researchers interested in collaboration and further information are invited to contact the corresponding author XZhang.
{"title":"Whole-course management of chronic obstructive pulmonary disease in primary healthcare: an internet of things-enabled prospective cohort study in China","authors":"Xingru Zhao, Haonan Kang, Yunxia An, Zhiwei Xu, Meihui Wei, Quncheng Zhang, Linqi Diao, Zhiping Guo, Xiaoju Zhang","doi":"10.1136/bmjresp-2023-001954","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-001954","url":null,"abstract":"Background Despite substantial progress in reducing the global burden of chronic obstructive pulmonary disease (COPD), traditional methods to promote understanding and management of COPD are insufficient. We developed an innovative model based on the internet of things (IoT) for screening and management of COPD in primary healthcare (PHC). Methods Electronic questionnaire and IoT-based spirometer were used to screen residents. We defined individuals with a questionnaire score of 16 or higher as high-risk population, COPD was diagnosed according to 2021 Global Initiative for COPD (Global Initiative for Chronic Obstructive Lung Disease) criteria. High-risk individuals and COPD identified through the screening were included in the COPD PHC cohort study, which is a prospective, longitudinal observational study. We provide an overall description of the study’s design framework and baseline data of participants. Results Between November 2021 and March 2023, 162 263 individuals aged over 18 from 18 cities in China were screened, of those 43 279 high-risk individuals and 6902 patients with COPD were enrolled in the cohort study. In the high-risk population, the proportion of smokers was higher than that in the screened population (57.6% vs 31.4%), the proportion of males was higher than females (71.1% vs 28.9%) and in people underweight than normal weight (57.1% vs 32.0%). The number of high-risk individuals increased with age, particularly after 50 years old (χ2=37 239.9, p<0.001). Female patients are more common exposed to household biofuels (χ2=72.684, p<0.05). The majority of patients have severe respiratory symptoms, indicated by a CAT score of ≥10 (85.8%) or an Modified Medical Research Council Dyspnoea Scale score of ≥2 (65.5%). Conclusion Strategy based on IoT model help improve the detection rate of COPD in PHC. This cohort study has established a large clinical database that encompasses a wide range of demographic and relevant data of COPD and will provide invaluable resources for future research. No data are available. Researchers interested in collaboration and further information are invited to contact the corresponding author XZhang.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/bmjresp-2023-001884
Vikram Mohan, Chandrasekar Rathinam, Derick Yates, Aatit Paungmali, Christopher Boos
Objective This study aimed to systematically review the psychometric properties of outcome measures that assess dysfunctional breathing (DB) in adults. Methods Studies on developing and evaluating measurement properties to assess DB were included. The study investigated the empirical research published between 1990 and February 2022, with an updated search in May 2023 in the Cochrane Library database of systematic reviews and the Cochrane Central Register of Controlled Trials, the Ovid Medline (full), the Ovid Excerta Medica Database, the Ovid allied and complementary medicines database, the Ebscohost Cumulative Index to Nursing and Allied Health Literature and the Physiotherapy Evidence Database. The included studies’ methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. Data analysis and synthesis followed the COSMIN methodology for reviews of outcome measurement instruments. Results Sixteen studies met the inclusion criteria, and 10 outcome measures were identified. The psychometric properties of these outcome measures were evaluated using COSMIN. The Nijmegen Questionnaire (NQ) is the only outcome measure with ‘sufficient’ ratings for content validity, internal consistency, reliability and construct validity. All other outcome measures did not report characteristics of content validity in the patients’ group. Discussion The NQ showed high-quality evidence for validity and reliability in assessing DB. Our review suggests that using NQ to evaluate DB in people with bronchial asthma and hyperventilation syndrome is helpful. Further evaluation of the psychometric properties is needed for the remaining outcome measures before considering them for clinical use. PROSPERO registration number CRD42021274960. Data are available in a public, open access repository. All the relevant data were available at .
目的 本研究旨在系统回顾评估成人呼吸功能障碍（DB）的结果测量的心理测量学特性。方法 纳入有关开发和评估 DB 测量特性的研究。研究调查了 1990 年至 2022 年 2 月间发表的实证研究，并于 2023 年 5 月在 Cochrane Library 系统综述数据库和 Cochrane Central Register of Controlled Trials、Ovid Medline（全文）、Ovid Excerta Medica 数据库、Ovid allied and complementary medicines 数据库、Ebscohost Cumulative Index to Nursing and Allied Health Literature 和物理治疗证据数据库中进行了更新检索。纳入研究的方法学质量采用基于共识的健康测量工具选择标准（COSMIN）偏倚风险检查表进行评估。数据分析和综合采用 COSMIN 方法对结果测量工具进行审查。结果 16 项研究符合纳入标准，并确定了 10 种结果测量方法。COSMIN 对这些结果测量工具的心理测量特性进行了评估。奈梅亨问卷（NQ）是唯一一个在内容效度、内部一致性、可靠性和结构效度方面获得 "充分 "评价的结果测量工具。在患者组中，所有其他结果测量均未报告内容效度特征。讨论 NQ 在评估 DB 方面显示了高质量的有效性和可靠性证据。我们的综述表明，使用 NQ 评估支气管哮喘和过度换气综合征患者的 DB 情况是有帮助的。在考虑将其余结果测量用于临床之前，还需要对其心理测量特性进行进一步评估。PROSPERO 注册号为 CRD42021274960。数据可在公开、开放的资料库中获取。所有相关数据可在 .
{"title":"Validity and reliability of outcome measures to assess dysfunctional breathing: a systematic review","authors":"Vikram Mohan, Chandrasekar Rathinam, Derick Yates, Aatit Paungmali, Christopher Boos","doi":"10.1136/bmjresp-2023-001884","DOIUrl":"https://doi.org/10.1136/bmjresp-2023-001884","url":null,"abstract":"Objective This study aimed to systematically review the psychometric properties of outcome measures that assess dysfunctional breathing (DB) in adults. Methods Studies on developing and evaluating measurement properties to assess DB were included. The study investigated the empirical research published between 1990 and February 2022, with an updated search in May 2023 in the Cochrane Library database of systematic reviews and the Cochrane Central Register of Controlled Trials, the Ovid Medline (full), the Ovid Excerta Medica Database, the Ovid allied and complementary medicines database, the Ebscohost Cumulative Index to Nursing and Allied Health Literature and the Physiotherapy Evidence Database. The included studies’ methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. Data analysis and synthesis followed the COSMIN methodology for reviews of outcome measurement instruments. Results Sixteen studies met the inclusion criteria, and 10 outcome measures were identified. The psychometric properties of these outcome measures were evaluated using COSMIN. The Nijmegen Questionnaire (NQ) is the only outcome measure with ‘sufficient’ ratings for content validity, internal consistency, reliability and construct validity. All other outcome measures did not report characteristics of content validity in the patients’ group. Discussion The NQ showed high-quality evidence for validity and reliability in assessing DB. Our review suggests that using NQ to evaluate DB in people with bronchial asthma and hyperventilation syndrome is helpful. Further evaluation of the psychometric properties is needed for the remaining outcome measures before considering them for clinical use. PROSPERO registration number CRD42021274960. Data are available in a public, open access repository. All the relevant data were available at <https://osf.io/49hju/>.","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"21 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140611867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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