Evidence map›Paper›PMID 16227328›Full record

Trial reportThorax2006

Clinical efficacy of anti-pneumococcal vaccination in patients with COPD.

I Alfageme, R Vazquez, N Reyes, J Muñoz, A Fernández, M Hernandez, M Merino, J Perez, J Lima

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Thorax, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 12 pooled it
9.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 12 syntheses or guidelines pooled it, 233 citations in OpenAlex.

  1. Pooled it
  2. Pneumococcal Vaccine for Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2023
    Guideline
  3. Pooled it
  4. Romanian clinical guideline for diagnosis and treatment of COPD.The Journal of international medical research · 2020
    Guideline
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Vaccines for preventing pneumococcal infection in adults.The Cochrane database of systematic reviews · 2013
    Pooled it
  10. Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011
    Guideline
  11. Efficacy of pneumococcal vaccination in adults: a meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2009
    Pooled it
  12. Guideline
  13. Long-term comparative immunogenicity of protein conjugate and free polysaccharide pneumococcal vaccines in chronic obstructive pulmonary disease.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2012
    Trial
  14. Trial
  15. Review
  16. Article
  17. Review
  18. Review
  19. Article
  20. Article

8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

I AlfagemePneumology Section, Valme University Hospital, 41014 Seville, Spain. ialfageme@separ.es
R Vazquez
N Reyes
J Muñoz
A Fernández
M Hernandez
M Merino
J Perez
J Lima
Hospital Universitario de Valme · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA study was undertaken to evaluate the clinical efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV) in immunocompetent patients with chronic obstructive pulmonary disease (COPD).

methodsA randomised controlled trial was carried out in 596 patients with COPD of mean (SD) age 65.8 (9.7) years, 298 of whom received PPV. The main outcome was radiographically proven community acquired pneumonia (CAP) of pneumococcal or unknown aetiology after a mean period of 979 days (range 20-1454).

resultsThere were 58 first episodes of CAP caused by pneumococcus or of unknown aetiology, 25 in the intervention group and 33 in the non-intervention group. Kaplan-Meier survival curves for CAP did not show significant differences between the intervention and non-intervention arms (log rank test = 1.15, p = 0.28) in the whole group of patients. The efficacy of PPV in all patients was 24% (95% CI -24 to 54; p = 0.333). In the subgroup aged <65 years the efficacy of PPV was 76% (95% CI 20 to 93; p = 0.013), while in those with severe functional obstruction (forced expiratory volume in 1 second <40%) it was 48% (95% CI -7 to 80; p = 0.076). In younger patients with severe airflow obstruction the efficacy was 91% (95% CI 35 to 99; p = 0.002). There were only five cases of non-bacteraemic pneumococcal CAP, all in the non-intervention group (log rank test = 5.03; p = 0.025). Multivariate analysis gave a hazard ratio for unknown and pneumococcal CAP in the vaccinated group, adjusted for age, of 0.20 (95% CI 0.06 to 0.68; p = 0.01).

conclusionsPPV is effective in preventing CAP in patients with COPD aged less than 65 years and in those with severe airflow obstruction. No differences were found among the other groups of patients with COPD.

Indexed as

Pneumococcal VaccinesAdultAgedCommunity-Acquired InfectionsFemaleForced Expiratory VolumeHumansImmunocompetenceMaleMiddle AgedPneumococcal InfectionsProspective StudiesPulmonary Disease, Chronic ObstructiveStreptococcus pneumoniaeSurvival AnalysisTreatment OutcomePneumococcal Vaccines

Identifiers

PMID16227328
PMCPMC2080738
OpenAlexW2163870873

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.