Evidence map›Paper›PMID 21499589›Full record

GuidelineCanadian respiratory journal

Managing dyspnea in patients with advanced chronic obstructive pulmonary disease: a Canadian Thoracic Society clinical practice guideline.

Darcy D Marciniuk, Donna Goodridge, Paul Hernandez, Graeme Rocker, Meyer Balter, Pat Bailey, Gord Ford, Jean Bourbeau, Denis E O'Donnell, Francois Maltais and 7 more

Registry-linked trialOpen access · goldAbstract readPractice GuidelineSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Canadian respiratory journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06304207 (Comparison of Telehealth and Onsite Supervised Maintenance Exercise Program for Adults With Chronic Lung Disease), which is not on this map. Cited by 76 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 4 pooled it
11.2field-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.

NCT06304207 naunknown statusnot on this map

Comparison of Telehealth and Onsite Supervised Maintenance Exercise Program for Adults With Chronic Lung Disease: A Pilot Randomized Controlled Trial

TypeinterventionalSponsorMGH Institute of Health ProfessionsRan2023 to 2026Enrolled30ConditionsCopd, COPD Exacerbation, COPD Bronchitis, Emphysema or COPDArmsOnsite Maintenance Exercise Training, Telehealth Maintenance Exercise
3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 4 syntheses or guidelines pooled it, 269 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Guideline
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  12. Buspirone for management of dyspnea in cancer patients receiving chemotherapy: a randomized placebo-controlled URCC CCOP study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2016
    Trial
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  15. Article
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  17. Application of Fan Therapy in Alleviating Dyspnea.Journal of multidisciplinary healthcare · 2025
    Review
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  20. Review

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

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 8 institutions in 2 countries.

Darcy D MarciniukUniversity of Saskatchewan, Saskatoon, Saskatchewan. ctsinfo@lung.ca
Donna Goodridge
Paul Hernandez
Graeme Rocker
Meyer Balter
Pat Bailey
Gord Ford
Jean Bourbeau
Denis E O'Donnell
Francois Maltais
Richard A Mularski
Andrew J Cave
Irvin Mayers
Vicki Kennedy
Thomas K Oliver
Candice Brown
Canadian Thoracic Society COPD Committee Dyspnea Expert Working Group
Canadian Thoracic Society · CADalhousie University · CAUniversity of Alberta · CAUniversity of Saskatchewan · CAKaiser Permanente · USLaurentian University · CAQueen's University · CASaskatchewan Health Authority · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Dyspnea is a cardinal symptom of chronic obstructive pulmonary disease (COPD), and its severity and magnitude increases as the disease progresses, leading to significant disability and a negative effect on quality of life. Refractory dyspnea is a common and difficult symptom to treat in patients with advanced COPD. There are many questions concerning optimal management and, specifically, whether various therapies are effective in this setting. The present document was compiled to address these important clinical issues using an evidence-based systematic review process led by a representative interprofessional panel of experts. The evidence supports the benefits of oral opioids, neuromuscular electrical stimulation, chest wall vibration, walking aids and pursed-lip breathing in the management of dyspnea in the individual patient with advanced COPD. Oxygen is recommended for COPD patients with resting hypoxemia, but its use for the targeted management of dyspnea in this setting should be reserved for patients who receive symptomatic benefit. There is insufficient evidence to support the routine use of anxiolytic medications, nebulized opioids, acupuncture, acupressure, distractive auditory stimuli (music), relaxation, handheld fans, counselling programs or psychotherapy. There is also no evidence to support the use of supplemental oxygen to reduce dyspnea in nonhypoxemic patients with advanced COPD. Recognizing the current unfamiliarity with prescribing and dosing of opioid therapy in this setting, a potential approach for their use is illustrated. The role of opioid and other effective therapies in the comprehensive management of refractory dyspnea in patients with advanced COPD is discussed.

Indexed as

Oxygen Inhalation TherapyAnalgesics, OpioidCanesDyspneaElectric Stimulation TherapyHumansPulmonary Disease, Chronic ObstructiveAnalgesics, Opioid

Identifiers

PMID21499589
PMCPMC3084418
OpenAlexW2146250410

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.