Evidence map›Paper›PMID 28288488›Full record

ArticleAnnals of internal medicine2017

Survival Comparison of Patients With Cystic Fibrosis in Canada and the United States: A Population-Based Cohort Study.

Anne L Stephenson, Jenna Sykes, Sanja Stanojevic, Bradley S Quon, Bruce C Marshall, Kristofer Petren, Josh Ostrenga, Aliza K Fink, Alexander Elbert, Christopher H Goss

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

76 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Association of site of treatment with clinical outcomes following intravenous antimicrobial treatment of a pulmonary exacerbation.Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2022
    Trial
  4. Feasibility and efficacy of combined pancreatic islet-lung transplantation in cystic fibrosis-related diabetes-PIM study: A multicenter phase 1-2 trial.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022
    Trial
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  15. Factors associated with cystic fibrosis mortality before the age of 30: retrospective analysis of a cohort in southern Brazil.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2024
    Article
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16 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Anne L StephensonFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Jenna SykesFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Sanja StanojevicFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Bradley S QuonFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Bruce C MarshallFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Kristofer PetrenFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Josh OstrengaFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Aliza K FinkFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Alexander ElbertFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.
Christopher H GossFrom St. Michael's Hospital, University of Toronto, and The Hospital for Sick Children, Toronto, Ontario, Canada; University of British Columbia, Vancouver, British Columbia, Canada; Cystic Fibrosis Foundation, Bethesda, Maryland; and University of Washington Medical Center, Seattle, Washington.

Funding

Translational Research Center to Expedite Novel Therapies in Cystic FibrosisP30DK089507 · NIDDK · SEATTLE CHILDREN'S HOSPITAL · PI Christopher Hooper Goss, Lucas R Hoffman · 2010 to 2026
$21.4M
Proof of Principle Evaluation of IV Gallium Nitrate in Patients with CFUM1HL119073 · NHLBI · UNIVERSITY OF WASHINGTON · PI GOSS, CHRISTOPHER HOOPER, SINGH, PRADEEP K · 2013 to 2017
$4.8M
Early Intervention in Pulmonary Exacerbation in CFR01HL103965 · NHLBI · UNIVERSITY OF WASHINGTON · PI GOSS, CHRISTOPHER HOOPER, LECHTZIN, NOAH · 2010 to 2014
$3.8M
Investigating treatment resistance mechanisms in chronic bacterial infectionsR01AI101307 · NIAID · UNIVERSITY OF WASHINGTON · PI BRUCE, JAMES EDWARD, MANOIL, COLIN · 2012 to 2016
$2.9M
Regulation of host inflammatory responses and outcome in melioidosis by TLR5R01HL113382 · NHLBI · UNIVERSITY OF WASHINGTON · PI WEST, TIMOTHY EOIN · 2012 to 2016
$2.6M
Phase 2 Study of Intravenous Gallium Nitrate in the Treatment of Cystic FibrosisR01FD003704 · FDA · UNIVERSITY OF WASHINGTON · PI GOSS, CHRISTOPHER HOOPER · 2009 to 2018
$2.0M
FDA HHS R01 FD003704NHLBI NIH HHS R01 HL103965NHLBI NIH HHS R01 HL113382NHLBI NIH HHS UM1 HL119073NIAID NIH HHS R01 AI101307NIDDK NIH HHS P30 DK089507
6 · The paper itself

Abstract

backgroundIn 2011, the median age of survival of patients with cystic fibrosis reported in the United States was 36.8 years, compared with 48.5 years in Canada. Direct comparison of survival estimates between national registries is challenging because of inherent differences in methodologies used, data processing techniques, and ascertainment bias.

objectiveTo use a standardized approach to calculate cystic fibrosis survival estimates and to explore differences between Canada and the United States.

designPopulation-based study.

setting42 Canadian cystic fibrosis clinics and 110 U.S. cystic fibrosis care centers. PATIENTS: Patients followed in the Canadian Cystic Fibrosis Registry (CCFR) and U.S. Cystic Fibrosis Foundation Patient Registry (CFFPR) between 1990 and 2013. MEASUREMENTS: Cox proportional hazards models were used to compare survival between patients followed in the CCFR (n = 5941) and those in the CFFPR (n = 45 448). Multivariable models were used to adjust for factors known to be associated with survival.

resultsMedian age of survival in patients with cystic fibrosis increased in both countries between 1990 and 2013; however, in 1995 and 2005, survival in Canada increased at a faster rate than in the United States (P < 0.001). On the basis of contemporary data from 2009 to 2013, the median age of survival in Canada was 10 years greater than in the United States (50.9 vs. 40.6 years, respectively). The adjusted risk for death was 34% lower in Canada than the United States (hazard ratio, 0.66 [95% CI, 0.54 to 0.81]). A greater proportion of patients in Canada received transplants (10.3% vs. 6.5%, respectively [standardized difference, 13.7]). Differences in survival between U.S. and Canadian patients varied according to U.S. patients' insurance status. LIMITATION: Ascertainment bias due to missing data or nonrandom loss to follow-up might affect the results.

conclusionDifferences in cystic fibrosis survival between Canada and the United States persisted after adjustment for risk factors associated with survival, except for private-insurance status among U.S. patients. Differential access to transplantation, increased posttransplant survival, and differences in health care systems may, in part, explain the Canadian survival advantage. PRIMARY FUNDING SOURCE: U.S. Cystic Fibrosis Foundation.

Indexed as

CanadaCystic FibrosisHumansInsurance CoverageInsurance, HealthLung TransplantationProportional Hazards ModelsRisk FactorsSingle-Payer SystemSurvival RateUnited States

Identifiers

PMID28288488
PMCPMC5467971

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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.