Evidence map›Paper›PMID 37652570›Full record

Observational studyThe European respiratory journal2023

Real-world effectiveness of airway clearance techniques in children with cystic fibrosis.

Nicole Filipow, Sanja Stanojevic, Emma Raywood, Harriet Shannon, Gizem Tanriver, Kunal Kapoor, Helen Douglas, Gwyneth Davies, Rachel O'Connor, Nicky Murray and 1 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The European respiratory journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.4field-weighted citation impact, top 7% 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

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Review
  4. Cystic fibrosis year in review 2023.Pediatric pulmonology · 2024
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Nicole FilipowPhysiotherapy, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID 0000-0003-3544-6136
Sanja StanojevicCommunity Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Emma RaywoodPhysiotherapy, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID 0000-0002-0993-5115
Harriet ShannonPhysiotherapy, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Gizem TanriverPhysiotherapy, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Kunal KapoorPhysiotherapy, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Helen DouglasPhysiotherapy, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Gwyneth DaviesPopulation Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID 0000-0001-7937-2728
Rachel O'ConnorPaediatric Cystic Fibrosis Centre, Royal London Hospital, Barts Health NHS Trust, London, UK.
Nicky MurrayPaediatric Cystic Fibrosis Unit, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Eleanor MainPhysiotherapy, UCL Great Ormond Street Institute of Child Health, University College London, London, UK e.main@ucl.ac.uk.ORCID 0000-0002-9739-3167
Great Ormond Street Hospital · GBBarts Health NHS Trust · GBDalhousie University · CAGuy's and St Thomas' NHS Foundation Trust · GB

Funding

Department of HealthMedical Research Council MR/T041285/1
6 · The paper itself

Abstract

backgroundCystic fibrosis (CF) is commonly characterised by thick respiratory mucus. From diagnosis, people with CF are prescribed daily physiotherapy, including airway clearance techniques (ACTs). ACTs consume a large proportion of treatment time, yet the efficacy and effectiveness of ACTs are poorly understood. This study aimed to evaluate associations between the quality and quantity of ACTs and lung function in children and young people with CF.

methodsProject Fizzyo, a longitudinal observational cohort study in the UK, used remote monitoring with electronic pressure sensors attached to four different commercial ACT devices to record real-time, breath-by-breath pressure data during usual ACTs undertaken at home over 16 months in 145 children. ACTs were categorised either as conformant or not with current ACT recommendations based on breath pressure and length measurements, or as missed treatments if not recorded. Daily, weekly and monthly associations between ACT category and lung function were investigated using linear mixed effects regression models adjusting for clinical confounders.

resultsAfter exclusions, 45 224 ACT treatments (135 individuals) and 21 069 days without treatments (141 individuals) were analysed. The mean±sd age of participants was 10.2±2.9 years. Conformant ACTs (21%) had significantly higher forced expiratory volume in 1 s (FEV

conclusionsACTs are beneficial when performed as recommended, but most people use techniques that do not improve lung function. Work is needed to monitor and improve ACT quality and to increase the proportion of people doing effective airway clearance at home.

Indexed as

Cystic FibrosisAdolescentChildForced Expiratory VolumeHumansLinear ModelsPrednisoneSputumPrednisone

Identifiers

PMID37652570
PMCPMC10492663
OpenAlexW4386325730

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.