Evidence map›Paper›PMID 39947737›Full record

Trial reportBMJ open respiratory research2025

Investigating a structured diagnostic approach for chronic breathlessness in primary care: a mixed-methods feasibility cluster randomised controlled trial.

Gillian Doe, Jill Clanchy, Simon Wathall, Shaun Barber, Sarah A Edwards, Helen Evans, Darren Jackson, Natalie Armstrong, Michael C Steiner, Rachael A Evans

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

10 authors.

Gillian DoeNIHR Respiratory BRC Leicester, Department of Respiratory Sciences, University of Leicester, Leicester, UK.ORCID http://orcid.org/0000-0003-4782-5811
Jill ClanchyClinical Trials Unit, University of Leicester, Leicester, UK.
Simon WathallClinical Trials Unit, Keele University, Newcastle-under-Lyme, UK.
Shaun BarberClinical Trials Unit, University of Leicester, Leicester, UK.
Sarah A EdwardsNIHR Respiratory BRC Leicester, University Hospitals of Leicester NHS Trust, Leicester, UK.
Helen EvansNIHR Respiratory BRC Leicester, University Hospitals of Leicester NHS Trust, Leicester, UK.
Darren JacksonChair Hinckley & Bosworth Medical Alliance, Leicester, UK.
Natalie ArmstrongDepartment of Population Health Sciences, University of Leicester, Leicester, Leicestershire, UK.
Michael C SteinerNIHR Respiratory BRC Leicester, Department of Respiratory Sciences, University of Leicester, Leicester, UK.ORCID http://orcid.org/0000-0002-0127-0614
Rachael A EvansNIHR Respiratory BRC Leicester, Department of Respiratory Sciences, University of Leicester, Leicester, UK re66@leicester.ac.uk.ORCID http://orcid.org/0000-0002-1667-868X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is a need to reduce delays to diagnosis for chronic breathlessness to improve patient outcomes.

objectiveTo conduct a mixed-methods feasibility study of a larger cluster randomised controlled trial (cRCT) investigating a structured symptom-based diagnostic approach versus usual care for chronic breathlessness in primary care.

methods10 general practitioner practices were cluster randomised to a structured diagnostic approach for chronic breathlessness including early parallel investigations (intervention) or usual care. Adults over 40 years old at participating practices were eligible if presenting with chronic breathlessness without an existing explanatory diagnosis. The primary feasibility outcomes were participant recruitment and retention rate at 1 year. Secondary outcomes included number of investigations at 3 months, and investigations, diagnoses and patient-reported outcome measures (PROMs) at 1 year. Semistructured interviews were completed with patients and clinicians, and analysed using thematic analysis.

resultsRecruitment rate was 32% (48/150): 65% female, mean (SD) age 66 (11) years, body mass index 31.2 kg/m

conclusionsA cRCT investigating a symptom-based diagnostic approach for chronic breathlessness is feasible in primary care showing potential for timely investigations and diagnoses, with PROMs potentially indicating patient-level benefit. A further refined fully powered cRCT with health economic analysis is needed.

Indexed as

DyspneaAgedChronic DiseaseDelayed DiagnosisFeasibility StudiesFemaleHumansMaleMiddle AgedPatient Reported Outcome MeasuresPrimary Health CareQuality of LifeNot Applicable

Identifiers

PMID39947737
PMCPMC11831280

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.