Evidence map›Paper›PMID 41760356›Full record

SynthesisBMJ open respiratory research2026

Community-based prediction models of cardiovascular events, acute exacerbations and all-cause mortality in individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis on behalf of the International Cardiovascular and Respiratory Alliance.

Tobin Joseph, Keerthenan Raveendra, Mohammad Haris, Jasmin Kirupananthan, Amaan Aslam, Alexandra Mircescu, Ashmit Bhardwaj, Aidan Wong, Ramesh Nadarajah, David B Price and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

12 authors.

Tobin JosephLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK t.joseph@leeds.ac.uk.ORCID http://orcid.org/0000-0002-9283-9895
Keerthenan RaveendraLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Mohammad HarisLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Jasmin KirupananthanLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Amaan AslamLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Alexandra MircescuLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Ashmit BhardwajLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Aidan WongLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Ramesh NadarajahLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
David B PriceObservational and Pragmatic Research Institute, Singapore.
Mohit BhutaniMedicine, University of Alberta, Edmonton, Alberta, Canada.
Chris GaleLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPreventable morbidity and mortality from chronic obstructive pulmonary disease (COPD) accrue from major adverse cardiovascular events (MACEs) and acute exacerbations of COPD (AECOPD). The study aims to summarise models for the prediction of these cardiopulmonary events in community-based settings.

methodsWe searched for studies of multivariable models derived, validated or augmented for the prediction of cardiopulmonary events in COPD and used community-based data sources using MEDLINE and Embase from inception through 10 April 2025. Discrimination measures for the model with C-statistic data from ≥3 cohorts were pooled by Bayesian meta-analysis, and heterogeneity and risk of bias assessments were undertaken.

resultsNo models were identified that predicted cardiopulmonary events in COPD using community-based data. Of the 71 models included, 5 predicted cardiovascular events, 32 predicted AECOPD and 30 predicted all-cause mortality. None were eligible for meta-analysis for the prediction of cardiovascular events or AECOPD. For all-cause mortality, age, dyspnoea and airflow obstruction-surprise question (ADO-SQ) (0.763, 95% CI 0.533 to 0.942) and body mass index, airflow obstruction, dyspnoea score and exercise capacity (BODE) (0.753, 95% CI 0.583 to 0.907) demonstrated good prediction performance, while ADO (0.638, 95% CI 0.443 to 0.827) demonstrated adequate prediction performance. The risk of bias was high for 57.9% of studies, and none had clinical utility evaluated.

conclusionsDespite the high burden of MACE and AECOPD, there is an absence of community-based models that predict this composite outcome. Models to identify individuals with COPD at high risk of cardiopulmonary events could enable targeted clinical intervention. PROSPERO REGISTRATION NUMBER: CRD420251026275.

Indexed as

Cardiovascular DiseasesPulmonary Disease, Chronic ObstructiveDisease ProgressionHumansPrognosisRisk AssessmentCOPD epidemiologyCOPD Exacerbations

Identifiers

PMID41760356
PMCPMC12958919

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Registered trials

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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.