Evidence map›Paper›PMID 41802592›Full record

ArticleChest2026

Antimicrobial Treatment of Mild Mycobacterium avium Complex Pulmonary Disease Predicted to Increase Survival and Quality-Adjusted Life Years: A Microsimulation Decision Analysis Model.

Omri A Arbiv, Gemma Postill, Yunjoo Im, Byung Woo Jhun, Petros Pechlivanoglou, Sarah K Brode, Ahmed M Bayoumi, Theodore K Marras

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Omri A ArbivDivision of Respirology, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Clinical-Investigator Program, University of British Columbia, Vancouver, BC, Canada. Electronic address: correspondence@omriarbiv.com.
Gemma PostillInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Yunjoo ImDivision of Pulmonology, Allergy, and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea.
Byung Woo JhunDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Seoul, Korea.
Petros PechlivanoglouInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, ON, Canada; Toronto Health Economic and Technology Assessment Collaborative, Toronto, ON, Canada.
Sarah K BrodeDivision of Respirology, University of Toronto, Toronto, ON, Canada; Division of Respirology, University Health Network, Toronto, ON, Canada.
Ahmed M BayoumiInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of General Internal Medicine, St. Michael's Hospital, Toronto, ON, Canada; MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.
Theodore K MarrasDivision of Respirology, University of Toronto, Toronto, ON, Canada; Division of Respirology, University Health Network, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMycobacterium avium complex pulmonary disease (MAC-PD) can lead to chronic lung disease, which can necessitate intensive antimicrobial therapy. In patients with mild MAC-PD, uncertainty exists regarding whether guideline-based antimicrobial treatment should be used as compared with watchful waiting. RESEARCH QUESTION: What are the long-term consequences of initiation of antimicrobial treatment compared with watchful waiting in patients with mild MAC-PD? STUDY DESIGN AND

methodsWe simulated a cohort of 70-year-old Canadian individuals with nodular bronchiectatic MAC-PD with a macrolide-susceptible specimen and normal lung function. We used a lifetime model to compare guideline-based treatment with observation for patients with MAC-PD, accounting for common adverse events, culture conversion rates, and disease recurrences from prior literature. Our outcomes were quality-adjusted life years (QALYs) and life years. The primary analysis was a probabilistic Monte Carlo simulation to estimate the mean and 95% uncertainty intervals (UIs) for each outcome under treatment and observation, as well as the treatment to observation difference. Additional outcomes included deterministic analysis and 1-way and 2-way deterministic sensitivity analyses.

resultsIn the primary analysis, the cohort of individuals receiving antimicrobial treatment showed a mean of 15.9 QALYs (95% UI, 12.4-19.3 QALYs), whereas those under observation showed 13.4 QALYs (95% UI, 9.0-16.4 QALYs), with a treatment to observation difference of 2.5 QALYs (95% UI, 0.8-4.7 QALYs). Similarly, those receiving treatment showed a mean 18.3 life years (95% UI, 19.2-25.5 life years), and those under observation showed 15.8 life years (95% UI, 17.3-22.2 life years). The treatment to observation difference was 2.5 years (95% UI, 1.0-4.2 years). Increase in QALYs and life years was consistent across almost all sensitivity analyses.

interpretationIn a simulated cohort, guideline-based treatment increased QALYs and life years in patients with mild MAC-PD. Our findings can support patients and physicians in deciding on treatment approach.

Indexed as

Anti-Bacterial AgentsLung DiseasesMycobacterium avium ComplexMycobacterium avium-intracellulare InfectionQuality-Adjusted Life YearsAgedCanadaComputer SimulationDecision Support TechniquesFemaleHumansMaleMonte Carlo MethodAnti-Bacterial Agentsdecision modelingMycobacterium aviumnontuberculous mycobacteriaquality-adjusted life year

Identifiers

PMID41802592
PMCPMC13494443

What OpenQuestion holds

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LicenceCC BY-NC-ND
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.