Evidence map›Paper›PMID 41889165›Full record

ArticlePediatric pulmonology2026

Transforming Care in Cystic Fibrosis: The Long-Term Impact of Quality Improvement Projects on Clinical Outcomes.

S Karabulut, M Yuksel Kalyoncu, M Selcuk Balcı, N Metin Cakar, C A Yıldız, B Uzunoglu, G Tastan, D Kocaman, C Yılmaz Yeğit, A P Ergenekon and 5 more

Abstract read
In one paragraph

Article in Pediatric pulmonology, 2026. 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

15 authors.

S KarabulutDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-4606-8946
M Yuksel KalyoncuDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-4594-2822
M Selcuk BalcıDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-2146-3966
N Metin CakarDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.
C A YıldızDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.
B UzunogluSelim Coremen Cystic Fibrosis Center, Marmara University School of Medicine, Istanbul, Turkey.
G TastanSelim Coremen Cystic Fibrosis Center, Marmara University School of Medicine, Istanbul, Turkey.
D KocamanSelim Coremen Cystic Fibrosis Center, Marmara University School of Medicine, Istanbul, Turkey.
C Yılmaz YeğitDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.
A P ErgenekonDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.
E Erdem EralpDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.ORCID https://orcid.org/0000-0001-8829-3431
Y GokdemirDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.
F KarakocDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.
S Z NasrDepartment of Pediatrics, Division of Pediatric Pulmonology, University of Michigan, Ann Arbor, Michigan, USA.
B KaradagDepartment of Pediatrics, Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to evaluate 5-year outcomes of a structured quality improvement (QI) program implemented as part of the standard of care at our CF center, focusing on changes in body mass index (BMI) and forced expiratory volume in 1 s (FEV₁) in pwCF followed at our institution.

methodsThe medical records of pwCF registered at our CF center between January 1, 2018, and December 31, 2022, were retrospectively reviewed. Demographic and clinical data of pwCF submitted by our center to the European Cystic Fibrosis Society Patient Registry (ECFSPR) were used for this analysis. Structured QI strategies were initiated in 2018 after collaboration with the University of Michigan CF Center and focused on nutrition, respiratory care, and treatment adherence. Time-dependent changes in FEV1 percent predicted (FEV1pp) were evaluated using a linear mixed-effects regression model.

resultsAll 440 pwCF followed at our center during the study period were included in the analysis. Over 5 years, BMI z-scores improved significantly in children (p < 0.001), while adult BMI remained stable (p = 0.10). No significant linear change in mean FEV₁pp was observed in adjusted longitudinal models (p > 0.05), however, descriptive analyses showed an increase in median FEV₁pp among adults. Higher BMI was associated with better lung function (p < 0.001) and lower IV antibiotic burden in correlation analyses (children: p < 0.001; adults: p = 0.045). The estimated mean survival age of the analysis cohort was 46.1 years.

conclusionTo our knowledge, this is the first report of a cohort of Turkish pwCF summarizing 5-year longitudinal registry data with survival estimates. These findings suggest that sustained, center-wide QI efforts may help maintain or improve clinical outcomes, particularly in settings with limited access to CFTR modulators.

Indexed as

Cystic FibrosisQuality ImprovementAdolescentAdultBody Mass IndexChildChild, PreschoolFemaleForced Expiratory VolumeHumansMaleRegistriesRetrospective StudiesYoung Adultchildrencystic fibrosislung functionnutritionpatient registrysurvival analysis

Identifiers

PMID41889165
PMCPMC13022515

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LicenceCC BY-NC-ND
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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.