Evidence map›Paper›PMID 41942485›Full record

Trial reportNPJ primary care respiratory medicine2026

Identifying patients with mild-to-moderate COPD who require intensified initial treatment to control annualized clinically important deterioration.

Zihui Wang, Yumin Zhou, Wei-Jie Guan, Junfeng Lin, Guannan Cai, Jinping Zheng, Fan Wu, Zhishan Deng, Nan-Shan Zhong, Pixin Ran

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

Trial report in NPJ primary care respiratory medicine, 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
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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

10 authors.

Zihui Wang *National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Yumin Zhou *National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Wei-Jie Guan *National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Junfeng LinNational Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Guannan CaiNational Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Jinping ZhengNational Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Fan WuNational Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Zhishan DengNational Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
Nan-Shan ZhongNational Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China. nanshan@vip.163.com.
Pixin RanNational Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China. pxran@gzhmu.edu.cn.

Funding

Guangzhou National Laboratory SRPG22 018, SRPG22 016the Clinical and Epidemiological Research Project of State Key Laboratory of Respiratory Disease SKLRD-L-202402the Foundation of Zhongnanshan Meical Foundation of Guangdong Province ZNSA-2021011the National Natural Science Foundation of China 81970045, 81970038, and 82270043the Plan on Enhancing Scientific Research in Guangzhou Medical University GMUCR2024-01012
6 · The paper itself

Abstract

backgroundThe chronic obstructive pulmonary disease (COPD) guidelines recommend selecting initial treatment based on the severity of respiratory symptoms or exacerbation history. However, some patients still experience clinically important deterioration (CID) despite this strategy. Therefore, we aimed to identify the risk factors to guide initial treatment, focusing on mild-to-moderate COPD patients whose annualized CID cannot be controlled by a single-bronchodilator.

methodsPatients in the tiotropium group from a randomized controlled trial were included. Over 2 years, annualized CID was defined as forced expiratory volume in one second (FEV

resultsOf 312 patients with mild-to-moderate COPD receiving tiotropium, 29.2% still experienced annualized CID. The proportions of patients who developed annualized CID regarding FEV

conclusionPatients with more prominent airflow limitation and higher smoking pack-years warrant intensified initial treatment to control their annualized CID.

Indexed as

Bronchodilator AgentsPulmonary Disease, Chronic ObstructiveTiotropium BromideAgedBayes TheoremDisease ProgressionFemaleForced Expiratory VolumeHumansMaleMiddle AgedRisk FactorsSeverity of Illness IndexBronchodilator AgentsTiotropium Bromide

Identifiers

PMID41942485
PMCPMC13230894

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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.