کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4211676 1280648 2007 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
External validity of randomized controlled trials in COPD
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی ریوی و تنفسی
پیش نمایش صفحه اول مقاله
External validity of randomized controlled trials in COPD
چکیده انگلیسی

SummaryBackgroundCOPD is a heterogeneous disease comprising a wide range of clinical phenotypes, depending on the degree to which emphysema, chronic bronchitis, reversible bronchospasm and small airways inflammation are present. Not all of these phenotypes may be represented among the subjects included in randomized controlled drug trials (RCTs) in COPD, making it difficult for doctors to know to what extent RCT evidence applies to individual patients. From a respiratory health survey of adults randomly selected from the community, we have estimated the proportion of subjects with COPD who would have been eligible for inclusion in major COPD RCTs.MethodsA postal survey was sent to 3500 randomly selected individuals aged 25–75 years. Respondents were invited to complete a detailed respiratory questionnaire and pulmonary function tests. Subjects with COPD defined by post-bronchodilator spirometry were assessed against the eligibility criteria of 18 major RCTs cited in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines.FindingsOf 749 subjects completing the full survey, 117 had COPD. Of these, a median of 5% (range 0–20%) of subjects met inclusion criteria for the major RCTs. Of 55 subjects with COPD receiving treatment, 0–9% (median 5%) met inclusion criteria for the major RCTs.InterpretationThe major COPD RCTs on which the GOLD treatment guidelines are based may have limited external validity. Over 90% of the COPD subjects in the community who were taking medication, did so on the basis of RCTs for which they would not have been eligible.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Respiratory Medicine - Volume 101, Issue 6, June 2007, Pages 1313–1320
نویسندگان
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