PMID- 25147348
OWN - NLM
STAT- MEDLINE
DCOM- 20150708
LR  - 20141101
IS  - 1479-9731 (Electronic)
IS  - 1479-9723 (Linking)
VI  - 11
IP  - 4
DP  - 2014 Nov
TI  - Predictors of efficacy for endobronchial valves in bronchoscopic lung volume 
      reduction: A meta-analysis.
PG  - 237-45
LID - 10.1177/1479972314546766 [doi]
AB  - Over the last several years, numerous trials have been carried out to check the 
      efficacy of one-way valves in the management of advanced emphysema. While the 
      design of the valves has not altered much, by selectively studying these valves 
      in a select group of participants, such as those with and without intact fissures 
      (FI+ and FI-), and by using different procedural techniques, our understanding of 
      the valves has evolved. In this meta-analysis, we sought to study the effect of 
      these factors on the efficacy of one-way valves. From PubMed and Embase, we 
      included only those studies that provided separate data on fissure integrity or 
      collateral ventilation. Our study outcomes included the mean change in forced 
      expiratory volume in first second (FEV1), 6-minute walk distance (6MWD) and the 
      St George's Respiratory Questionnaire (SGRQ). In the FI+ subgroup of 
      participants, the pooled standardized mean difference in FEV1, 6MWD, and SGRQ 
      were 0.50 (95% confidence interval (CI): 0.34 to 0.67), p </= 0.001, 0.29 (95% CI: 
      0.13 to 0.45), p </= 0.001 and -6.02 (95% CI: -12.12 to 0.06), p = 0.05, 
      respectively. In comparison, these results were superior to the FI- subgroup of 
      participants. A separate analysis of the FI+ subgroup based on lobar occlusion 
      versus nonlobar occlusion favored the former for superior efficacy. The 
      preliminary findings of our meta-analysis confirm that one-way valves perform 
      better in a select group of patients who show intact fissures on lung imaging 
      pretreatment and in those who achieve lobar occlusion.
CI  - (c) The Author(s) 2014.
FAU - Iftikhar, Imran H
AU  - Iftikhar IH
AD  - Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, 
      University of South Carolina, Columbia, SC, USA imran.iftikhar@uscmed.sc.edu.
FAU - McGuire, Franklin R
AU  - McGuire FR
AD  - Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, 
      University of South Carolina, Columbia, SC, USA.
FAU - Musani, Ali I
AU  - Musani AI
AD  - Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, 
      National Jewish Health, Denver, CO, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20140821
PL  - England
TA  - Chron Respir Dis
JT  - Chronic respiratory disease
JID - 101197408
SB  - IM
MH  - *Bronchoscopy
MH  - Emphysema/physiopathology/*therapy
MH  - Humans
MH  - Pneumonectomy/*instrumentation/methods
MH  - *Prostheses and Implants
MH  - Pulmonary Disease, Chronic Obstructive/physiopathology/*therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Endobronchial valves
OT  - bronchoscopy
OT  - chronic obstructive pulmonary disease
OT  - emphysema
OT  - lung volume reduction
OT  - meta-analysis
EDAT- 2014/08/26 06:00
MHDA- 2015/07/15 06:00
CRDT- 2014/08/23 06:00
PHST- 2014/08/23 06:00 [entrez]
PHST- 2014/08/26 06:00 [pubmed]
PHST- 2015/07/15 06:00 [medline]
AID - 1479972314546766 [pii]
AID - 10.1177/1479972314546766 [doi]
PST - ppublish
SO  - Chron Respir Dis. 2014 Nov;11(4):237-45. doi: 10.1177/1479972314546766. Epub 2014 
      Aug 21.