PMID- 28005150
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20181203
IS  - 1432-1750 (Electronic)
IS  - 0341-2040 (Linking)
VI  - 195
IP  - 1
DP  - 2017 Feb
TI  - Early Trends in Bronchoscopic Lung Volume Reduction: A Systematic Review and 
      Meta-analysis of Efficacy Parameters.
PG  - 19-28
LID - 10.1007/s00408-016-9969-x [doi]
AB  - INTRODUCTION: The goal of our systematic review and meta-analysis is to examine 
      the therapeutic effectiveness of bronchoscopic lung volume reduction (BLVR), and 
      to compare it with medical management and lung volume reduction surgery. METHODS: 
      Variables of interest were absolute change in FEV1, 6MWT, and SGRQ. Meta-analysis 
      was performed for the BLVR modalities with >/=3 trials. Of the 18 shortlisted 
      publications, only valves (four trials; n = 159) and coils (six trials; n = 194) 
      qualified for meta-analysis. To avoid redundant reporting for valves, only the 
      data for intact fissure subjects were analyzed. Outcome data are presented as the 
      mean difference from baseline with 95% confidence interval at 6-months follow-up. 
      RESULTS: For BLVR using valves, the pooled mean difference (PMD) for FEV1 was 
      0.146 L (95% CI 0.111-0.181; p < 0.001), 6MWT was 45.225 meters (95% CI 
      26.954-63.495; p < 0.001), and SGRQ was -8.825 points (95% CI -14.824 to -2.825; 
      p = 0.004). All the PMDs were statistically significant and higher than their 
      respective minimal clinically important difference (MCID). For BLVR using coils, 
      the PMD for FEV1 was 0.080 L (95% CI 0.057-0.104; p < 0.001), 6MWT was 45.320 
      meters (95% CI 28.040-62.600; p < 0.001), and SGRQ was -10.570 points (95% CI 
      -13.299 to -7.841; p < 0.001). All three variables showed statistically 
      significant PMDs but that for FEV1 was smaller than the MCID. Data from BLVR 
      modalities with <3 major publications are reviewed in the discussion section. 
      CONCLUSIONS: BLVR offers early promise in the palliation of advanced emphysema. 
      Better characterization of patients to identify phenotypes that will derive 
      sustained benefit is needed.
FAU - Kumar, Abhishek
AU  - Kumar A
AD  - Mercy Medical Center, Cedar Rapids, IA, USA. medshek@gmail.com.
AD  - State University of New York/University at Buffalo, Buffalo, NY, USA. 
      medshek@gmail.com.
FAU - Dy, Rajany
AU  - Dy R
AD  - State University of New York/University at Buffalo, Buffalo, NY, USA.
FAU - Singh, Kanwaljit
AU  - Singh K
AD  - University of Massachusetts, Worcester, MA, USA.
FAU - Jeffery Mador, M
AU  - Jeffery Mador M
AD  - State University of New York/University at Buffalo, Buffalo, NY, USA.
AD  - Western New York Veterans Administration Healthcare System, Buffalo, NY, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20161222
PL  - United States
TA  - Lung
JT  - Lung
JID - 7701875
SB  - IM
MH  - *Bronchoscopy/adverse effects
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Pneumonectomy/adverse effects/instrumentation/*methods/trends
MH  - Pulmonary Emphysema/*physiopathology/*surgery
MH  - Treatment Outcome
MH  - Walk Test
OTO - NOTNLM
OT  - Bronchoscopic lung volume reduction (BLVR)
OT  - COPD
OT  - Emphysema
OT  - Endoscopic lung volume reduction
OT  - Lung volume reduction
EDAT- 2016/12/23 06:00
MHDA- 2018/01/05 06:00
CRDT- 2016/12/23 06:00
PHST- 2016/10/19 00:00 [received]
PHST- 2016/12/05 00:00 [accepted]
PHST- 2016/12/23 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
PHST- 2016/12/23 06:00 [entrez]
AID - 10.1007/s00408-016-9969-x [pii]
AID - 10.1007/s00408-016-9969-x [doi]
PST - ppublish
SO  - Lung. 2017 Feb;195(1):19-28. doi: 10.1007/s00408-016-9969-x. Epub 2016 Dec 22.