Evidence map›Paper›PMID 33214560›Full record

SynthesisNPJ primary care respiratory medicine2020

Systematic review of clinical effectiveness, components, and delivery of pulmonary rehabilitation in low-resource settings.

G M Monsur Habib, Roberto Rabinovich, Kalyani Divgi, Salahuddin Ahmed, Samir Kumar Saha, Sally Singh, Aftab Uddin, Md Nazim Uzzaman, Hilary Pinnock

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in NPJ primary care respiratory medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
3.9field-weighted citation impact, top 5% of its field
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

38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.

  1. Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review.International journal of environmental research and public health · 2023
    Pooled it
  2. Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2022
    Pooled it
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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

9 authors at 7 institutions in 4 countries.

G M Monsur HabibBangladesh Primary Care Respiratory Society (BPCRS), Khulna, Bangladesh.ORCID 0000-0003-1544-2322
Roberto RabinovichELEGI/Colt Laboratory, Centre for Inflammation Research, QMRI, The University of Edinburgh and Respiratory Department, Royal Infirmary Edinburgh, Edinburgh, UK.
Kalyani DivgiChest Research Foundation, Pune, India.
Salahuddin AhmedNIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK.
Samir Kumar SahaDhaka Shishu Hospital, Dhaka, Bangladesh.
Sally SinghPulmonary and Cardiac Rehabilitation, Department of Respiratory Medicine (Acute Division), University Hospitals of Leicester NHS Trust, Leicester, UK.
Aftab UddinInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Md Nazim UzzamanBangladesh Primary Care Respiratory Society (BPCRS), Khulna, Bangladesh.ORCID 0000-0001-9528-6299
Hilary PinnockNIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, University of Edinburgh, Edinburgh, UK. hilary.pinnock@ed.ac.uk.ORCID 0000-0002-5976-8386
University of Edinburgh · GBBangladesh Shishu (Children) Hospital & Institute · BDCentre for Global Health Research · CAEdinburgh Royal Infirmary · GBInternational Centre for Diarrhoeal Disease Research · BDJohns Hopkins University · USUniversity Hospitals of Leicester NHS Trust · GB

Funding

Department of Health
6 · The paper itself

Abstract

Pulmonary rehabilitation (PR) is a guideline-recommended multifaceted intervention that improves the physical and psychological well-being of people with chronic respiratory diseases (CRDs), though most of the evidence derives from trials in high-resource settings. In low- and middle-income countries, PR services are under-provided. We aimed to review the effectiveness, components and mode of delivery of PR in low-resource settings. Following Cochrane methodology, we systematically searched (1990 to October 2018; pre-publication update March 2020) MEDLINE, EMBASE, CABI, AMED, PUBMED, and CENTRAL for controlled clinical trials of adults with CRD (including but not restricted to chronic obstructive pulmonary disease) comparing PR with usual care in low-resource settings. After duplicate selection, we extracted data on exercise tolerance, health-related quality of life (HRQoL), breathlessness, included components, and mode of delivery. We used Cochrane risk of bias (RoB) to assess study quality and synthesised data narratively. From 8912 hits, we included 13 studies: 11 were at high RoB; 2 at moderate RoB. PR improved functional exercise capacity in 10 studies, HRQoL in 12, and breathlessness in 9 studies. One of the two studies at moderate RoB showed no benefit. All programmes included exercise training; most provided education, chest physiotherapy, and breathing exercises. Low cost services, adapted to the setting, used limited equipment and typically combined outpatient/centre delivery with a home/community-based service. Multicomponent PR programmes can be delivered in low-resource settings, employing a range of modes of delivery. There is a need for a high-quality trial to confirm the positive findings of these high/moderate RoB studies.

Indexed as

Breathing ExercisesHumansLung DiseasesPatient Education as TopicPulmonary Disease, Chronic ObstructiveTreatment Outcome

Identifiers

PMID33214560
PMCPMC7677536
OpenAlexW3099544583

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.