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Efficacy of Bronchoscopic Lung Volume Reduction for Severe Emphysema: A Meta-Regression
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A5012 - Efficacy of Bronchoscopic Lung Volume Reduction for Severe Emphysema: A Meta-Regression
Author Block: C. Thao, S. Thapa, J. S. Wang Memoli, M. P. Schreiber; Medstar Washington Hospital Center, Washington, DC, United States.
Rationale: COPD is a disease process where management largely addresses symptom control and avoidance of complications. Bronchoscopic lung volume reduction (BLVR) has been described as a therapeutic option for patients with severe emphysema. While prior analyses have demonstrated significant improvement in both clinical (objective) and quality of life (subjective) measures, there is poor consistency between studies regarding primary end points. We presented a meta-regression hypothesizing that an association exists between spirometric and functional or quality of life outcomes among patients undergoing BLVR for severe emphysema.
Methods: A meta-analysis was performed across multiple databases (Pubmed, MEDLINE, EMBASE, Google Scholar) using a systematic approach. Randomized controlled studies for all BLVR techniques (endobronchial valve, coil, vapor ablation) were selected for meta-analysis. Quality assessment was performed using Cochrane risk of bias assessment and data analysis was carried in RevMan 5.3 by random-effects model. Data from selected studies was extracted and meta-regression was performed using statistical software (Stata).
Results: 13 studies were included (n=1,995)for meta-analysis. Results of meta-analysis data were consistent with previously published results (e.g. significant improvement in FEV1, 6MWD, SGRQ). Results considered for regression included spirometric and plethsymographic measures (FEV1, FVC, RV) and functional status measures (6-minute walk distance (6MWD), and St. George’s Respiratory Questionnaire (6MWD)). No significant associations were observed between the two categories: Change in FEV1 vs. 6MWD (p=0.8), FEV1 vs. SGRQ (p=0.09), FVC vs. 6MWD (p=0.6), 6MWD vs. SGRQ (p=0.9) (all others, insufficient observations).
Conclusion: BLVR is associated with improved pulmonary function test results, functional status, and quality of life. No association could be identified between these result categories. Standardization of ongoing research assessing BLVR outcomes should be considered as no association between functional status and pulmonary function is observed among BLVR patients.
Author Block: C. Thao, S. Thapa, J. S. Wang Memoli, M. P. Schreiber; Medstar Washington Hospital Center, Washington, DC, United States.
Rationale: COPD is a disease process where management largely addresses symptom control and avoidance of complications. Bronchoscopic lung volume reduction (BLVR) has been described as a therapeutic option for patients with severe emphysema. While prior analyses have demonstrated significant improvement in both clinical (objective) and quality of life (subjective) measures, there is poor consistency between studies regarding primary end points. We presented a meta-regression hypothesizing that an association exists between spirometric and functional or quality of life outcomes among patients undergoing BLVR for severe emphysema.
Methods: A meta-analysis was performed across multiple databases (Pubmed, MEDLINE, EMBASE, Google Scholar) using a systematic approach. Randomized controlled studies for all BLVR techniques (endobronchial valve, coil, vapor ablation) were selected for meta-analysis. Quality assessment was performed using Cochrane risk of bias assessment and data analysis was carried in RevMan 5.3 by random-effects model. Data from selected studies was extracted and meta-regression was performed using statistical software (Stata).
Results: 13 studies were included (n=1,995)for meta-analysis. Results of meta-analysis data were consistent with previously published results (e.g. significant improvement in FEV1, 6MWD, SGRQ). Results considered for regression included spirometric and plethsymographic measures (FEV1, FVC, RV) and functional status measures (6-minute walk distance (6MWD), and St. George’s Respiratory Questionnaire (6MWD)). No significant associations were observed between the two categories: Change in FEV1 vs. 6MWD (p=0.8), FEV1 vs. SGRQ (p=0.09), FVC vs. 6MWD (p=0.6), 6MWD vs. SGRQ (p=0.9) (all others, insufficient observations).
Conclusion: BLVR is associated with improved pulmonary function test results, functional status, and quality of life. No association could be identified between these result categories. Standardization of ongoing research assessing BLVR outcomes should be considered as no association between functional status and pulmonary function is observed among BLVR patients.
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