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53. Selective androgen receptor modulation for muscle weakness in chronic obstructive pulmonary disease: a randomised control trial

Author

Mohan, Divya, primary, Rossiter, Harry, additional, Watz, Henrik, additional, Fogarty, Charles, additional, Evans, Rachael A, additional, Man, William, additional, Tabberer, Maggie, additional, Beerahee, Misba, additional, Kumar, Subramanya, additional, Millns, Helen, additional, Thomas, Sebin, additional, Tal-Singer, Ruth, additional, Russell, Alan J, additional, Holland, Marie Claire, additional, Akinseye, Chika, additional, Neil, David, additional, and Polkey, Michael I, additional

Published
2022
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54. Cost-effectiveness of outpatient versus inpatient non-invasive ventilation setup in obesity hypoventilation syndrome: the OPIP trial

Author

Murphy, Patrick Brian, primary, Patout, Maxime, additional, Arbane, Gill, additional, Mandal, Swapna, additional, Kaltsakas, Georgios, additional, Polkey, Michael I, additional, Elliott, Mark, additional, Muir, Jean-François, additional, Douiri, Abdel, additional, Parkin, David, additional, Janssens, Jean-Paul, additional, Pépin, Jean Louis, additional, Cuvelier, Antoine, additional, Flach, Clare, additional, and Hart, Nicholas, additional

Published
2022
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55. Lung function in COPD

Author

Gilchrist, Frances, Kon, Onn Min, Polkey, Michael I., Parnham, Michael J., editor, Hansel, Trevor T., editor, and Barnes, Peter J., editor

Published
2004
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66. Strategies to deliver smoking cessation interventions during targeted lung health screening - a systematic review and meta-analysis.

Author

Williams, Parris J., Philip, Keir E. J., Alghamdi, Saeed M., Perkins, Alexis M., Buttery, Sara C., Polkey, Michael I., Laverty, Anthony A., and Hopkinson1, Nicholas S.

Abstract

Introduction Lung cancer screening presents an important teachable moment to promote smoking cessation, but the most effective strategy to deliver support in this context remains to be established. Methods We undertook a systematic review and meta-analysis of smoking cessation interventions delivered during lung health screening, published prior to 20/07/2022 MEDLINE, PsychINFO, CENTRAL, EMBASE, CINAHL and Scopus databases. Two reviewers screened titles, and abstracts, four reviewed each full text using prespecified criteria, extracted relevant data, assessed risk of bias and confidence in findings using the GRADE criteria. The review was registered prospectively on PROSPERO (CRD42021242431). Results 10 randomised controlled trials and three observational studies with a control group were identified. Meta-analysis of nine RCTs demonstrated that smoking cessation interventions delivered during lung screening programmes increased quit rates compared to usual care (odds ratios: 2.01, 95%: 1.49–2.72 p < 0.001). Six RCTs using intensive (≥3 behavioural counselling sessions) interventions demonstrated greater quit rates compared to usual care (OR: 2.11, 95% CI 1.53–2.90, p < 0.001). A meta-analysis of two RCTs found intensive interventions were more effective than non-intensive (OR: 2.07, 95%CI 1.26–3.40 p = 0.004), Meta-analysis of two RCTs of non-intensive interventions (≤2 behavioural counselling sessions or limited to online information audio take home materials such as pamphlets) did not show a higher quit rate than usual care (OR: 0.90, 95% CI 0.39–2.08 p = 0.80). Discussion Moderate quality evidence supports smoking cessation interventions delivered within a lung screening setting compared to usual care, with high-quality evidence that more intensive interventions are likely to be most effective. [ABSTRACT FROM AUTHOR]

Published
2023
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77. Cardiovascular risk prediction using physical performance measures in COPD: results from a multicentre observational study

Author

Fermont, Jilles M, Fisk, Marie, Bolton, Charlotte E, MacNee, William, Cockcroft, John R, Fuld, Jonathan, Cheriyan, Joseph, Mohan, Divya, Mäki-Petäjä, Kaisa M, Al-Hadithi, Ali B, Tal-Singer, Ruth, Müllerova, Hana, Polkey, Michael I, Wood, Angela M, McEniery, Carmel M, Wilkinson, Ian B, ERICA Consortium, Fermont, Jilles M [0000-0001-5042-5785], Fisk, Marie [0000-0002-1292-7642], Bolton, Charlotte E [0000-0002-9578-2249], Cheriyan, Joseph [0000-0001-6921-1592], Mäki-Petäjä, Kaisa M [0000-0001-7312-6200], Al-Hadithi, Ali B [0000-0003-0417-9653], Tal-Singer, Ruth [0000-0002-5275-8062], Polkey, Michael I [0000-0003-1243-8571], Wood, Angela M [0000-0002-7937-304X], and Apollo - University of Cambridge Repository

Subjects
primary care, Pulmonary Disease, Chronic Obstructive, Cardiovascular Diseases, Heart Disease Risk Factors, Risk Factors, chronic airways disease, respiratory medicine (see thoracic medicine), Humans, epidemiology, Physical Functional Performance, Pulse Wave Analysis, Carotid Intima-Media Thickness, cardiac epidemiology
Abstract

OBJECTIVES: Although cardiovascular disease (CVD) is a common comorbidity associated with chronic obstructive pulmonary disease (COPD), it is unknown how to improve prediction of cardiovascular (CV) risk in individuals with COPD. Traditional CV risk scores have been tested in different populations but not uniquely in COPD. The potential of alternative markers to improve CV risk prediction in individuals with COPD is unknown. We aimed to determine the predictive value of conventional CVD risk factors in COPD and to determine if additional markers improve prediction beyond conventional factors. DESIGN: Data from the Evaluation of the Role of Inflammation in Chronic Airways disease cohort, which enrolled 729 individuals with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II-IV COPD were used. Linked hospital episode statistics and survival data were prospectively collected for a median 4.6 years of follow-up. SETTING: Five UK centres interested in COPD. PARTICIPANTS: Population-based sample including 714 individuals with spirometry-defined COPD, smoked at least 10 pack years and who were clinically stable for >4 weeks. INTERVENTIONS: Baseline measurements included aortic pulse wave velocity (aPWV), carotid intima-media thickness (CIMT), C reactive protein (CRP), fibrinogen, spirometry and Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) Index, 6 min walk test (6MWT) and 4 m gait speed (4MGS) test. PRIMARY AND SECONDARY OUTCOME MEASURES: New occurrence (first event) of fatal or non-fatal hospitalised CVD, and all-cause and cause-specific mortality. RESULTS: Out of 714 participants, 192 (27%) had CV hospitalisation and 6 died due to CVD. The overall CV risk model C-statistic was 0.689 (95% CI 0.688 to 0.691). aPWV and CIMT neither had an association with study outcome nor improved model prediction. CRP, fibrinogen, GOLD stage, BODE Index, 4MGS and 6MWT were associated with the outcome, independently of conventional risk factors (p

Published
2020
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82. Impact of COVID-19 on people with asthma: a mixed methods analysis from a UK wide survey

Author

Philip, Keir Elmslie James, primary, Buttery, Sara, additional, Williams, Parris, additional, Vijayakumar, Bavithra, additional, Tonkin, James, additional, Cumella, Andrew, additional, Renwick, Lottie, additional, Ogden, Lizzie, additional, Quint, Jennifer K, additional, Johnston, Sebastian L, additional, Polkey, Michael I, additional, and Hopkinson, Nicholas S, additional

Published
2022
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93. Cost-effectiveness of outpatient versus inpatient non-invasive ventilation setup in obesity hypoventilation syndrome: the OPIP trial.

Author

Murphy, Patrick Brian, Patout, Maxime, Arbane, Gill, Mandal, Swapna, Kaltsakas, Georgios, Polkey, Michael I., Elliott, Mark, Muir, Jean-François, Douiri, Abdel, Parkin, David, Janssens, Jean-Paul, Pépin, Jean Louis, Cuvelier, Antoine, Flach, Clare, and Hart, Nicholas

Subjects
HYPOVENTILATION, NONINVASIVE ventilation, NURSE practitioners, GENERAL practitioners, COST effectiveness
Abstract

Background: Current guidelines recommend that patients with obesity hypoventilation syndrome (OHS) are electively admitted for inpatient initiation of home non-invasive ventilation (NIV). We hypothesised that outpatient NIV setup would be more cost-effective.Methods: Patients with stable OHS referred to six participating European centres for home NIV setup were recruited to an open-labelled clinical trial. Patients were randomised via web-based system using stratification to inpatient setup, with standard fixed level NIV and titrated during an attended overnight respiratory study or outpatient setup using an autotitrating NIV device and a set protocol, including home oximetry. The primary outcome was cost-effectiveness at 3 months with daytime carbon dioxide (PaCO2) as a non-inferiority safety outcome; non-inferiority margin 0.5 kPa. Data were analysed on an intention-to-treat basis. Health-related quality of life (HRQL) was measured using EQ-5D-5L (5 level EQ-5D tool) and costs were converted using purchasing power parities to £(GBP).Results: Between May 2015 and March 2018, 82 patients were randomised. Age 59±14 years, body mass index 47±10 kg/m2 and PaCO2 6.8±0.6 kPa. Safety analysis demonstrated no difference in ∆PaCO2 (difference -0.27 kPa, 95% CI -0.70 to 0.17 kPa). Efficacy analysis showed similar total per-patient costs (inpatient £2962±£580, outpatient £3169±£525; difference £188.20, 95% CI -£61.61 to £438.01) and similar improvement in HRQL (EQ-5D-5L difference -0.006, 95% CI -0.05 to 0.04). There were no differences in secondary outcomes.Discussion: There was no difference in medium-term cost-effectiveness, with similar clinical effectiveness, between outpatient and inpatient NIV setup. The home NIV setup strategy can be led by local resource demand and patient and clinician preference.Trial Registration Numbers: NCT02342899 and ISRCTN51420481. [ABSTRACT FROM AUTHOR]

Published
2023
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96. Short physical performance battery as a practical tool to assess mortality risk in chronic obstructive pulmonary disease

Author

Fermont, Jilles M., Mohan, Divya, Fisk, Marie, Bolton, Charlotte E., Macnee, William, Cockcroft, John R., McEniery, Carmel, Fuld, Jonathan, Cheriyan, Joseph, Tal-Singer, Ruth, Wood, Angela M., Wilkinson, Ian B., and Polkey, Michael I.

Subjects
Ageing, General Medicine, Geriatrics and Gerontology
Abstract

RATIONALE: chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and common in older adults. The BODE Index is the most recognised mortality risk score in COPD but includes a 6-minute walk test (6MWT) that is seldom available in practise; the BODE Index may be better adopted if the 6MWT was replaced. OBJECTIVES: we investigated whether a modified BODE Index in which 6MWT was replaced by an alternative measure of physical capacity, specifically the short physical performance battery (SPPB) or components, retained its predictive ability for mortality in individuals with COPD. METHODS: we analysed 630 COPD patients from the ERICA cohort study for whom UK Office for National Statistics verified mortality data were available. Variables tested at baseline included spirometry, 6MWT, SPPB and its components (4-m gait speed test [4MGS], chair stand and balance). Predictive models were developed using stratified multivariable Cox regression, and assessed by C-indices and calibration plots with 10-fold cross-validation and replication. RESULTS: during median 2years of follow-up, 60 (10%) individuals died. There was no significant difference between the discriminative ability of BODE6MWT (C-index 0.709, 95% confidence interval [CI], 0.680-0.737), BODESPPB (C-index 0.683, 95% CI, 0.647-0.712), BODE4MGS (C-index 0.676, 95% CI, 0.643-0.700) and BODEBALANCE (C-index 0.686, 95% CI, 0.651-0.713) for predicting mortality. CONCLUSIONS: the SPPB, and its 4MGS and balance components, can potentially be used as an alternative to the 6MWT in the BODE Index without significant loss of predictive ability in all-cause mortality.

Published
2021

97. Patterns of physical activity progression in patients with COPD

Author

Koreny, Maria, Demeyer, Heleen, Benet, Marta, Arbillaga-Etxarri, Ane, Balcells, Eva, Barberan-Garcia, Anael, Gimeno-Santos, Elena, Hopkinson, Nicholas S, De Jong, Corina, Karlsson, Niklas, Louvaris, Zafeiris, Polkey, Michael I, Puhan, Milo A, Rabinovich, Roberto A, Rodríguez-Roisin, Robert, Vall-Casas, Pere, Vogiatzis, Ioannis, Troosters, Thierry, Garcia-Aymerich, Judith, Delgado, Anna, Torrent-Pallicer, Jaume, Vilaró, Jordi, et al, University of Zurich, and Garcia-Aymerich, Judith

Subjects
2740 Pulmonary and Respiratory Medicine, 610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI)
Published
2021

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