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BackgroundMethodsResultsDiscussionConclusionsThis paper considers weaknesses in a study by Cohen et al. (2006) on the impacts of community singing on health. These include high demand characteristics, lack of attention to attrition, flawed statistical analysis, and measurement. Nevertheless, the study is uncritically cited, in evidence reviews, with findings taken at face value.Google Scholar, SCOPUS and BASE citation functions for Cohen et al. identified 32 evidence reviews in peer-reviewed journals. Eleven of these reviews, published between 2010 and 2023, focused on creative arts interventions.We demonstrate limitations in the Cohen et al. research which undermine the conclusions they reach regarding the health benefits of group singing. Subsequent evidence reviews take the findings at face value and offer little critical commentary.We consider what is needed to improve evidence reviews in the field of creative arts and health research.A more robust approach is needed in reviewing research evidence in the field of arts and health. The Cohen et al. paper is not suitable for inclusion in future evidence reviews. [ABSTRACT FROM AUTHOR]

Background: Both adherence rates to pulmonary rehabilitation (PR) programmes and long-term attendance in exercise training after PR remain a challenge. In our previous randomised controlled trial (RCT), effects were positively associated with a dose-response pattern, regardless of whether PR contained conventional physical exercise training (PExT) or Singing for Lung Health (SLH) as a training modality within a 10 weeks' PR programme for chronic obstructive pulmonary disease (COPD). However, long-term status of this RCT cohort remains unknown. In this study, we investigated whether current status (=attendance in supervised exercise training or a lung choir and scoring in quality of life (QoL)) was related to initial PR completion, randomisation, or adherence., Methods: We collected data via telephone, using a researcher-developed questionnaire on current self-reported attendance in supervised exercise training or a lung choir and on perceived benefits of the initial RCT intervention. Additionally, we used COPD-validated questionnaires (primarily: QoL (measure: St George's Respiratory Questionnaire; SGRQ)., Results: In 2023 (i.e., mean/median 4.7 years after initial PR), surviving participants were contacted ( n  = 196; 73% of 270), and 160 (82% of 196) were included. Out of the included participants, 30 (19%) had not completed initial PR. Compared to the initial PR-completers, non-completers reported less current attendance in exercise training or lung choir (24% vs. 46%, p  = 0.03) but SGRQ scores were comparable. Yet, those who attended exercise training or lung choir at present ( n  = 66/160; 41% out of 160) reported better QoL score than those with no current attendance (SGRQ; Attending: 39.9 ± 15.4; Not attending: 43.1 ± 16.7; p  = 0.02). Neither having had SLH instead of PExT, nor adherence level during initial PR, was related to current attendance or to QoL scores., Conclusion: This study indicates that long-term self-reported attendance and current QoL scores are positively related to initial completion of a PR programme. Surprisingly, neither initial PR content (PExT or SLH) nor initial PR adherence was related to long-term outcomes. We suggest that future PR programmes include special attention to those who do not complete PR to support long-term attendance and QoL status., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Kaasgaard, Bodtger, Skou, Clift, Hilberg, Rasmussen and Løkke.)

Background: Pulmonary rehabilitation (PR) is a cornerstone in chronic obstructive pulmonary disease (COPD) management. However, PR adherence is generally low, and barriers include availability, economic issues, motivation and an inability to attend or perform physical training. Therefore, alternative, evidence-based PR activities are required. Singing may have benefits for quality of life (QoL), respiratory control and well-being in COPD, but the impact on the PR key outcome, physical exercise capacity, is uncertain., Methods: In this randomised controlled trial (NCT03280355), we investigated the effectiveness of 10 weeks of PR, including either "Singing for Lung Health" (SLH) training or standard physical exercise training (PExT). The primary outcome was a change in exercise capacity (6-min walk distance (6MWD)) from baseline to post-PR. Secondary outcomes were changes in QoL (St George's Respiratory Questionnaire (SGRQ)), Hospital Anxiety and Depression Score (HADS), lung function, dyspnoea and adherence., Results: We included 270 COPD patients, and 195 completed the study. Demographics across groups were comparable, and both groups improved significantly in 6MWD and SGRQ score. SLH was non-inferior to PExT in improving 6MWD (mean±sd 13.1±36.3 m versus 14.1±32.3 m, p=0.81; difference 1.0 m, 95% CI -7.3-9.3 m) with 21.8% and 25.0%, respectively (p=0.57), reaching the 6MWD minimal important difference of 30 m. We found no significant between-group differences concerning SGRQ, HADS, lung function, dyspnoea or adherence., Conclusion: Our study suggests that SLH is non-inferior to PExT in improving 6MWD during a 10-week PR programme. Future studies addressing reproducibility, long-term effects and health economics are needed., Competing Interests: Conflict of interest: M. Kaasgaard holds a diploma graduate degree from the Royal Danish Academy of Music in Voice and Voice Pedagogy. Conflict of interest: D.B. Rasmussen has nothing to disclose. Conflict of interest: K.H. Andreasson has nothing to disclose. Conflict of interest: O. Hilberg has nothing to disclose. Conflict of interest: A. Løkke has nothing to disclose. Conflict of interest: P. Vuust is leader of the research centre, Center for Music in the Brain. Conflict of interest: U. Bodtger has nothing to disclose., (Copyright ©The authors 2022.)