证据

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证据表单

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Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.

该表单为 Cochrane Clinical Answer 针对上述重要临床问题所报道的分析总结。


进行 GRADE 后发现,证据可信度为高或中高,对于关键结局,干预组的有效性/获益高于对照组。


人群: COPD 成人患者

干预: IDM ᵃ

比较: 常规治疗(医务人员定期随访)

结局效能(BMJ 评价)?证据可信度(GRADE)?

生活质量(>6 个月至 15 个月):St George 呼吸问卷(SGRQ)ᵇ

干预组结果更优

中度

功能性运动能力(>6 至 15 个月)

干预组结果更优

中度

呼吸病变相关性入院(12 个月)

干预组结果更优

所有入院

干预组结果更优

中度

平均患者住院天数(全因)

干预组结果更优

中度

急诊科就诊

干预组结果更优

中度

出现 ≥1 次加重的患者数

无统计学差异

未针对此结局进行 GRADE 评估

死亡率

无统计学差异

未针对此结局进行 GRADE 评估

需要至少一个疗程口服类固醇

无统计学差异

未针对此结局进行 GRADE 评估

需要至少一个疗程抗生素

无统计学差异

未针对此结局进行 GRADE 评估

注意

ᶜ 此 Cochrane Clinical Answer(CCA)所依据的 Cochrane 评价指出,IDM 在短期和中期的效果更好,而且效应量在纳入的研究和干预之间各不相同。IDM 应经过仔细设计和评估,各组成部分应与患者个体目标相关联。

ᵃ 包括在初级、二级和三级医疗机构中进行组织性干预、专业性干预、患者导向干预和经济干预。参阅 CCA 及其所依据的 Cochrane 评价,获取具体干预和 IDM 计划主要组成部分的更多信息。

ᵇ 该结果虽然具有统计学意义,但并未完全达到最小临床意义差值。CCA 还报道了一项通过“慢性呼吸疾病问卷“测量的生活质量亚组分析。然而,只有两项研究报道了这一点,并且分析的效能较弱。

该证据表单关联以下章节:

该表单为 Cochrane Clinical Answer 针对上述重要临床问题所报道的分析总结。


进行 GRADE 后发现,证据可信度为高或中高,对于关键结局,干预组的有效性/获益高于对照组。


人群: 中重度 COPD 成人

干预: 乌美铵(每日一次,干粉吸入 12-52 周)

比较: 安慰剂

结局效能(BMJ 评价)?证据可信度(GRADE)?

52 周时需要使用皮质类固醇、抗生素或两者兼有的急性加重参与者人数

干预组结果更优

24-52 周生活质量(使用圣乔治呼吸问卷 [St George's Respiratory Questionnaire, SGRQ] 进行评测)

干预组结果更优

中度

52 周时因 COPD 急性加重入院的参与者人数(通过短暂呼吸困难指数 [Transitional Dyspnoea Index, TDI] 进行评估)

无统计学差异

24 周症状改善

干预组结果更优

4-52 周肺功能

干预组结果更优

非致死性严重不良事件

无统计学差异

中度

不良事件

无统计学差异

中度

该证据表单关联以下章节:

该表单为 Cochrane Clinical Answer 针对上述重要临床问题所报道的分析总结。


进行 GRADE 后发现,证据可信度为中或中低,对于关键结局,干预组的有效性/获益可能高于对照组。


人群: COPD 成人患者 ᵃ

干预: LABA 加 LAMA

比较: LABA 加 ICS

结局效能(BMJ 评价)?证据可信度(GRADE)?

12 至 52 周时出现加重

干预组结果更优

12 至 52 周时出现严重不良反应

无统计学差异

中度

St George 呼吸问卷(SGRQ)总评分在 12 至 52 周时与基线相比的变化

无统计学差异

SGRQ 总评分较基线提高(≥4 个单位)(随访时限为 24 至 52 周)

干预组结果更优

中度

一秒用力呼气容积(forced expiratory volume in 1 second, FEV1)谷水平与基线相比的变化(随访时限为 12 至 52 周)

干预组结果更优

中度

肺炎(随访时限为 12 至 52 周)

干预组结果更优

全因死亡率(随访时限为 12 至 52 周)

无统计学差异

因 COPD 加重住院

-

没有关于这一结局的数据报告

注意

ᵃ 诊断依据慢性阻塞性肺疾病(Chronic Obstructive Lung Disease, GOLD)指南。在多数纳入的研究中,研究对象为无近期加重的中至重度 COPD 患者。

该证据表单关联以下章节:

Cochrane Clinical Answers

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Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.

  • What are the effects of integrated disease management (IDM) interventions for people with chronic obstructive pulmonary disease (COPD)?
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  • How does umeclidinium bromide compare with placebo for people with chronic obstructive pulmonary disease (COPD)?
    Show me the answer
  • How does long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA) compare with LABA plus inhaled corticosteroid (ICS) for people with stable chronic obstructive pulmonary disease (COPD)?
    Show me the answer
  • How does tiotropium compare with ipratropium bromide for people with chronic obstructive pulmonary disease (COPD)?
    Show me the answer
  • How does a combined inhaler with once‐daily long‐acting beta2‐agonist (LABA) plus a long‐acting muscarinic antagonist (LAMA) compare with placebo for adults with chronic obstructive pulmonary disease (COPD)?
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  • What are the longer-term (>6 months) effects of inhaled corticosteroids in people with stable chronic obstructive pulmonary disease?
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  • What are the effects of long‐acting inhaled therapies for adults with chronic obstructive pulmonary disease (COPD)?
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  • In people with chronic obstructive pulmonary disease (COPD), what are the effects of combined corticosteroid and long-acting beta-agonist (LABA) in one inhaler versus LABA alone?
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  • How do phosphodiesterase‐4 inhibitors compare with placebo for people with chronic obstructive pulmonary disease?
    Show me the answer
  • What are the effects of prophylactic antibiotics for people with chronic obstructive pulmonary disease (COPD)?
    Show me the answer
  • What are the effects of influenza vaccine in people with chronic obstructive pulmonary disease (COPD)?
    Show me the answer
  • For people with chronic bronchitis or chronic obstructive pulmonary disease, how do mucolytic agents compare with placebo?
    Show me the answer
  • What are the effects of pulmonary rehabilitation after exacerbation in people with chronic obstructive pulmonary disease?
    Show me the answer
  • How does bronchoscopic lung volume reduction compare with medical therapy in people with chronic obstructive pulmonary disease?
    Show me the answer
  • How do statins compare with placebo for people with chronic obstructive pulmonary disease (COPD)?
    Show me the answer
  • How does lung volume reduction surgery compare with usual medical care in people with diffuse emphysema?
    Show me the answer

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