Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide. As this progressive lung disease continues to burden the global healthcare system, new research spearheaded by experts at the Mayo Clinic brings a comprehensive perspective to COPD management. This article discusses the protocol for a systematic review and evidence map aimed at improving the treatment for stable chronic obstructive pulmonary disease, shedding light on existing knowledge and identifying gaps for future research.
Introduction
Chronic Obstructive Pulmonary Disease, characteristically identified by persistent respiratory symptoms and airflow limitation, remains an enigmatic challenge for medical professionals. COPD is primarily caused by tobacco smoking; however, additional risk factors such as biomass fuel combustion and environmental pollution play significant roles. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) provides guidelines for the diagnosis and management of COPD, highlighting the strategic importance of updated and evidence-based approaches to care.
The Evolving COPD Treatment Landscape
The COPD treatment landscape has evolved rapidly over the past decades, introducing various pharmacological and non-pharmacological interventions. Inhaled corticosteroids (ICS), long-acting beta-agonists (LABAs), long-acting muscarinic antagonists (LAMAs), and combination inhaler therapies have reshaped the treatment protocol. However, these advancements have brought about increasing uncertainty regarding the precise role and optimal use of these therapies, especially inhaled corticosteroids, within the context of stable COPD management.
The Critical Need for Systematic Reviews and Evidence Maps
In response to the overwhelming influx of literature and the complexities involved in managing stable COPD, there is a critical need for novel approaches to evidence synthesis. Systematic reviews and evidence maps are indispensable tools in this regard. Claudia C. Dobler and colleagues from the Mayo Clinic’s Evidence-Based Practice Center have recognized this need and initiated a project to create an umbrella systematic review design. Their work, published in BMJ Open, aims to streamline treatment decisions and foster shared decision-making between patients and healthcare providers.
The Study Protocol and Methods
The systematic review follows a detailed protocol registered under CRD42018095079 and adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. The comprehensive literature search involves databases such as Ovid MEDLINE, Ovid Embase, the Cochrane Database of Systematic Reviews, and Scopus. The inclusion criteria focus on systematic reviews that examine the effectiveness of any pharmacological or non-pharmacological intervention on patient-important outcomes or lung function in patients with stable COPD.
The selection process for systematic reviews is guided by a predetermined protocol that evaluates the credibility of studies and rates the quality of the evidence. Data synthesis culminates in an evidence map, presenting a clear matrix that correlates available treatments for stable COPD with quantitative estimates on patient-centered symptoms and outcomes, accompanied by evidence certainty and size indicators.
The Impact and Future Directions
By synthesizing evidence into a comprehensive map, this protocol will serve as a foundational step towards creating tools for shared decision-making and establishing a future research agenda in COPD treatment. The evidence map will not only aid clinicians in navigating the maze of COPD management options but also empower patients to engage in their care. Additionally, the mission extends to identify research gaps and set priorities for future investigations to enhance COPD management further.
Conclusion
The protocol for a systematic review and evidence map is a testament to the ongoing efforts to crystallize the approach to COPD treatment. The findings from this project promise to benefit patients, healthcare providers, and researchers alike—ushering in an era of clarity and precision in COPD management.
DOI and References
DOI: 10.1136/bmjopen-2018-027935
References
1. Dobler CC, et al. Treatment of stable chronic obstructive pulmonary disease: protocol for a systematic review and evidence map. BMJ Open. 2019;9(5):e027935.
2. Global Initiative for Chronic Obstructive Lung Disease. [Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2019 report.](https://goldcopd.org/gold-reports/)
3. Miake-Lye IM, et al. What is an evidence map? A systematic review of published evidence maps and their definitions, methods, and products. Syst Rev. 2016;5:28.
4. Miravitlles M, et al. Clinical phenotypes of COPD: identification, definition, and implications for guidelines. Arch Bronconeumol. 2012;48(3):86-98.
5. Adeloye D, et al. Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J Glob Health. 2015;5(2):020415.
Keywords
1. COPD Treatment Protocols
2. Systematic Review COPD
3. Evidence Map COPD
4. Chronic Obstructive Pulmonary Disease Management
5. COPD Inhaler Therapy