Abstract:
BACKGROUND:Guidelines are critical for facilitating cost-effective COPD care. Development and implementation in low-and middle-income countries (LMICs) is challenging. To guide future strategy, an overview of current global COPD guidelines is required. RESEARCH QUESTION:We systematically reviewed national COPD guidelines, focusing on worldwide availability and identification of potential development, content, context, and quality gaps that may hamper effective implementation. STUDY DESIGN AND METHODS:Scoping review of national COPD management guidelines. We assessed: (1) global guideline coverage; (2) guideline information (authors, target audience, dissemination plans); (3) content (prevention, diagnosis, treatments); (4) ethical, legal, and socio-economic aspects; and (5) compliance with the eight Institute of Medicine (IOM) guideline standards. LMICs guidelines were compared with those from high-income countries (HICs). RESULTS:Of the 61 national COPD guidelines identified, 30 were from LMICs. Guidelines did not cover 1.93 billion (30.2%) people living in LMICs, whereas only 0.02 billion (1.9%) in HICs were without national guidelines. Compared with HICs, LMIC guidelines targeted fewer health-care professional groups and less often addressed case finding and co-morbidities. More than 90% of all guidelines included smoking cessation advice. Air pollution reduction strategies were less frequently mentioned in both LMICs (47%) and HICs (42%). LMIC guidelines fulfilled on average 3.37 (42%) of IOM standards, compared with 5.29 (66%) in HICs (P < .05). LMICs scored significantly lower compared with HICs regarding conflicts of interest management, updates, articulation of recommendations, and funding transparency (all, P < .05). INTERPRETATION:Several development, content, context, and quality gaps exist in COPD guidelines from LMICs that may hamper effective implementation. Overall, COPD guidelines in LMICs should be more widely available and should be transparently developed and updated. Guidelines may be further enhanced by better inclusion of local risk factors, case findings, and co-morbidity management, preferably tailored to available financial and staff resources.
journal_name
Chestjournal_title
Chestauthors
Tabyshova A,Hurst JR,Soriano JB,Checkley W,Wan-Chun Huang E,Trofor AC,Flores-Flores O,Alupo P,Gianella G,Ferdous T,Meharg D,Alison J,Correia de Sousa J,Postma MJ,Chavannes NH,van Boven JFMdoi
10.1016/j.chest.2020.09.260subject
Has Abstractpub_date
2020-10-08 00:00:00eissn
0012-3692issn
1931-3543pii
S0012-3692(20)34869-8pub_type
杂志文章相关文献
CHEST文献大全abstract::Clinically apparent involvement of the nervous system occurs in a relatively small number of patients with sarcoidosis. The diagnosis of neurosarcoidosis is often difficult and particularly so in patients who lack either pulmonary or systemic manifestations of sarcoidosis. Furthermore, clinical features of neurosarcoi...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.112.1.220
更新日期:1997-07-01 00:00:00
abstract::Most panels that develop clinical practice guidelines are poorly equipped to address resource allocation or cost issues associated with management options. This risks neglect, arbitrariness, lack of transparency, and methodological flaws in consideration of resource allocation. We provide recommendations for guideline...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.129.1.182
更新日期:2006-01-01 00:00:00
abstract::The inhibitory effect of lidocaine and lidocaine plus methylparaben as a preservative was studied with 25 strains of bacteria. The tested strains were mixed with each topical anesthetic preparation, and quantitative cultures were performed on aspirates at 0, 30, 60, and 120 minutes. Results were compared to counts obt...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.76.1.37
更新日期:1979-07-01 00:00:00
abstract::A case of idiopathic pulmonary hypertension is associated with portal venous thrombosis. The patient's chest roentgenogram revealed numerous nodular densities which at necropsy were found to have been caused by an exuberant fibroblastic reaction around small pulmonary arterioles. This is an example of the unusual asso...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.78.1.111
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVE:To compare the short-term physiologic effects of mask pressure support ventilation (PSV) and proportional assist ventilation (PAV) in patients in clinically stable condition with chronic ventilatory failure (CVF). DESIGN:Randomized, controlled physiologic study. SETTING:Lung function units of two pulmonary ...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.122.2.479
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To determine the success rate and correlates of ambulatory peak expiratory flow (PEF) monitoring in an epidemiologic study. DESIGN:An observational survey. SETTING:Several communities in California. PARTICIPANTS:We studied 1,223 nonsmoking men and women (mean age, 66 years) from an established cohort. OUT...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.112.4.895
更新日期:1997-10-01 00:00:00
abstract:STUDY OBJECTIVE:This study aimed to determine the differences between ciliary beat frequencies of respiratory ciliated cells from peripheral bronchioles and from proximal bronchi in humans. DESIGN:Measurements were made from resected lungs. Ciliated cells were harvested by brushing the mucosa of each site immediately ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.3.692
更新日期:1997-03-01 00:00:00
abstract::We report an individual with limb-girdle muscular dystrophy who has devised a way to assist her respiration by using her hands braced against the tray of her wheelchair. Utilizing this method, she was able to increase her tidal volume (VT) and lower her respiratory rate compared to unassisted spontaneous breathing, th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.3.949
更新日期:2003-03-01 00:00:00
abstract::The influence of positive expiratory pressure (PEP) applied during inhalation of a beta 2-agonist in treatment of bronchial asthma was investigated in a randomized crossover study with two-week treatment periods. In one period, two puffs (0.5 mg) of terbutaline was given from a metered dose inhaler and inhaled through...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.100.2.317
更新日期:1991-08-01 00:00:00
abstract::Between January 1990 and August 1991, there were 37 patients admitted to our Department of Internal Medicine with hematologic malignancies or solid tumors who showed colonization of the respiratory tract with Pseudomonas cepacia. Extensive surveillance cultures of the environmental surfaces and respiratory equipment o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.6.1706
更新日期:1993-06-01 00:00:00
abstract::Direct mechanical ventricular actuation (DMVA) is a non-blood-contacting method of biventricular cardiac massage which may be applied expediently for total circulatory support. The purpose of this study was to assess the feasibility of DMVA application for patients suffering refractory cardiac arrest. Following inform...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.100.1.86
更新日期:1991-07-01 00:00:00
abstract:OBJECTIVES:Tumor necrosis factor (TNF)-alpha is known to be a proinflammatory cytokine that has a pronounced negative inotropic effect and plays an important role in ischemic-reperfusion injury. METHODS:Twenty isolated rat hearts were randomly divided equally into two groups (heparin and non-heparin) and were perfused...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.3.1805
更新日期:2005-09-01 00:00:00
abstract:STUDY OBJECTIVE:s: Patients with rheumatoid arthritis (RA) have a high prevalence of pulmonary function test (PFT) abnormality, but the long-term significance of this is unknown. We performed a longitudinal study of pulmonary function in asymptomatic, nonsmoking patients with active RA requiring disease-modifying drugs...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.124.4.1224
更新日期:2003-10-01 00:00:00
abstract::Hybrid myocardial revascularization combines coronary surgery with percutaneous intervention as an alternative therapy for ischemic heart disease. The order and sequence of the hybrid approach is not yet clearly defined. We report on the benefits of an enhanced surgical suite equipped with a carbon fiber operating tab...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.6.4046
更新日期:2005-12-01 00:00:00
abstract::Dobutamine stress echocardiography detects myocardial ischemia by inducing regional left ventricular systolic dysfunction. Augmentation of wall motion in hypokinetic segments has also been noted with low-dose dobutamine, suggesting myocardial viability. We report a case of regional ventricular improvement during high-...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.1.291
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:There is controversy about whether therapy with inhaled corticosteroids (ICSs) modifies the natural history of COPD, characterized by an accelerated decline in FEV(1). METHODS:The Inhaled Steroids Effect Evaluation in COPD (ISEEC) study is a pooled study of patient-level data from seven long-term randomized...
journal_title:Chest
pub_type: 杂志文章,meta分析
doi:10.1378/chest.06-1696
更新日期:2007-03-01 00:00:00
abstract::Of 354 thoracotomies, 114 cases involved intraoperative cytopathologic evaluation. The study included 86 men and 28 women, and 184 specimens were examined. Smears were taken from the lung lesion or lymph node and the chest wall or bronchial stump by imprint or needle aspiration. Intraoperative evaluations were compare...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.5.1156
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Cytochrome P-450 2J2 (CYP2J2) has recently been shown to be an important enzyme in the metabolism of epoxygenase-derived eicosanoids that play important functional roles in pulmonary physiology and may contribute to the pathogenesis of asthma. STUDY OBJECTIVE:The focus of our pilot study was to evaluate whe...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-0371
更新日期:2007-07-01 00:00:00
abstract::A survey of American College of Chest Physicians (ACCP) members was conducted to determine their degree of involvement in the diagnosis and prevention of occupational and environmental respiratory disease (OERD). Although the response rate was relatively low, the results are likely to be representative. Calculations b...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.107.4.1156
更新日期:1995-04-01 00:00:00
abstract::To establish an early diagnosis and have a quantitative estimation of congestion or edema, pulmonary CT scans were performed to detect the increase of regional lung water volume of patients with congestive heart failure. CT scanning of the upper, middle, and lower lung fields at maximum inspiration and hemodynamic ana...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.109.6.1439
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Non-small cell lung cancer (NSCLC) staging is currently being revised by the International Association for the Study of Lung Cancer (IASLC). Among other changes, the revised staging system proposes the subdivision of the T1 tumor ( journal_title:Chest pub_type: 杂志文章 doi:10.1378/chest.09-0823 更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:IV hydration before and after cardiac catheterization is effective in preventing contrast-associated renal dysfunction for patients with mild-to-moderate renal insufficiency, but necessitates overnight hospital admission. We tested an outpatient oral precatheterization hydration strategy in comparison with o...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.114.6.1570
更新日期:1998-12-01 00:00:00
abstract::We evaluated the effects of a new semisynthetic macrolide antibiotic, roxithromycin, on the bronchial hyperresponsiveness to histamine in children with asthma. Twelve hospitalized asthmatic children, aged 11 to 15 years (mean age, 12.9 years), were enrolled in this study. They were treated with 150 mg of roxithromycin...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.106.2.458
更新日期:1994-08-01 00:00:00
abstract::The relative usefulness of a combination of some tumor markers, such as CEA, AFP, ferritin and NSE for the diagnosis of lung cancer was assessed by multiple logistic analysis. Serum concentration of these markers was determined in 68 patients with lung cancer (50 with NSCLC and 18 with SCLC, in 68 patients with benign...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.3.639
更新日期:1990-03-01 00:00:00
abstract::Various malformations of the aortic arch and great vessels have been reported in the literature, which reflects the complexity of their embryologic development. Most of them are of incidental finding and remain asymptomatic but can be responsible for respiratory or digestive symptoms and be associated with congenital ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.09-2244
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To study the incidence of phrenic neuropathy following coronary artery bypass grafting and determine long-term outcome. DESIGN:Prospective observational. SETTING:Surgical ICU in a university hospital, out-patient follow-up. PATIENTS:Ninety-two consecutive patients undergoing open heart surgery. INTERVENTI...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.3.850
更新日期:1993-03-01 00:00:00
abstract::Over the last few years, there has been a renewed interest in patients with characteristics of both asthma and COPD. Although the precise definition of asthma-COPD overlap (ACO) is still controversial, patients with overlapping features are frequently encountered in clinical practice, and may indeed have worse clinica...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2018.07.028
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The relationships among systolic pulmonary artery pressure (SPAP), diastolic pulmonary artery pressure (DPAP), and mean pulmonary artery pressure (MPAP) have been found to be constant in humans breathing air, at rest, while supine. It would be important for those studying the pulmonary circulation if this re...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-1367
更新日期:2008-03-01 00:00:00
abstract::In small-cell lung cancer, the optimal combination of chemotherapy and radiotherapy is not clearly established. To assess the value of delayed thoracic radiotherapy, we performed a randomized clinical trial in 53 complete responder patients after eight courses of chemotherapy. Twenty-seven patients received a mean of ...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.104.3.726
更新日期:1993-09-01 00:00:00
abstract::The self-expandable stainless steel stents (Gianturco, William Cook, Bjaeverskov, Denmark) used extensively in biliary ducts and the vascular system have recently been modified for use in the tracheobronchial tree. Between March 1991 and September 1992, six patients with unresectable tracheobronchial and mediastinal d...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.1.86
更新日期:1994-07-01 00:00:00