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Boonjindasup W, Chang AB, McElrea MS, Yerkovich ST, Marchant JM. Does the routine use of spirometry improve clinical outcomes in children?-A systematic review. Pediatr Pulmonol 2022; 57:2390-2397. [PMID: 35754141 PMCID: PMC9796376 DOI: 10.1002/ppul.26045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/18/2022] [Accepted: 06/04/2022] [Indexed: 01/01/2023]
Abstract
Spirometry provides a quantitative measure of lung function and its use is recommended as an adjunct to enhance pediatric respiratory healthcare in many clinical practice guidelines. However, there is limited evidence confirming the benefits (or otherwise) of using spirometry from either clinician or patient perspectives. This systematic review aimed to determine the impact of spirometry on change in clinical decision making and patient-reported outcome measures. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, www.clinicaltrials.gov, and World Health Organization International Clinical Trials Registry Platform, from inception to July 2021. We included randomized controlled trials (RCTs) comparing the use versus non-use of spirometry during standard clinical review in children aged <18 years with respiratory problems in clinics. We used Cochrane methodology. The search identified 3475 articles; 8 full-text articles were reviewed but only 1 study fulfilled the inclusion criteria. The single study involved two cluster RCTs of spirometry for children with asthma in general practice. The included study did not find any significant intergroup difference at the 12-month follow-up for asthma-related quality-of-life and clinical endpoints. However, the findings were limited by methodological weaknesses and high risks of bias. With a paucity of data, the clinical benefits of spirometry remain unclear. Thus, there is a clear need for RCTs that provide high-quality evidence to support the routine use of spirometry in children with suspected or known lung disease. Pending the availability of better evidence, we recommend that clinicians adhere to the current clinical practice recommendations.
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Affiliation(s)
- Wicharn Boonjindasup
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Cough & Airways Research Group, Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Paediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Cough & Airways Research Group, Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Margaret S McElrea
- Cough & Airways Research Group, Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Stephanie T Yerkovich
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Cough & Airways Research Group, Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie M Marchant
- Cough & Airways Research Group, Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Respiratory & Sleep Medicine, Queensland Children's Hospital, Brisbane, Queensland, Australia
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Kim YH, Yang HJ, Choi JH, Kim DK, Yoo Y, Lee B, Kim MA, Kim BS, Kim WY, Kim JH, Park Y, Park SY, Bae WY, Song K, Yang MS, Lee SM, Lee YM, Lee HJ, Cho JH, Jee HM, Koh YI. Clinical diagnostic guidelines for allergic rhinitis: diagnosis. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2017. [DOI: 10.5124/jkma.2017.60.1.81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Young Hyo Kim
- Department of Otorhinolaryngology, Inha University College of Medicine, Incheon, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
- SCH Biomedical Informatics Research Unit, Seoul, Korea
| | - Jeong-Hee Choi
- Department of Pulmonology and Allergy, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Allergy Immunology Center, Korea University, Seoul, Korea
| | - Bora Lee
- Department of Biostatistics, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Mi-Ae Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | | | - Jeong Hee Kim
- Department of Pediatrics, Inha University College of Medicine, Incheon, Korea
| | - Yang Park
- Department of Pediatrics, Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
| | | | - Woo Yong Bae
- Department of Otorhinolaryngology, Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Keejae Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Catholic Kwandong Universtiy College of Medicine, Incheon, Korea
| | - Min-Suk Yang
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sang Min Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea
| | | | | | | | - Hye Mi Jee
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Young-Il Koh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Aziz T, Biron VL, Ansari K, Flores-Mir C. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg 2014; 43:11. [PMID: 24762010 PMCID: PMC4042609 DOI: 10.1186/1916-0216-43-11] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 04/09/2014] [Indexed: 11/24/2022] Open
Abstract
Objective To perform a systematic review of measurement tools utilized for the diagnosis of nasal septal deviation (NSD). Methods Electronic database searches were performed using MEDLINE (from 1966 to second week of August 2013), EMBASE (from 1966 to second week of August 2013), Web of Science (from 1945 to second week of August 2013) and all Evidence Based Medicine Reviews Files (EBMR); Cochrane Database of Systematic Review (CDSR), Cochrane Central Register of Controlled Trials (CCTR), Cochrane Methodology Register (CMR), Database of Abstracts of Reviews of Effects (DARE), American College of Physicians Journal Club (ACP Journal Club), Health Technology Assessments (HTA), NHS Economic Evaluation Database (NHSEED) till the second quarter of 2013. The search terms used in database searches were ‘nasal septum’, ‘deviation’, ‘diagnosis’, ‘nose deformities’ and ‘nose malformation’. The studies were reviewed using the updated Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Results Online searches resulted in 23 abstracts after removal of duplicates that resulted from overlap of studies between the electronic databases. An additional 15 abstracts were excluded due to lack of relevance. A total of 8 studies were systematically reviewed. Conclusions Diagnostic modalities such as acoustic rhinometry, rhinomanometry and nasal spectral sound analysis may be useful in identifying NSD in anterior region of the nasal cavity, but these tests in isolation are of limited utility. Compared to anterior rhinoscopy, nasal endoscopy, and imaging the above mentioned index tests lack sensitivity and specificity in identifying the presence, location, and severity of NSD.
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Affiliation(s)
| | | | | | - Carlos Flores-Mir
- University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Edmonton, Alberta, Canada.
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