Angela T Burge, Adelle M Gadowski, Lorena Romero, Guido Vagheggini, Anna Spathis, Natasha E Smallwood, Magnus Ekström, Anne E Holland
{"title":"The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review.","authors":"Angela T Burge, Adelle M Gadowski, Lorena Romero, Guido Vagheggini, Anna Spathis, Natasha E Smallwood, Magnus Ekström, Anne E Holland","doi":"10.1183/16000617.0027-2024","DOIUrl":"10.1183/16000617.0027-2024","url":null,"abstract":"<p><strong>Background: </strong>In adults with serious respiratory illness, fatigue is prevalent and under-recognised, with few treatment options. The aim of this review was to assess the impact of graded exercise therapy (GET) on fatigue in adults with serious respiratory illness.</p><p><strong>Methods: </strong>Electronic databases were searched to identify randomised controlled trials (RCTs) testing GET (involving incremental increases in exercise from an established baseline) in adults with serious respiratory illness. The primary outcome was fatigue and secondary outcomes were health-related quality of life (HRQoL) and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data.</p><p><strong>Results: </strong>76 RCTs were included with 3309 participants, most with a diagnosis of COPD or asthma. Reductions in fatigue measured by the Chronic Respiratory Disease Questionnaire fatigue domain score were demonstrated following GET consisting of aerobic with/without resistance training (mean difference (MD) 0.53 points, 95% CI 0.41-0.65, 11 RCTs, 624 participants) and GET using resistance training alone (MD 0.58 points, 95% CI 0.21-0.96, two RCTs, 82 participants) compared with usual care. Although the mean effect exceeded the minimal important difference, the lower end of the confidence intervals did not always exceed this threshold so the clinical significance could not be confirmed. GET consistently improved HRQoL in people with a range of chronic respiratory diseases on multiple HRQoL measures. No serious adverse events related to GET were reported.</p><p><strong>Conclusion: </strong>GET may improve fatigue alongside consistent improvements in HRQoL in people with serious respiratory illness. These findings support the use of GET in the care of people with serious respiratory illness.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mattia Nigro, Irena F Laska, Letizia Traversi, Edoardo Simonetta, Eva Polverino
{"title":"Epidemiology of bronchiectasis.","authors":"Mattia Nigro, Irena F Laska, Letizia Traversi, Edoardo Simonetta, Eva Polverino","doi":"10.1183/16000617.0091-2024","DOIUrl":"10.1183/16000617.0091-2024","url":null,"abstract":"<p><p>Bronchiectasis is a chronic respiratory disease characterised by permanent enlargement of the airways associated with cough, sputum production and a history of pulmonary exacerbations. In the past few years, incidence and prevalence of bronchiectasis have increased worldwide, possibly due to advances in imaging techniques and disease awareness, leading to increased socioeconomic burden and healthcare costs. Consistently, a mortality increase in bronchiectasis patient cohorts has been demonstrated in certain areas of the globe, with mortality rates of 16-24.8% over 4-5 years of follow-up. However, heterogeneity in epidemiological data is consistent, as reported prevalence in the general population ranges from 52.3 to more than 1000 per 100 000. Methodological flaws in the designs of available studies are likely to underestimate the proportion of people suffering from this condition worldwide and comparisons between different areas of the globe might be unreliable due to different assessment methods or local implementation of the same method in different contexts. Differences in disease severity associated with diverse geographical distribution of aetiologies, comorbidities and microbiology might explain an additional quota of heterogeneity. Finally, limited access to care in certain geographical areas is associated with both underestimation of the disease and increased severity and mortality. The aim of this review is to provide a snapshot of available real-world epidemiological data describing incidence and prevalence of bronchiectasis in the general population. Furthermore, data on mortality, healthcare burden and high-risk populations are provided. Finally, an analysis of the geographical distribution of determinants contributing to differences in bronchiectasis epidemiology is offered.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natasha E Smallwood, Amy Pascoe, Marlies Wijsenbeek, Anne-Marie Russell, Anne E Holland, Lorena Romero, Magnus Ekström
{"title":"Opioids for the palliation of symptoms in people with serious respiratory illness: a systematic review and meta-analysis.","authors":"Natasha E Smallwood, Amy Pascoe, Marlies Wijsenbeek, Anne-Marie Russell, Anne E Holland, Lorena Romero, Magnus Ekström","doi":"10.1183/16000617.0265-2023","DOIUrl":"10.1183/16000617.0265-2023","url":null,"abstract":"<p><strong>Background: </strong>People living with serious respiratory illness experience a high burden of distressing symptoms. Although opioids are prescribed for symptom management, they generate adverse events, and their benefits are unclear.</p><p><strong>Methods: </strong>We examined the efficacy and safety of opioids for symptom management in people with serious respiratory illness. Embase, MEDLINE and the Cochrane Central Register of Controlled Trials were searched up to 11 July 2022. Reports of randomised controlled trials administering opioids to treat symptoms in people with serious respiratory illness were included. Key exclusion criteria included <80% of participants having a nonmalignant lung disease. Data were extracted regarding study characteristics, outcomes of breathlessness, cough, health-related quality of life (HRQoL) and adverse events. Treatment effects were pooled using a generic inverse variance model with random effects. Risk of bias was assessed using the Cochrane Risk of Bias tool version 1.</p><p><strong>Results: </strong>Out of 17 included trials, six were laboratory-based exercise trials (n=70), 10 were home studies measuring breathlessness in daily life (n=788) and one (n=18) was conducted in both settings. Overall certainty of evidence was \"very low\" to \"low\". Opioids reduced breathlessness intensity during laboratory exercise testing (standardised mean difference (SMD) -0.37, 95% CI -0.67- -0.07), but not breathlessness measured in daily life (SMD -0.10, 95% CI -0.64-0.44). No effects on HRQoL (SMD -0.42, 95% CI -0.98-0.13) or cough (SMD -1.42, 95% CI -3.99-1.16) were detected. In at-home studies, opioids led to increased frequency of nausea/vomiting (OR 3.32, 95% CI 1.70-6.51), constipation (OR 3.08, 95% CI 1.69-5.61) and drowsiness (OR 1.37, 95% CI 1.01-1.86), with serious adverse events including hospitalisation and death identified.</p><p><strong>Conclusions: </strong>Opioids improved exertional breathlessness in laboratory exercise studies, but did not improve breathlessness, cough or HRQoL measured in daily life at home. There were significant adverse events, which may outweigh any benefits.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma L Coindy, Claudia Efstathiou, Shubha Talwar, Annick Moureau, Charlotte Vernhes, Peter J M Openshaw, Ryan S Thwaites
{"title":"Antibody-mediated protection against respiratory syncytial virus in children.","authors":"Emma L Coindy, Claudia Efstathiou, Shubha Talwar, Annick Moureau, Charlotte Vernhes, Peter J M Openshaw, Ryan S Thwaites","doi":"10.1183/16000617.0106-2024","DOIUrl":"10.1183/16000617.0106-2024","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is a major global pathogen, causing lower respiratory tract disease in at-risk populations including young children. Antibodies form a crucial layer of protection from RSV disease, particularly in immunologically naïve infants. Such antibodies are derived from the mother <i>via</i> transplacental transfer and breast milk, but may be particularly low in high-risk infants such as those born preterm. Maternally derived antibodies can now be supplemented by the administration of anti-RSV monoclonal antibodies, while a rising wave of maternal and paediatric vaccine strategies are approaching. The implementation of these prophylactics may profoundly decrease the healthcare burden of RSV. In this article, we review the role of antibody-mediated immunity in protecting children from RSV. We focus on maternally derived antibodies as the main source of protection against RSV and study factors that influence the scale of this transfer. The role of passive and active prophylactic approaches in protecting infants against RSV are discussed and knowledge gaps in our understanding of antibody-mediated protection against RSV are identified.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Menne R van Boven, Gerard J Hutten, Rianne Richardson, Marsh Königs, Aleid G Leemhuis, Wes Onland, Suzanne W J Terheggen-Lagro, Jaap Oosterlaan, Anton H van Kaam
{"title":"Impaired lung function and associated risk factors in children born prematurely: a systematic review and meta-analysis.","authors":"Menne R van Boven, Gerard J Hutten, Rianne Richardson, Marsh Königs, Aleid G Leemhuis, Wes Onland, Suzanne W J Terheggen-Lagro, Jaap Oosterlaan, Anton H van Kaam","doi":"10.1183/16000617.0114-2024","DOIUrl":"10.1183/16000617.0114-2024","url":null,"abstract":"<p><strong>Background: </strong>Immature lung development and respiratory morbidity place preterm-born children at high risk of long-term pulmonary sequelae. This systematic review and meta-analysis aims to quantify lung function in preterm-born children and identify risk factors for a compromised lung function.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, Cochrane Library, Web of Science and Scopus for relevant studies published on preterm cohorts born since 1990. Studies comparing forced expiratory volume in 1 s (FEV<sub>1</sub>) in preterm-born children aged ≥5 years to term-born controls or normative data were included. Study quality was assessed using the Newcastle-Ottawa Scale for cohort studies. Standardised mean differences in FEV<sub>1</sub> and secondary spirometry outcomes per study were pooled using meta-analysis. The impact of different demographic and neonatal variables on studies' FEV<sub>1</sub> effect sizes was investigated by meta-regression analyses. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework.</p><p><strong>Results: </strong>We identified 42 studies with unique cohorts including 4743 preterm children and 9843 controls. Median gestational age in the studies was 28.0 weeks and age at assessment ranged from 6.7 to 16.7 years. Preterm children had lower FEV<sub>1</sub> than controls (-0.58 sd, 95% CI -0.69- -0.47 sd, p<0.001) resulting in a relative risk of 2.9 (95% CI 2.4-3.4) for abnormal outcome, with high certainty of evidence. FEV<sub>1</sub> was significantly associated with gestational age, birthweight, bronchopulmonary dysplasia and invasive mechanical ventilation in univariate meta-regression analyses (R<sup>2</sup>=36-96%).</p><p><strong>Conclusion: </strong>This systematic review shows robust evidence of impaired lung function in preterm-born children with a high certainty of evidence.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Manti, Paola Magri, Annalisa De Silvestri, Maria De Filippo, Martina Votto, Gian Luigi Marseglia, Amelia Licari
{"title":"Epidemiology of severe asthma in children: a systematic review and meta-analysis.","authors":"Sara Manti, Paola Magri, Annalisa De Silvestri, Maria De Filippo, Martina Votto, Gian Luigi Marseglia, Amelia Licari","doi":"10.1183/16000617.0095-2024","DOIUrl":"10.1183/16000617.0095-2024","url":null,"abstract":"<p><strong>Background: </strong>Severe asthma significantly impacts a minority of children with asthma, leading to frequent symptoms, hospitalisations and potential long-term health consequences. However, accurate global data on severe asthma epidemiology is lacking. This study aims to address this gap, providing data on severe asthma epidemiology, regional differences and associated comorbidities.</p><p><strong>Methods: </strong>We conducted a rigorous systematic review and meta-analysis following a registered protocol (PROSPERO CRD42023472845). We searched PubMed, Scopus and Web of Science for cohort or cross-sectional studies published since 2003, evaluating severe asthma incidence and prevalence in children. Study quality and risk of bias were assessed using STROBE guidelines.</p><p><strong>Results: </strong>Nine studies investigating European children with asthma (aged 5-18 years) were included in the meta-analysis. No significant publication bias was found. The overall severe asthma prevalence in children with asthma was 3% (95% CI 1-6; I<sup>2</sup>=99.9%; p<0.001), with no significant difference between males and females. Prevalence estimates varied significantly depending on the diagnostic criteria used (Global Initiative for Asthma: 6%; European Respiratory Society/American Thoracic Society: 1%; other: 3%). Because none of the examined studies were prospectively designed, incidence rates could not be determined.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis provide the first robust assessment of severe asthma prevalence among European children. Our findings underscore the need for comprehensive research to address knowledge gaps in severe asthma, including determining incidence rates, standardising definitions, investigating regional differences and evaluating comorbidities and treatment strategies.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Common single nucleotide polymorphisms associated with idiopathic pulmonary fibrosis: a systematic review.","authors":"Sahajal Dhooria, Riya Sharma, Amanjit Bal, Inderpaul Singh Sehgal, Dharambir Kashyap, Valliappan Muthu, Kuruswamy Thurai Prasad, Ritesh Agarwal, Ashutosh Nath Aggarwal","doi":"10.1183/16000617.0018-2024","DOIUrl":"https://doi.org/10.1183/16000617.0018-2024","url":null,"abstract":"<p><strong>Background: </strong>Several genetic variants are associated with the risk of idiopathic pulmonary fibrosis (IPF). These have not been systematically reviewed.</p><p><strong>Methods: </strong>We searched the PubMed, Embase and GWAS Catalog databases for studies indexed between inception and 15 January 2024 describing genetic variants associated with IPF susceptibility. We included studies describing common associated single nucleotide polymorphisms (SNPs). We excluded studies describing rare variants, non-SNP variants and those without an allelic model analysis. We recorded study type, participant characteristics, genotyping methods, IPF diagnostic criteria, the SNPs and the respective genes, odds ratios, and other details. We also searched databases for functions of the identified genes.</p><p><strong>Results: </strong>The primary search retrieved 2697 publications; we included 42 studies. There were nine genome-wide association/linkage studies, while 27 were candidate gene studies. The studies included 22-11 160 IPF subjects. 88 SNPs in 58 genes or loci were found associated with IPF susceptibility. <i>MUC5B</i> rs35705950 was the most studied SNP. Most (n=51) SNPs were in the intronic or intergenic regions; only 11 were coding sequence variants. The SNPs had odds ratios ranging from 0.27 to 7.82 for an association with IPF. Only 22 SNPs had moderate-large effects (OR >1.5 or <0.67). Only 49.1% of the associated genes have a known functional role in IPF; the role of G protein-related signalling and transcriptional regulation (zinc-finger proteins) remain unexplored.</p><p><strong>Conclusion: </strong>Several common SNPs in over 50 genes have been found associated with IPF susceptibility. These variants may inform gene panels for future studies (PROSPERO CRD42023408912).</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 173","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabelle Fajac, Pierre-Régis Burgel, Clémence Martin
{"title":"New drugs, new challenges in cystic fibrosis care.","authors":"Isabelle Fajac, Pierre-Régis Burgel, Clémence Martin","doi":"10.1183/16000617.0045-2024","DOIUrl":"https://doi.org/10.1183/16000617.0045-2024","url":null,"abstract":"<p><p>Cystic fibrosis (CF) is a genetic disease caused by variants in the gene encoding for the CF transmembrane conductance regulator (CFTR) protein, a chloride and bicarbonate channel. CFTR dysfunction results in a multiorgan disease with the main clinical features being exocrine pancreatic insufficiency and diffuse bronchiectasis with chronic airway infection leading to respiratory failure and premature death. Over the past decades, major progress has been made by implementing multidisciplinary care, including nutritional support, airway clearance techniques and antibiotics in specialised CF centres. The past decade has further seen the progressive development of oral medications, called CFTR modulators, for which around 80% of people with CF are genetically eligible in Europe. CFTR modulators partially restore ion transport and lead to a rapid and major improvement in clinical manifestations and lung function, presumably resulting in longer survival. CFTR modulators have been game-changing in the care of people with CF. However, many questions remain unanswered, such as the long-term effects of CFTR modulators, especially when treatment is started very early in life, or the new CF-related disease emerging due to CFTR modulators. Moreover, severe complications of CF, such as diabetes or cirrhosis, are not reversed on CFTR modulators and around 20% of people with CF bear <i>CFTR</i> variants leading to a CFTR protein that is unresponsive to CFTR modulators. Challenges also arise in adapting CF care to a changing disease. In this review article, we highlight the new questions and challenges emerging from this revolution in CF care.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 173","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hayoung Choi, Jin-Fu Xu, Sanjay H Chotirmall, James D Chalmers, Lucy C Morgan, Raja Dhar
{"title":"Bronchiectasis in Asia: a review of current status and challenges.","authors":"Hayoung Choi, Jin-Fu Xu, Sanjay H Chotirmall, James D Chalmers, Lucy C Morgan, Raja Dhar","doi":"10.1183/16000617.0096-2024","DOIUrl":"10.1183/16000617.0096-2024","url":null,"abstract":"<p><p>Recent bronchiectasis studies from large-scale multinational, multicentre registries have demonstrated that the characteristics of the disease vary according to geographic region. However, most perspectives on bronchiectasis are dominated by data from Western countries. This review intends to provide an Asian perspective on the disease, focusing on the established registries in India, Korea and China. Asian patients with bronchiectasis are less likely to show female predominance and experience exacerbations, are more likely to be younger, have milder disease, and have fewer options for guideline-recommended treatment than those living in other global regions. Furthermore, Asian bronchiectasis patients demonstrate different comorbidities, microbiological profiles and unique endophenotypes, including post-tuberculosis and dry bronchiectasis. Notably, each Asian region reveals further geographic variations and inter-patient differences. Future studies are warranted to better characterise Asian patients with bronchiectasis.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 173","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciara Ottewill, Margaret Gleeson, Patrick Kerr, Elaine Mac Hale, Richard W Costello
{"title":"Digital health delivery in respiratory medicine: adjunct, replacement or cause for division?","authors":"Ciara Ottewill, Margaret Gleeson, Patrick Kerr, Elaine Mac Hale, Richard W Costello","doi":"10.1183/16000617.0251-2023","DOIUrl":"https://doi.org/10.1183/16000617.0251-2023","url":null,"abstract":"<p><p>Digital medicine is already well established in respiratory medicine through remote monitoring digital devices which are used in the day-to-day care of patients with asthma, COPD and sleep disorders. Image recognition software, deployed in thoracic radiology for many applications including lung cancer screening, is another application of digital medicine. Used as clinical decision support, this software will soon become part of day-to-day practice once concerns regarding generalisability have been addressed. Embodied in the electronic health record, digital medicine also plays a substantial role in the day-to-day clinical practice of respiratory medicine. Given the considerable work the electronic health record demands from clinicians, the next tangible impact of digital medicine may be artificial intelligence that aids administration, makes record keeping easier and facilitates better digital communication with patients. Future promises of digital medicine are based on their potential to analyse and characterise the large amounts of digital clinical data that are collected in routine care. Offering the potential to predict outcomes and personalise therapy, there is much to be excited by in this new epoch of innovation. However, these digital tools are by no means a silver bullet. It remains uncertain whether, let alone when, the promises of better models of personalisation and prediction will translate into clinically meaningful and cost-effective products for clinicians.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 173","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}