Shah Neeraj M, Apps Chloe, Amin Reshma, Kaltsakas Georgios, Hart Nicholas, Murphy Patrick B, Rose Louise
Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK.
ERJ Open Res. 2025 Jul 21;11(4). doi: 10.1183/23120541.01007-2024. eCollection 2025 Jul.
Techniques to support secretion clearance for individuals with neuromuscular conditions and respiratory muscle weakness include mechanical insufflation-exsufflation and chest wall vibrations. Assessing the comparative efficacy of these techniques is challenging due to the absence of a core outcome set. We sought to describe outcomes and measurement instruments reported in studies of airway clearance techniques for individuals with neuromuscular conditions living in the community.
We conducted a scoping review of primary research studies. We searched six databases from inception to 22 February 2024. Two reviewers independently screened citations against the inclusion criteria and extracted data on outcomes and measurement characteristics. Outcomes were categorised according to the Core Outcome Measures in Effectiveness Trials (COMET) 38-domain taxonomy.
We identified 75 eligible studies describing 55 outcomes. We grouped outcomes deemed overlapping and categorised them using the COMET 38-domain taxonomy, resulting in 34 distinct outcomes. Common physiological/clinical outcomes were cough strength (n=48 studies, 64%), lung volume (n=48, 64%) and insufflation capacity (n=22, 29%). The most common measurement tools for these outcomes were spirometer (n=38, 51%), peak flow meter (n=24, 32%) and pneumotachograph (n=20, 27%). The most common resource-use outcome was hospitalisation due to respiratory illness (n=13, 17%). Few studies reported on life impact outcomes, with the most common being comfort (n=6, 8%) and patient satisfaction (n=4, 5%).
We identified 34 outcomes from 75 studies, which were most commonly physiological/clinical, with resource-use and life impact outcomes being seldom reported. The number and range of outcomes and measures demonstrates the need for a core outcome set.
对于患有神经肌肉疾病且呼吸肌无力的个体，支持分泌物清除的技术包括机械吸气-呼气和胸壁振动。由于缺乏核心结局集，评估这些技术的相对疗效具有挑战性。我们试图描述社区中患有神经肌肉疾病的个体气道清除技术研究中报告的结局和测量工具。
我们对原始研究进行了范围综述。我们检索了六个数据库自创建至2024年2月22日的数据。两名审阅者根据纳入标准独立筛选文献，并提取有关结局和测量特征的数据。结局根据有效性试验核心结局测量指标（COMET）的38领域分类法进行分类。
我们确定了75项符合条件的研究，描述了55种结局。我们将被认为重叠的结局进行分组，并使用COMET的38领域分类法对其进行分类，从而得到34种不同的结局。常见的生理/临床结局包括咳嗽强度（48项研究，64%）、肺容量（48项，64%）和吸气能力（22项，29%）。这些结局最常用的测量工具是肺活量计（38项，51%）、峰值流量计（24项，32%）和呼吸流速仪（20项，27%）。最常见的资源使用结局是因呼吸系统疾病住院（13项，17%）。很少有研究报告生活影响结局，最常见的是舒适度（6项，8%）和患者满意度（4项，5%）。
我们从75项研究中确定了34种结局，其中最常见的是生理/临床结局，资源使用和生活影响结局很少被报告。结局和测量方法的数量及范围表明需要一个核心结局集。
