Management of Chronic Obstructive Pulmonary Disease - Literature review Example

Research Methods: Abstract and Referencing Management of Сhrоniс Оbstruсtivе Рulmоnаry Disеаsе Name Supervisor Abstract and Referencing Overview of the Abstracts Author(s) Abstract Summary Bourbeau et al., (2003). Bourbeau et al., (2003) conducted a study to assess the impact of a continuum self-management intervention on the utilization of care services and health status among people suffering from moderate to severe COPD. The researchers conducted a randomized clinical trial in which the participants underwent a self-management program or usual care, while the intervention was comprised of an all-inclusive patient awareness course delivered via weekly visits by qualified health practitioners for two months coupled with telephone follow-ups. The study established significant reduction (39.8% and 57.1%) in the number of patients with COPD admitted for exacerbation in the intervention group in comparison to the conventional care group (p=.01) and those admitted for other health conditions (p=.01), respectively; significant reduction (41.0% and 58.9%) in emergency unit visits and unscheduled physician visits, respectively. The study concluded that a range of self-management designed for patients battling with COPD administered by qualified medical professionals can bear significant reduction in the use of health care services and exacerbate health condition. Polkey et al. (2013) This research determined the minimum clinically significant difference for in 6MWD over a one-year period as a primary function of death and patient admission. The study carried an observation of a cohort of individuals with COPD. It utilized data from ECLIPSE cohort (n=2,112) and used mortality of hospitalization as index events. The researchers measured change in 6MWD in the one-year time prior to the event and related change in 6MWD to health status especially due to lung function. The findings of the study revealed that of participants that experienced change in the 6MWD data, 94 and 323 died and admitted, respectively. 6MWD dropped by 29.7m more among patients who died compared to those who survived (p > 0.001). Also, the research found no significant variations for first admissions, and weak relationships with change in lung function or health status. The study conclude that a 30- or-more-decrease in the 6MWD is significantly related to increased chances of mortality but not patient admission because of exacerbation in individuals battling with COPD and representing a less important clinical difference. Leuppi et al., (2013) This study determined if a short-term (5days) systematic glucocorticoid intervention in individuals suffering from COPD exacerbation is more effective compared to conventional (14days) intervention in clinical results and whether the former reduced the exposure to steroid. The study involved a randomized, noninferiority multicenter experiment in five hospitals in Switzerland. 314 patients visiting the emergency unit with acute COPD exacerbation participated in the trial. The subjects were monitored using 40mg of prednisome for 5 or 14 days on a daily basis in a placebo-controlled, double-blinded manner. 289/314 (92 percent) of the patients who were hospitalized were incorporated in the intention-to-treat assessment 296 in the per-protocol evaluation. The average cumulative prednisome dose was considerably higher in the conventional group, 95% CI, 710 to 876mg compared 95% CI, 311 to 446mg (p=.001), and no frequent occurrence of treatment related negative reactions such as hypertension. Scanlon et al. (2000) This study basically aims at assessing 3,926 smokers (3,818 with evaluated results; average age at incorporation, 48.5 years; 36% women) exhibiting mild-to-moderate airway obstruction. The researchers intend to conduct a randomized clinical trial at 10 hospitals in North America. The researchers measured lung function. The study established that participants who ceased smoking recorded improvement in FEVI within a 1-year period after stopping (mean of 47 ml or 2%). Also, the subsequent level of drop in FEVI among participants who sustained cessation was half the rate among participants who continued smoking. Methacholine responsiveness, age, sex, reactivity to beta-agonist, race, and baseline smoking were determined to be the major predictors that lead to change in lung function. The research concluded that smokers exhibiting airway obstruction can benefit from smoking cessation regardless of past heavy cigarette consumption, older age, bad baseline lung function, or airway hyperreactivity. Fan et al., (2012) This investigation aimed at establishing the effectiveness of a comprehensive care management program (CCMP) in lowering the risk of patient admission. The study conducted a randomized, controlled comparison of CCMP with 20 Veteran Affairs as the guide-line usual care. The program encompassed COPD awareness carried out in two distinctive settings in terms of 4 individual and 1 group sessions, an exacerbation identification and treatment framework, and scheduled telephone calls to manage cases. The research established 27% and 24% COPD-associated admission in the 1-year cumulative incidence in the ultimate intervention and the resulting usual care groups, respectively (1.13: 1.80 hazard ratio). Moreover, the study found deaths resulting from COPD to account for the significant difference; 28 and 10 deaths from all causes in the intervention and usual care groups (3.00: 6.17 hazard ratio). Also, the CCMP was related to unexpected death, findings that significantly differ from other studies conducted previously. Therefore, the authors suggest a data monitoring committee to consider the design of undertaking clinical trials applying behavioral treatments. Celli et al. (2012) This study aimed hypothesis based that aimed at underlying the incorporation of inflammatory biomarkers in determining the predictive variables that will improve accuracy of clinical prediction of death in COPD. The study was characterized by1, 843 participants who were incorporated in the ECLIPSE study. The participants were followed for 3 years. The research employed Kaplan-Meier curves, Cox proportional hazards assessments, and long-rank analysis to establish the predictive value of death of clinical factors, and C statistics that evaluated the incorporated discriminatory power provided by the incorporation of biomarkers. The analyses found BODE, age, and admission history as the most effective predictors for mortality employing clinical variables. For instance, a single biomarkers (IL-6) markedly enhanced the C statistics to 0.708, which was further improved to 0.706 by incorporating biomarkers. The researchers concluded that the incorporation of a panel of chosen biomarkers bear significant improvement on the capability of determined clinical variables to predict death in COPD. Barnes (2013) In this article, Barnes (2013) explores new anti-inflammatory targets for COPD. The study ascertains that COPD is a source of chronic inflammation of the peripheral airways and lung parenchyma. Consequently, inflammation results to the progressive obstruction of the airways. The results hold that an improved comprehension of the inflammatory processes that arise as a result of pathphysiology of this condition has come up with a number of new therapeutic targets. Therefore, the author discusses a several promising of the identified targets, which include new antioxidants, kinase inhibitors. In addition, the author discusses medications targeting cellular senescence, colonization of microbes, resistance of corticosteroid and epigenetic control of expression of the inflammatory gene. Vogelmeier et al (2013) The researchers conducted a double-blind, double-dummy, parallel-group study to relate the effectiveness, safety, and tolerability of QVA149 against salmeterol-fluticasone (SFC) for a 2-weeks period with mild-to-severe COPD patients. 523 patients (aged 40 and above, GOLD levels II to II, without exacerbation in the past one year) were randomly prescribed QVA149 110/50 ug or SFC 50/500 ug once a day or for a 26-week period, respectively. The study found out that the overall cases of adverse occurrence (encompassing COPD exacerbations) was 54.4% and 60.2% for the QVA149 and SFC groups, respectively. The rate of severe events was consistent between intervention groups and COPD worsening was established the most recurrent severe event. The conclusion of the study was a recommendation for a once-daily QVA149 offers marked, sustained, and clinically positive outcomes in lung function as compared to twice-daily SFC, with marked symptomatic benefit, which reveal the potential of dual bronchodilation as an intervention alternative for patients with non-exacerbating symptomatic COPD. Han et al (2014) This investigation identified the kinds of exacerbations with highest chances of being limited and clinically subgroups with higher chances of benefiting from a 250mg-daily dose ofazithromycin, supplemented to usual care. The investigation found azithromycin to be most effective in reducing AECOPD necessitating antibiotic and steroid drugs and no difference in intervention response by sex, chronic bronchitis existence, concomitant inhaled oxygen, or supplemental oxygen use (with P = 0.75, 0.19, 0.29, and 0.23, respectively). The study further established that axithromycin does not reduce exacerbation in existing smokers. The study concludes that azithromycin is most effective dealing with AECOPD prevention through necessitating antibiotic and steroid drugs. Also established insignificant evidence of treatment impact in the smokers. Himelhoch et al (2015) The purpose of this research was to determine COPD prevalence among patients with serious mental conditions. A sample 200 randomly selected adults were used in the study. Those who were selected to participate in the study were diagnosed by mental conditions. The study found out that COPD prevalence stood at 22.6%; with patients with serious mental diseases having significantly higher chances of developing chronic bronchitis compared to emphysema, at 19.5% vs 6.1% and 7.9 vs 1.5%, respectively. The study concluded that COPD prevalence is significantly higher among patients battling with severe mental disorders compared to comparison subjects, therefore, justifying the need for primary and secondary prevention. Summary of the overall structure of the sources Despite that the 10 articles are published in different journals, their overall structure is consistent. In fact, only one (Barnes, 2013) differs in structure. The table below illustrates the general structure of the papers. General Structure of the papers Element Purpose Title State the topic of the research/paper Abstract Provides an extract of crucial information from the whole paper Background Introduces central concepts, justification of the study, and paper aim/objective Methodology Highlights procedures, instruments, participants and other instruments utilized in research process Results and discussion Reveal the findings of the research experiments and elaborate on the findings. Other than in Barnes (2013), other papers present results and discussion in different subheadings Conclusion State the general finding of the whole research process Acknowledgement Reveal individuals and institution that played an integral part in the research process References List the sources that were incorporated in the whole paper Appendix Some papers provide other materials used in the paper Background of the author Some paper include a brief background of the author(s) Suggestions on Scientific Abstract Writing and the Golden Rule The abstract constitute the only section of a scientific paper not only published in conference proceedings, but also the vast majority of readers access. In light of this observation, it becomes imperative for authors to ensure they do not incorporate bias and unjustifiable arguments and observations in the abstract that may deceive readers. Nonetheless, the majority of research and publications about writing scientific abstracts converge on a similar outline with almost the same sections. These sections include the background, methods, results/findings and discussion, and conclusions. Other suggestions include other sections such as objective and limitations between background and methods, and at the end of the abstract, respectively. In light of these suggestions, it is clear that the ‘golden rule’ is generally acceptable since the majority of authors subscribe to an almost similar structure or outline when drafting their abstract. How the abstracts meet the golden rule, convey the essential information and motivate the reader Paper Authors Meets Golden Rule? Abstract made me want to read paper Abstract conveyed all essential info from paper 1 Bourbeau et al., (2003). Yes Yes Yes 2 Polkey et al.,(2013) Yes Yes Yes 3 Leuppi et al., (2013) Yes Partly Almost 4 Scanlon et al. (2000) Yes Yes Yes 5 Fan et al., (2012) Yes Yes Yes 6 Celli et al. (2012) Yes Yes 7 Barnes (2013) No No No 8 Vogelmeier et al (2013) Yes Yes Yes 9 Vogelmeier et al (2013) Yes Partly Yes 10 Han et al. (2014) Yes Partly Almost The Peer Review Process Leuppi, J.D., Schuetz, P., Bingisser, R., Bodmer, M., Briel, M., Drescher, T., Duerring, U., Henzen, C., Leibbrandt, Y., Maier, S. and Miedinger, D., 2013. Short-term vs conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: the REDUCE randomized clinical trial. Jama, 309(21), pp.2223-2231 How the Review Process Enhance Integrity in Scientific Inquiry The peer review process contributes to integrity in scientific inquiry through a number of ways. First, ‘raw’ articles and papers are assessed to determine whether or not they are original and timely. Furthermore, the review process evaluate the materials to determine if their writing is clear, research methods are appropriate, data and data collection instruments are valid, and conclusions are not only derived in a systematic way, but are logic and supported by concrete evidence as well. Moreover, the editing process ensures that the information provided is important and the topic is of interest in a certain discipline. Materials that fail the acid test; are not eligible for publication and have insufficient priority for publication are dropped promptly. Besides that, it is imperative to note that the peer review process is conducted by individuals who are excellent experts in certain fields hence ensuring utmost integrity in scientific inquiry. The relevance of unrefereed conference presentations and online material as scientific references These materials are not good for incorporation in scientific papers because they are not reviewed by experts to authenticate their integrity required in scientific publications. Furthermore, their time of publication, originality, clarity of writing, appropriateness of their research methods and validity of their data and data collection instruments, and the logic of their claims and conclusions may render them unsuitable for use in scientific inquiry. Despite that their information and topic may be relevant and of particular interest, their integrity, validity and reliability are major concerns. Also, their author may not be an expert in that field. Percentage of “unreliable” references included in the reference list Considering all the papers included in the reference list, the percentage of unreliable references is zero (0%) as all the 10 papers underwent the peer review process and are published in various journals. Similarly, there are no internet references incorporated in the 10 papers. DOI, criteria for documents to get it and how it differs from an ISBN A digital object identifier (DOI) is a distinct alphanumeric string provided by the International DOI Foundation. A DOI is primarily assigned to a document for content identification and provision of reliable links to their location online. For a document to be assigned a DOI, it has to be published and made available electronically. The major factor differentiating DOI and ISBN is that the former begins with a 10 and feature a suffix and prefix separated by a slash. Read More