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\n\n \n \n \n \n \n \n Preventing adverse cardiac events (PACE) in chronic obstructive pulmonary disease (COPD): study protocol for a double-blind, placebo controlled, randomised controlled trial of bisoprolol in COPD.\n \n \n \n \n\n\n \n Martin, A.; Hancox, R. J; Chang, C. L; Beasley, R.; Wrobel, J.; McDonald, V.; Dobler, C. C; Yang, I. A; Farah, C. S; Cochrane, B.; Hillis, G. S; Scowcroft, C. P.; Aggarwal, A.; Di Tanna, G. L.; Balicki, G.; Galgey, S.; and Jenkins, C.\n\n\n \n\n\n\n
BMJ Open, 11(8): e053446. August 2021.\n
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@article{martin_preventing_2021,\n\ttitle = {Preventing adverse cardiac events ({PACE}) in chronic obstructive pulmonary disease ({COPD}): study protocol for a double-blind, placebo controlled, randomised controlled trial of bisoprolol in {COPD}},\n\tvolume = {11},\n\tissn = {2044-6055, 2044-6055},\n\tshorttitle = {Preventing adverse cardiac events ({PACE}) in chronic obstructive pulmonary disease ({COPD})},\n\turl = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2021-053446},\n\tdoi = {10.1136/bmjopen-2021-053446},\n\tabstract = {Introduction\n Heart disease in chronic obstructive pulmonary disease (COPD) is a common but neglected comorbidity. Patients with COPD are frequently excluded from clinical trials of treatments aimed at reducing cardiac morbidity and mortality, which has led to undertreatment of cardiovascular disease in patients with COPD. A particular concern in COPD is the underuse of beta (β)-blockers. There is observational evidence that cardioselective β-blockers are safe and may even reduce mortality risk in COPD, although some evidence is conflicting. There is an urgent need to answer the research question: Are cardioselective β-blockers safe and of benefit in people with moderately severe COPD? The proposed study will investigate whether cardioselective β-blocker treatment in patients with COPD reduces mortality and cardiac and respiratory morbidity.\n \n \n Methods and analyses\n This is a double-blind, randomised controlled trial to be conducted in approximately 26 sites in Australia, New Zealand, India, Sri Lanka and other countries as required. Participants with COPD will be randomised to either bisoprolol once daily (range 1.25–5 mg, dependent on tolerated dose) or matched placebo, in addition to receiving usual care for their COPD over the study duration of 24 months.\n \n The study will enrol 1164 participants with moderate to severe COPD, aged 40–85 years. Participants will be symptomatic from their COPD and have a postbronchodilator forced expiratory volume in 1 s (FEV\n 1\n ) ≥30\\% and ≤70\\% predicted and a history of at least one exacerbation requiring systemic corticosteroids, antibiotics or both in the prior 24 months.\n \n \n \n Ethics and dissemination\n The study protocol has been approved by the Sydney Local Health District Human Research Ethics Committee at The Concord Repatriation General Hospital.\n \n \n Trial registration numbers\n \n NCT03917914\n ; CTRI/2020/08/027322.},\n\tlanguage = {en},\n\tnumber = {8},\n\turldate = {2021-10-02},\n\tjournal = {BMJ Open},\n\tauthor = {Martin, Allison and Hancox, Robert J and Chang, Catherina L and Beasley, Richard and Wrobel, Jeremy and McDonald, Vanessa and Dobler, Claudia C and Yang, Ian A and Farah, Claude S and Cochrane, Belinda and Hillis, Graham S and Scowcroft, Caroline Polak and Aggarwal, Ashutosh and Di Tanna, Gian Luca and Balicki, Grace and Galgey, Shane and Jenkins, Christine},\n\tmonth = aug,\n\tyear = {2021},\n\tpages = {e053446},\n}\n\n
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\n Introduction Heart disease in chronic obstructive pulmonary disease (COPD) is a common but neglected comorbidity. Patients with COPD are frequently excluded from clinical trials of treatments aimed at reducing cardiac morbidity and mortality, which has led to undertreatment of cardiovascular disease in patients with COPD. A particular concern in COPD is the underuse of beta (β)-blockers. There is observational evidence that cardioselective β-blockers are safe and may even reduce mortality risk in COPD, although some evidence is conflicting. There is an urgent need to answer the research question: Are cardioselective β-blockers safe and of benefit in people with moderately severe COPD? The proposed study will investigate whether cardioselective β-blocker treatment in patients with COPD reduces mortality and cardiac and respiratory morbidity. Methods and analyses This is a double-blind, randomised controlled trial to be conducted in approximately 26 sites in Australia, New Zealand, India, Sri Lanka and other countries as required. Participants with COPD will be randomised to either bisoprolol once daily (range 1.25–5 mg, dependent on tolerated dose) or matched placebo, in addition to receiving usual care for their COPD over the study duration of 24 months. The study will enrol 1164 participants with moderate to severe COPD, aged 40–85 years. Participants will be symptomatic from their COPD and have a postbronchodilator forced expiratory volume in 1 s (FEV 1 ) ≥30% and ≤70% predicted and a history of at least one exacerbation requiring systemic corticosteroids, antibiotics or both in the prior 24 months. Ethics and dissemination The study protocol has been approved by the Sydney Local Health District Human Research Ethics Committee at The Concord Repatriation General Hospital. Trial registration numbers NCT03917914 ; CTRI/2020/08/027322.\n
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\n\n \n \n \n \n \n New Zealand COPD Guidelines: Quick Reference Guide.\n \n \n \n\n\n \n Hancox, R. J.; Jones, S.; Baggott, C.; Chen, D.; Corna, N.; Davies, C.; Fingleton, J.; Hardy, J.; Hussain, S.; Poot, B.; Reid, J.; Travers, J.; Turner, J.; and Young, R.\n\n\n \n\n\n\n
The New Zealand Medical Journal, 134(1530): 76–110. February 2021.\n
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@article{hancox_new_2021,\n\ttitle = {New {Zealand} {COPD} {Guidelines}: {Quick} {Reference} {Guide}},\n\tvolume = {134},\n\tissn = {1175-8716},\n\tshorttitle = {New {Zealand} {COPD} {Guidelines}},\n\tabstract = {The purpose of the Asthma and Respiratory Foundation of New Zealand's COPD Guidelines: Quick Reference Guide is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment, and management of chronic obstructive pulmonary disease (COPD) in clinical practice. The intended users are health professionals responsible for delivering acute and chronic COPD care in community and hospital settings, and those responsible for the training of such health professionals.},\n\tlanguage = {eng},\n\tnumber = {1530},\n\tjournal = {The New Zealand Medical Journal},\n\tauthor = {Hancox, Robert J. and Jones, Stuart and Baggott, Christina and Chen, David and Corna, Nicola and Davies, Cheryl and Fingleton, James and Hardy, Jo and Hussain, Syed and Poot, Betty and Reid, Jim and Travers, Justin and Turner, Joanna and Young, Robert},\n\tmonth = feb,\n\tyear = {2021},\n\tpmid = {33651780},\n\tkeywords = {Delivery of Health Care, Foundations, Health Knowledge, Attitudes, Practice, Health Personnel, Humans, New Zealand, Pulmonary Disease, Chronic Obstructive},\n\tpages = {76--110},\n}\n\n
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\n The purpose of the Asthma and Respiratory Foundation of New Zealand's COPD Guidelines: Quick Reference Guide is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment, and management of chronic obstructive pulmonary disease (COPD) in clinical practice. The intended users are health professionals responsible for delivering acute and chronic COPD care in community and hospital settings, and those responsible for the training of such health professionals.\n
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\n\n \n \n \n \n \n \n Validation of a diagnosis-agnostic symptom questionnaire for asthma and/or COPD.\n \n \n \n \n\n\n \n Karlsson, N.; Atkinson, M. J.; Müllerová, H.; Alacqua, M.; Keen, C.; Hughes, R.; Janson, C.; Make, B.; Price, D.; and Reddel, H. K.\n\n\n \n\n\n\n
ERJ Open Research, 7(1): 00828–2020. January 2021.\n
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\n\n \n \n Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n \n \n 2 downloads\n \n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@article{karlsson_validation_2021,\n\ttitle = {Validation of a diagnosis-agnostic symptom questionnaire for asthma and/or {COPD}},\n\tvolume = {7},\n\tissn = {2312-0541},\n\turl = {http://openres.ersjournals.com/lookup/doi/10.1183/23120541.00828-2020},\n\tdoi = {10.1183/23120541.00828-2020},\n\tabstract = {Background\n The Respiratory Symptoms Questionnaire (RSQ) is a novel, four-item patient-reported diagnosis-agnostic tool designed to assess the frequency of respiratory symptoms and their impact on activity, without specifying a particular diagnosis. Our objective was to examine its validity in patients with asthma and/or chronic obstructive pulmonary disease (COPD).\n \n \n Methods\n \n Baseline data were randomly sampled from patients who completed the RSQ in the NOVELTY study (\n ClinicalTrials.gov\n :\n NCT02760329\n ). The total sample (n=1530) comprised three randomly selected samples (n=510 each) from each physician-assigned diagnostic group (asthma, asthma+COPD and COPD). The internal consistency and structural validity of the RSQ were evaluated using exploratory and confirmatory factor analyses; psychometric performance was observed using Classical Test Theory and Item Response Theory analyses.\n \n \n \n Results\n \n For the total sample, the mean±\n sd\n RSQ score was 5.6±4.3 (range 0–16). Irrespective of diagnosis, the internal consistency of items was uniformly adequate (Cronbach's α=0.76–0.80). All items had high factor loadings and structural characteristics of the measure were invariant across groups. Using the total sample, RSQ items informatively covered the θ score range of –2.0 to 2.8, with discrimination coefficients for individual items being high to very high (1.7–2.6). Strong convergent correlations were observed between the RSQ and the St George's Respiratory Questionnaire (0.77, p{\\textless}0.001).\n \n \n \n Conclusions\n The RSQ is a valid, brief, patient-reported tool for assessing respiratory symptoms in patients across the whole spectrum of asthma and/or COPD, rather than using different questionnaires for each diagnosis. It can be used for monitoring respiratory symptoms in clinical practice, clinical trials and real-world studies.},\n\tlanguage = {en},\n\tnumber = {1},\n\turldate = {2021-04-30},\n\tjournal = {ERJ Open Research},\n\tauthor = {Karlsson, Niklas and Atkinson, Mark J. and Müllerová, Hana and Alacqua, Marianna and Keen, Christina and Hughes, Rod and Janson, Christer and Make, Barry and Price, David and Reddel, Helen K.},\n\tmonth = jan,\n\tyear = {2021},\n\tpages = {00828--2020},\n}\n\n
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\n Background The Respiratory Symptoms Questionnaire (RSQ) is a novel, four-item patient-reported diagnosis-agnostic tool designed to assess the frequency of respiratory symptoms and their impact on activity, without specifying a particular diagnosis. Our objective was to examine its validity in patients with asthma and/or chronic obstructive pulmonary disease (COPD). Methods Baseline data were randomly sampled from patients who completed the RSQ in the NOVELTY study ( ClinicalTrials.gov : NCT02760329 ). The total sample (n=1530) comprised three randomly selected samples (n=510 each) from each physician-assigned diagnostic group (asthma, asthma+COPD and COPD). The internal consistency and structural validity of the RSQ were evaluated using exploratory and confirmatory factor analyses; psychometric performance was observed using Classical Test Theory and Item Response Theory analyses. Results For the total sample, the mean± sd RSQ score was 5.6±4.3 (range 0–16). Irrespective of diagnosis, the internal consistency of items was uniformly adequate (Cronbach's α=0.76–0.80). All items had high factor loadings and structural characteristics of the measure were invariant across groups. Using the total sample, RSQ items informatively covered the θ score range of –2.0 to 2.8, with discrimination coefficients for individual items being high to very high (1.7–2.6). Strong convergent correlations were observed between the RSQ and the St George's Respiratory Questionnaire (0.77, p\\textless0.001). Conclusions The RSQ is a valid, brief, patient-reported tool for assessing respiratory symptoms in patients across the whole spectrum of asthma and/or COPD, rather than using different questionnaires for each diagnosis. It can be used for monitoring respiratory symptoms in clinical practice, clinical trials and real-world studies.\n
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\n\n \n \n \n \n \n \n Heterogeneity within and between physician-diagnosed asthma and/or COPD: NOVELTY cohort.\n \n \n \n \n\n\n \n Reddel, H. K; Vestbo, J.; Agustí, A.; Anderson, G. P; Bansal, A. T; Beasley, R.; Bel, E. H; Janson, C.; Make, B.; Pavord, I. D; Price, D.; Rapsomaniki, E.; Karlsson, N.; Finch, D. K; Nuevo, J.; de Giorgio-Miller, A.; Alacqua, M.; Hughes, R.; Müllerová, H.; and Gerhardsson de Verdier, M.\n\n\n \n\n\n\n
European Respiratory Journal,2003927. February 2021.\n
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@article{reddel_heterogeneity_2021,\n\ttitle = {Heterogeneity within and between physician-diagnosed asthma and/or {COPD}: {NOVELTY} cohort},\n\tissn = {0903-1936, 1399-3003},\n\tshorttitle = {Heterogeneity within and between physician-diagnosed asthma and/or {COPD}},\n\turl = {http://erj.ersjournals.com/lookup/doi/10.1183/13993003.03927-2020},\n\tdoi = {10.1183/13993003.03927-2020},\n\tabstract = {Background\n Studies of asthma and chronic obstructive pulmonary disease (COPD) typically focus on these diagnoses separately, limiting understanding of disease mechanisms and treatment options. NOVELTY is a global, 3-year, prospective observational study of patients with asthma and/or COPD from real-world clinical practice. We investigated heterogeneity and overlap by diagnosis and severity in this cohort.\n \n \n Methods\n Patients with physician-assigned asthma, COPD or both (asthma+COPD) were enrolled, stratified by diagnosis and severity. Baseline characteristics were reported descriptively by physician-assigned diagnosis and/or severity. Factors associated with physician-assessed severity were evaluated using ordinal logistic regression analysis.\n \n \n Results\n \n Of 11 243 patients, 5940 (52.8\\%) had physician-assigned asthma, 1396 (12.4\\%) had asthma+COPD and 3907 (34.8\\%) had COPD; almost half were from primary care. Symptoms, health-related quality of life and spirometry showed substantial heterogeneity and overlap between asthma, asthma+COPD and COPD, with 23\\%, 62\\% and 64\\% of patients, respectively, having post-bronchodilator FEV\n 1\n /FVC {\\textless}lower limit of normal.\n \n Symptoms and exacerbations increased with greater physician-assessed severity, and were higher in asthma+COPD, but 24.3\\% with mild asthma and 20.4\\% with mild COPD had experienced ≥1 exacerbation in the past 12 months. Medication records suggested both under-treatment and over-treatment relative to severity. Blood eosinophil counts varied little across diagnosis/severity groups, but blood neutrophil counts increased with severity across all diagnoses.\n \n \n Conclusion\n This analysis demonstrates marked heterogeneity within, and overlap between, physician-assigned diagnosis and severity groups in patients with asthma and/or COPD. Current diagnostic and severity classifications in clinical practice poorly differentiate between clinical phenotypes that may have specific risks and treatment implications.},\n\tlanguage = {en},\n\turldate = {2021-04-28},\n\tjournal = {European Respiratory Journal},\n\tauthor = {Reddel, Helen K and Vestbo, Jørgen and Agustí, Alvar and Anderson, Gary P and Bansal, Aruna T and Beasley, Richard and Bel, Elisabeth H and Janson, Christer and Make, Barry and Pavord, Ian D and Price, David and Rapsomaniki, Eleni and Karlsson, Niklas and Finch, Donna K and Nuevo, Javier and de Giorgio-Miller, Alex and Alacqua, Marianna and Hughes, Rod and Müllerová, Hana and Gerhardsson de Verdier, Maria},\n\tmonth = feb,\n\tyear = {2021},\n\tpages = {2003927},\n}\n\n
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\n Background Studies of asthma and chronic obstructive pulmonary disease (COPD) typically focus on these diagnoses separately, limiting understanding of disease mechanisms and treatment options. NOVELTY is a global, 3-year, prospective observational study of patients with asthma and/or COPD from real-world clinical practice. We investigated heterogeneity and overlap by diagnosis and severity in this cohort. Methods Patients with physician-assigned asthma, COPD or both (asthma+COPD) were enrolled, stratified by diagnosis and severity. Baseline characteristics were reported descriptively by physician-assigned diagnosis and/or severity. Factors associated with physician-assessed severity were evaluated using ordinal logistic regression analysis. Results Of 11 243 patients, 5940 (52.8%) had physician-assigned asthma, 1396 (12.4%) had asthma+COPD and 3907 (34.8%) had COPD; almost half were from primary care. Symptoms, health-related quality of life and spirometry showed substantial heterogeneity and overlap between asthma, asthma+COPD and COPD, with 23%, 62% and 64% of patients, respectively, having post-bronchodilator FEV 1 /FVC \\textlesslower limit of normal. Symptoms and exacerbations increased with greater physician-assessed severity, and were higher in asthma+COPD, but 24.3% with mild asthma and 20.4% with mild COPD had experienced ≥1 exacerbation in the past 12 months. Medication records suggested both under-treatment and over-treatment relative to severity. Blood eosinophil counts varied little across diagnosis/severity groups, but blood neutrophil counts increased with severity across all diagnoses. Conclusion This analysis demonstrates marked heterogeneity within, and overlap between, physician-assigned diagnosis and severity groups in patients with asthma and/or COPD. Current diagnostic and severity classifications in clinical practice poorly differentiate between clinical phenotypes that may have specific risks and treatment implications.\n
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\n\n \n \n \n \n \n \n Searching for the optimal oxygen saturation range in acutely unwell patients.\n \n \n \n \n\n\n \n Pilcher, J. M.; Kearns, C.; and Beasley, R.\n\n\n \n\n\n\n
Emergency Medicine Journal, 38(3): 168–169. March 2021.\n
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@article{pilcher_searching_2021,\n\ttitle = {Searching for the optimal oxygen saturation range in acutely unwell patients},\n\tvolume = {38},\n\tissn = {1472-0205, 1472-0213},\n\turl = {https://emj.bmj.com/lookup/doi/10.1136/emermed-2020-210749},\n\tdoi = {10.1136/emermed-2020-210749},\n\tlanguage = {en},\n\tnumber = {3},\n\turldate = {2021-02-24},\n\tjournal = {Emergency Medicine Journal},\n\tauthor = {Pilcher, Janine Marie and Kearns, Ciléin and Beasley, Richard},\n\tmonth = mar,\n\tyear = {2021},\n\tpages = {168--169},\n}\n\n
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