Noninvasive Ventilation in Exacerbations of Chronic Obstructive Pulmonary Disease: Implications of Different Meta-Analytic Strategies
Authors: John V. Peter, John L. Moran
Journal: Annals of Internal Medicine (2004)

Letters7 September 2004Noninvasive Ventilation in Exacerbations of Chronic Obstructive Pulmonary Disease: Implications of Different Meta-Analytic StrategiesJohn V. Peter, MD and John L. Moran, MBBS, FRACP, FANZCAJohn V. Peter, MDFrom Lyell McEwin Health Centre, Elizabeth, South Australia 5112; and The Queen Elizabeth Hospital, Woodville, South Australia 5011. and John L. Moran, MBBS, FRACP, FANZCAFrom Lyell McEwin Health Centre, Elizabeth, South Australia 5112; and The Queen Elizabeth Hospital, Woodville, South Australia 5011.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-5-200409070-00031-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Recent meta-analyses (1-3) have examined the role of noninvasive ventilation in acute exacerbations of chronic obstructive pulmonary disease (COPD).Objective: To assess the use of different analytic strategies in interpreting the results of these meta-analyses.Methods and Findings: Two issues are important in considering evidence for use of noninvasive ventilation in acute exacerbations of COPD. First, what constitutes an “acute exacerbation”? Exacerbation of COPD is defined (4) as “a sustained worsening of the patient's condition, from the stable state and beyond normal day-to-day variations, that is acute in onset and necessitates change in regular medication in ...References1. Keenan SP, Sinuff T, Cook DJ, Hill NS. Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature. Ann Intern Med. 2003;138:861-70. [PMID: 12779296] LinkGoogle Scholar2. Peter JV, Moran JL, Phillips-Hughes J, Warn D. Noninvasive ventilation in acute respiratory failure—a meta-analysis update. Crit Care Med. 2002;30:555-62. [PMID: 11990914] CrossrefMedlineGoogle Scholar3. Lightowler JV, Wedzicha JA, Elliott MW, Ram FS. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ. 2003;326:185. 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