Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 appraisals
European respiratory review : an official journal of the European Respiratory Society
Nutrition and growth of primary ciliary dyskinesia patients: a systematic review.
BACKGROUND: Growth, nutritional status and intake can be crucial for the management and prognosis of chronic lung diseases, including primary ciliary dyskinesia (PCD); yet research in PCD is scarce. In this study, we systematically reviewed the existing literature and summarised the evidence on growth, nutritional status and intake of patients with PCD. METHODS: We conducted searches in Medline, Embase, Scopus and PubMed limited to the past 20 years, due to changes in the diagnosis of PCD. Eligible studies included cross-sectional, case-control and prospective studies, and case series with >5 people that reported on the growth, nutritional status or intake of patients with PCD. We performed additional searches through reference list checking and in medRxiv for relevant preprints. The review was registered in PROSPERO (CRD420251065699). RESULTS: 50 studies were included in the qualitative synthesis. We observed variability in growth-related outcomes, with some studies reporting reduced z-score for height, body weight or BMI, while others reported no growth differences in patients with PCD. The prevalence of undernutrition ranged from 4 to 11%; underweight ranged from 0 to 50%. Overweight and obesity estimates ranged from 3 to 25%. The prevalence of vitamin D insufficiency was 54%, while deficiency was reported in 18-26% of study participants. Only three studies reported on the nutritional intake of patients with PCD. DISCUSSION: We observed considerable variability in growth-related outcomes and a lack of nutritional intake-related data in patients with PCD. The findings we noted related to malnutrition and vitamin D insufficiency/deficiency are alarming and warrant further investigation.
29 May 2026
Read appraisal →Journal of medical Internet research
Reporting of Telehealth Implementation in Cystic Fibrosis: Scoping Review Using a Novel Theory-Based Evaluation Lens
BACKGROUND: Many inductive reviews exploring telehealth and its application in health care have identified missing or inconsistently reported implementation data, calling for a standardized approach to telehealth research. OBJECTIVE: Using cystic fibrosis (CF) as a case exemplar, this study evaluated the adherence of telehealth research to standardized reporting frameworks through a theory-based evaluation lens to assess implementation reporting quality and identify knowledge gaps and strengths across the literature. METHODS: We conducted an updated systematic review of the PubMed, Scopus, and Web of Science databases using a novel deductive approach to identify relevant scientific papers available in English and focusing on the delivery of telehealth interventions to CF populations as part of or alongside routine CF care. Two relevant reporting checklists were identified in the Equator Network database (Guidelines and Checklist for the Reporting on Digital Health Implementations [iCHECK-DH] and Template for Intervention Description and Replication for Telehealth [TIDiER-telehealth]) to extract data from the papers. Each checklist category was described as being "fully reported" (score=2), "partially reported" (score=1), and "did not report" (score=0) for each paper. An overall score was calculated for adherence to the checklists. RESULTS: In total, 98 studies published between 2006 and May 2025 were included in this review, with the majority appearing during the COVID-19 pandemic (2021-2022). Most studies were conducted in a single country, predominantly the United States, Australia, and the United Kingdom, and were published in medical journals. Telehealth was variably described, with video call-based models in combination with remote monitoring being most common. The median score was 22/40 (range 11-29, 55.0% adherent) for iCHECK and 15/24 (range 6-23, 62.5% adherent) for TIDiER, demonstrating moderate overall reporting quality. For iCHECK, ≥50% of studies fully reported 6/20 categories, partially reported 9/20 categories, and did not report 3/20 categories. For TIDiER, ≥50% of studies fully reported 4/12 categories, partially reported 6/12 categories, and did not report 1/12 categories, indicating persistent gaps in intervention description despite improved partial reporting. CONCLUSIONS: Key areas, such as justification for telehealth, target populations, and outcomes, are well documented, offering valuable insights into the rationale for and outcomes associated with telehealth. However, implementation processes remain underreported, partly due to the more recent adoption of frameworks like iCHECK and TIDiER. The clinical implications of the current evidence limit the implementation of telehealth in terms of the ability to assess feasibility and readiness for adoption; understand financial implications and plan sustainably; ensure patient safety, data protection, and equity; interpret outcome data in context; and share, replicate, or scale evidence-based models of care. Strengthening the commitment to standardized telehealth reporting will ultimately support clinical decision-making and improve the effective and equitable integration of telehealth into care.
23 May 2026
Read appraisal →European respiratory review : an official journal of the European Respiratory Society
Prevalence of respiratory viruses in stable and acute asthma: a systematic review and meta-analysis
BACKGROUND: Respiratory viruses, frequently detected in asthma, are associated with worse outcomes. This meta-analysis systematically quantifies the prevalence of respiratory viruses in stable and acute asthma, across children and adults, and explores factors associated with increased viral burden through meta-regression. METHODS: This prospectively registered meta-analysis (PROSPERO-CRD42023375108) included studies employing molecular techniques to assess respiratory virus prevalence in asthma. Three databases were searched in August 2024. Risk of bias and certainty of evidence were assessed. We performed random-effects meta-analysis of proportions. RESULTS: We included 111 eligible studies. Moderate-certainty evidence indicated a pooled prevalence of any respiratory virus of 33.9% (95% confidence interval 24.8-43.7%) in children and 23.0% (12.9-35.0%) in adults with stable asthma. In acute asthma, prevalence increased to 58.8% (52.5-65.0%) in children and 49.9% (41.2-58.5%) in adults (moderate certainty). Rhinovirus was the most frequently identified virus, especially in acute asthma (45.0% in children versus 21.2% in adults). Respiratory syncytial virus and bocavirus were more common in younger children, while coronavirus and influenza were more frequently detected in adults; respiratory syncytial virus peaked in older adults too. A higher prevalence of influenza virus B and adenovirus in children, and of influenza virus A and parainfluenza 2 in adults with severe versus non-severe acute asthma suggests a potential association with more severe acute attacks. CONCLUSION: Respiratory viruses are common in both stable and acute asthma. This suggests that the diagnostic value of a positive viral test during acute episodes may be limited and could benefit from complementary biomarkers to improve interpretation.
10 Apr 2026
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