{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:51:46Z","timestamp":1791161506124,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015610","name":"Windermere Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015610","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>\n                      People with chronic obstructive pulmonary disease (\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      ) and interstitial lung disease (\n                      <jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content>\n                      ) experience chronic breathlessness and reduced quality of life (\n                      <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content>\n                      ). Specialised singing programs for people with lung disease may improve\n                      <jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content>\n                      and symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomised controlled trial conducted in Australia to determine the feasibility and effectiveness of 12\u2009weeks of online, guided group singing on QOL (primary outcome, as measured by SF36), as compared to usual care in people with COPD or ILD. Secondary outcomes: anxiety, depression, dyspnoea and loneliness. Intervention effectiveness was assessed using mixed effects linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and one participants were randomised (50 singing, 51 control; 64 COPD, 37 ILD; mean age 69.6\u2009years; 74% women; 42% mMRC\u2009=\u20092, 58% mMRC \u2265\u20093). The results of the primary endpoint were a mean treatment effect (MTE) of singing of 2.5 points (95% CI \u22121.9 to 6.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.266) on SF\u201036 mental health score (MCS) and 2.6 points (95% CI \u22120.9 to 6.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.138) on the physical component score (PCS), neither of which were statistically or clinically significant. In the per\u2010protocol analysis, significant improvement in MCS was detected in participants who attended 8 or more sessions (MTE:4.8; 95% CI 0.1 to 9.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047). No significant effects on secondary outcomes were detected. No adverse events were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This RCT demonstrated that online group singing is a feasible intervention for people with COPD or ILD and breathlessness. Although the intention\u2010to\u2010treat analysis did not demonstrate effectiveness, per\u2010protocol analyses suggest that singing may improve mental health components of QOL in people with COPD or ILD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70281","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:53:57Z","timestamp":1783468437000},"page":"1003-1013","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The\n                    <scp>SINFONIA<\/scp>\n                    Study: A Randomised Controlled Trial to Determine Feasibility and Effectiveness of Online Group Singing for People With\n                    <scp>COPD<\/scp>\n                    or\n                    <scp>ILD<\/scp>\n                    and Breathlessness"],"prefix":"10.1002","volume":"31","author":[{"given":"Natasha","family":"Smallwood","sequence":"first","affiliation":[{"name":"Chronic Respiratory Disease Research at The Alfred, School of Translational Medicine Monash University  Melbourne Victoria Australia"},{"name":"Department Respiratory Medicine Alfred Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3555-6856","authenticated-orcid":false,"given":"Amy","family":"Pascoe","sequence":"additional","affiliation":[{"name":"Chronic Respiratory Disease Research at The Alfred, School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Goh","sequence":"additional","affiliation":[{"name":"Austin Health  Heidelberg Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Zappino","sequence":"additional","affiliation":[{"name":"Chronic Respiratory Disease Research at The Alfred, School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1597-9421","authenticated-orcid":false,"given":"Sara","family":"Vogrin","sequence":"additional","affiliation":[{"name":"University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Ly","sequence":"additional","affiliation":[{"name":"Chronic Respiratory Disease Research at The Alfred, School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4071-2187","authenticated-orcid":false,"given":"Catherine","family":"Buchan","sequence":"additional","affiliation":[{"name":"Chronic Respiratory Disease Research at The Alfred, School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Spathis","sequence":"additional","affiliation":[{"name":"University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-0645","authenticated-orcid":false,"given":"Jennifer","family":"Philip","sequence":"additional","affiliation":[{"name":"Centre for Palliative Care St Vincent's Hospital and the University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2025.2453657"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S433541"},{"key":"e_1_2_12_4_1","volume-title":"The Burden of Chronic Respiratory Conditions in Australia: A Detailed Analysis of the Australian Burden of Disease Study 2011","author":"Australian Institute of Health and Welfare (AIHW)","year":"2011"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00205-2025"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30106-1"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02277-2016"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309-1634ST"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0027-2024"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.11656"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201609-1925ED"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0265-2023"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00335-2024"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/npjpcrm.2016.80"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460-6984.12527"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-018-0253-0"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01142-2021"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2024-002365"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S382037"},{"key":"e_1_2_12_20_1","volume-title":"Beyond the Burbs: Specialist Palliative Medicine Training in Rural Australia\u2014A Scoping Review","author":"Rural and Remote Institute of Palliative Medicine","year":"2024"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-022-02133-3"},{"key":"e_1_2_12_22_1","article-title":"Virtual Ethnography of Singing for Breathing in COPD and ILD Patients","volume":"64","author":"Ly L.","year":"2024","journal-title":"European Respiratory Journal"},{"key":"e_1_2_12_23_1","article-title":"SingINg for Breathing in COPD and ILD Patients: Longitudinal Qualitative Interview Study","volume":"64","author":"Ly L.","year":"2024","journal-title":"European Respiratory Journal"},{"key":"e_1_2_12_24_1","volume-title":"Stata Statistical Software: Release 17","author":"StataCorp","year":"2021"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_12_26_1","first-page":"1","article-title":"Key Reflections From Implementing SINFONIA, a Singing for Breathing Program for People Living With Chronic Obstructive Pulmonary Disease and Interstitial Lung Disease","volume":"1","author":"Zappino S.","year":"2025","journal-title":"Australian Journal of Music Therapy"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200012150-00008"},{"key":"e_1_2_12_28_1","volume-title":"SF\u201036 Physical and Mental Health Summary Scales: A User's Manual","author":"Ware J. E.","year":"1994"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.118521"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.42.10.773"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.4.1421"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0164027504268574"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-005-5994-6"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.284.6329.1607"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-10-41"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-12-69"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.1053356"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13102-025-01074-w"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312116671725"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0345-2020"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2003.20203.x"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/1479972314527469"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/1479972310393756"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2020-000737"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.2196\/57848"},{"key":"e_1_2_12_47_1","unstructured":"A.Masso \u201cCommunity Choirs in Australia\u201d(2013) https:\/\/www.musicinaustralia.org.au\/community\u2010choirs\u2010in\u2010australia\/#:~:text=Our%20research%20found%2081%25%20of %25%20and%205%25%20respectively."},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2014.953526"},{"key":"e_1_2_12_49_1","volume-title":"Education and Work, Australia","author":"Australian Bureau of Statistics","year":"2025"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/resp.70281","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/resp.70281","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/resp.70281","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:02:26Z","timestamp":1791158546000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/resp.70281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":48,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/resp.70281"],"URL":"https:\/\/doi.org\/10.1002\/resp.70281","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"2026-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}