{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:17:33Z","timestamp":1785525453864,"version":"3.56.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Philips Ib\u00e9rica, Sociedad Espa\u00f1ola de Neumolog\u00eda y Cirug\u00eda Tor\u00e1cica"},{"name":"Comunidad Aut\u00f3noma de Extremadura, Sociedad Neum\u00f3logos del Sur"},{"name":"Air Liquide Healthcare"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Obesity hypoventilation syndrome (OHS) is treated with noninvasive ventilation (NIV) that is titrated during polysomnography. Auto-adjusted NIV could obviate the need for polysomnographic titration, thereby reducing costs and delays in care. However, non-inferiority long-term clinical trials comparing auto-adjusted NIV with manually-adjusted NIV are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the comparative effectiveness of automatic vs manual NIV modality in OHS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter, blinded, parallel group, non-inferiority and cost-effectiveness trial, we randomly assigned treatment-na\u00efve ambulatory patients with OHS to auto-adjusted NIV (volume-targeted pressure support with auto-expiratory positive airway pressure) or manually-adjusted NIV (bilevel Positive Airway Pressure Spontaneous Timed mode (PAP ST).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The primary outcome was change in daytime PaCO2 at 12\u2009months, with the non-inferiority premise set at -2\u2009mm\u2009Hg. Secondary outcomes included symptoms, quality of life, and healthcare resource utilization. Intention-to-treat and per-protocol analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>205 ambulatory patients with OHS were randomized, 107 to auto-adjusted NIV and 89 to manually-adjusted NIV. The mean [95% CI] improvement in PaCO2 was -9.2 [-9.7; -8.7] mm\u2009Hg in the auto-adjusted group and -8.7 [-9.1; -8.3] mm\u2009Hg in the manually-adjusted group, with mean adjusted difference of 0.15\u2009mm\u2009Hg between groups ([low confidence limit -1.4]; non-inferiority P\u2009=\u2009.01). Cost-effectiveness was favorable to auto-adjusted group with a saving of 1528 \u20ac (95% CI, -2\u2009370; -6\u2009854) per patient. There were no significant differences in other secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In ambulatory patients with OHS, auto-adjusted NIV had a non-inferior long-term effectiveness compared to manually-adjusted NIV while being more cost-effective. Auto-adjusted NIV may be preferred in clinical practice given its lower complexity and cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinicaltrial.gov Identifier<\/jats:title>\n                    <jats:p>NCT04327336.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajrccm\/aamag018","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:44:53Z","timestamp":1769604293000},"page":"989-1004","source":"Crossref","is-referenced-by-count":3,"title":["Effectiveness of automatically-adjusted vs manually-adjusted noninvasive ventilation in obesity hypoventilation syndrome: a randomized clinical trial"],"prefix":"10.1093","volume":"212","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7220-6142","authenticated-orcid":false,"given":"Maria \u00c1ngeles","family":"S\u00e1nchez-Quiroga","sequence":"first","affiliation":[{"name":"Virgen del Puerto Hospital, Plasencia , 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