{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:02:26Z","timestamp":1768568546037,"version":"3.49.0"},"posted":{"date-parts":[[2024,9,4]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":43,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Approximately 2% of the global population has survived tuberculosis (TB). Increasing evidence indicates that a significant proportion of pulmonary TB survivors develop TB-associated respiratory disability, commonly referred to as post-TB lung disease (PLTD) and marked by impaired respiratory function, persistent symptoms, and activity limitations. However, the prevalence, risk factors, and progression of TB-associated respiratory disability throughout the life course are not well understood. To address these gaps, we will undertake a systematic review and individual participant-level data meta-analysis (IPD-MA) focusing on TB-associated respiratory disability in children, adolescents, and adults successfully treated for pulmonary TB.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>We will systematically search MEDLINE, Embase, CENTRAL, Global Index Medicus, and medRxiv for original studies investigating TB-associated respiratory disability in people of all ages who have completed treatment for microbiologically confirmed or clinically diagnosed pulmonary TB. Authors of eligible studies will be invited to contribute de-identified data and form a collaborative group. Primary outcomes will be (1) abnormal lung function based on spirometry parameters and (2) chronic respiratory symptoms. We will estimate the overall and subgroup-specific prevalence of each outcome through IPD meta-analysis. Next, we will develop clinical prediction tools assessing the risk of future TB-associated respiratory disability at (i) the start of TB treatment and (ii) end of TB treatment for those without existing signs of disability. Finally, we will use stepwise hierarchical modelling to identify epidemiological determinants of respiratory disability.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>This study has been approved by the ethics review boards at the Rhode Island Hospital (2138217-2) and the Research Institute of the McGill University Health Centre (2024-10345). Individual study authors will be required to obtain institutional approval prior to sharing data. Results will be disseminated through open-access, peer-reviewed publications and conference presentations.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Prospero registration number<\/jats:title>\n                  <jats:p>CRD42024529906<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Strengths and limitations of this study<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>An individual participant data meta-analysis allows for data harmonization to help overcome limitations of individual studies and aggregate meta-analysis, including small sample size, heterogeneity, and limited reporting of subgroups, such as age and other risk factors.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>We will be able to identify weaknesses in current reporting and recommend standards to support high-quality data collection and facilitate pooling of data.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Key limitations include authors\u2019 willingness to share data, representativeness of data contributed, and missing data.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>We will build an ongoing data collection platform to allow updating of evidence.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Results will have implications for public health, clinical trial design, and clinical practice to support TB survivors.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>","DOI":"10.1101\/2024.09.03.24313003","type":"posted-content","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T16:55:31Z","timestamp":1725468931000},"source":"Crossref","is-referenced-by-count":0,"title":["Tuberculosis-Associated Respiratory Disability in Children, Adolescents, and Adults: Protocol for a Systematic Review and Individual Participant Data Meta-Analysis"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2318-3802","authenticated-orcid":false,"given":"Silvia S.","family":"Chiang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7027-3579","authenticated-orcid":false,"given":"Kamila","family":"Romanowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Johnston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Petiquan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayara","family":"Bastos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dick","family":"Menzies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sierra","family":"Land","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Benedetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiz Ahmad","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8787-9139","authenticated-orcid":false,"given":"Marieke M.","family":"van der Zalm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2341-2166","authenticated-orcid":false,"given":"Jonathon R.","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2024090600500530000_2024.09.03.24313003v1.1","unstructured":"World Health Organization. Global tuberculosis report 2023. https:\/\/www.who.int\/publications-detail-redirect\/9789240083851 (accessed Feb 14, 2024)."},{"key":"2024090600500530000_2024.09.03.24313003v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30919-1"},{"key":"2024090600500530000_2024.09.03.24313003v1.3","doi-asserted-by":"crossref","first-page":"100377","DOI":"10.1016\/j.jctube.2023.100377","article-title":"Epidemiology and factors associated with Extra-pulmonary tuberculosis in a Low-prevalence area","volume":"32","year":"2023","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"2024090600500530000_2024.09.03.24313003v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2014.12.016"},{"key":"2024090600500530000_2024.09.03.24313003v1.5","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.ijid.2020.02.032","article-title":"Post tuberculosis treatment infectious complications","volume":"92","year":"2020","journal-title":"International Journal of Infectious Diseases"},{"key":"2024090600500530000_2024.09.03.24313003v1.6","first-page":"751","article-title":"Post-Tuberculosis Lung Disease: Clinical Review of an Under-Recognised Global Challenge","volume":"100","year":"2021","journal-title":"RES"},{"key":"2024090600500530000_2024.09.03.24313003v1.7","doi-asserted-by":"crossref","first-page":"820","DOI":"10.5588\/ijtld.20.0067","article-title":"Post-tuberculosis lung health: perspectives from the First International Symposium","volume":"24","year":"2020","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024090600500530000_2024.09.03.24313003v1.8","unstructured":"World Health Organization. How to use the ICF: A practical manual for using the International Classification of Functioning, Disability and Health (ICF). 2013; published online Oct."},{"key":"2024090600500530000_2024.09.03.24313003v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101979"},{"key":"2024090600500530000_2024.09.03.24313003v1.10","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0221-2022"},{"key":"2024090600500530000_2024.09.03.24313003v1.11","doi-asserted-by":"crossref","first-page":"e0000805","DOI":"10.1371\/journal.pgph.0000805","article-title":"Magnitude and factors associated with post-tuberculosis lung disease in low- and middle-income countries: A systematic review and meta-analysis","volume":"2","year":"2022","journal-title":"PLOS Glob Public Health"},{"key":"2024090600500530000_2024.09.03.24313003v1.12","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/24745332.2022.2036504","article-title":"Chapter 5: Treatment of tuberculosis disease","volume":"6","year":"2022","journal-title":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine"},{"key":"2024090600500530000_2024.09.03.24313003v1.13","doi-asserted-by":"crossref","first-page":"248","DOI":"10.5588\/ijtld.22.0514","article-title":"Post-TB health and wellbeing","volume":"27","year":"2023","journal-title":"int j tuberc lung dis"},{"key":"2024090600500530000_2024.09.03.24313003v1.14","doi-asserted-by":"crossref","first-page":"797","DOI":"10.5588\/ijtld.21.0425","article-title":"Clinical standards for the assessment, management and rehabilitation of post-TB lung disease","volume":"25","year":"2021","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"key":"2024090600500530000_2024.09.03.24313003v1.15","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/S2213-2600(24)00078-X","article-title":"\u2018Yes! We can end TB,\u2019 but remember the sequelae in children","volume":"12","year":"2024","journal-title":"Lancet Respir Med"},{"key":"2024090600500530000_2024.09.03.24313003v1.16","doi-asserted-by":"crossref","unstructured":"Nevitt SJ , Tudur Smith C. Practical Considerations and Challenges When Conducting an Individual Participant Data (IPD)Individual participant data (IPD) Meta-Analysis. In: Evangelou E , Veroniki AA , eds. Meta-Research: Methods and Protocols. New York, NY: Springer US, 2022: 263\u201378.","DOI":"10.1007\/978-1-0716-1566-9_16"},{"key":"2024090600500530000_2024.09.03.24313003v1.17","doi-asserted-by":"crossref","unstructured":"Page MJ , McKenzie JE , Bossuyt PM , et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. bmj 2021; 372. https:\/\/www.bmj.com\/content\/372\/bmj.n71.short (accessed Aug 22, 2024).","DOI":"10.1136\/bmj.n71"},{"key":"2024090600500530000_2024.09.03.24313003v1.18","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"2024090600500530000_2024.09.03.24313003v1.19","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ581"},{"key":"2024090600500530000_2024.09.03.24313003v1.20","doi-asserted-by":"publisher","DOI":"10.1136\/thx.54.7.581"},{"key":"2024090600500530000_2024.09.03.24313003v1.21","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05636"},{"key":"2024090600500530000_2024.09.03.24313003v1.22","doi-asserted-by":"publisher","DOI":"10.2340\/1650197719702239298"},{"key":"2024090600500530000_2024.09.03.24313003v1.23","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.5.9710086"},{"key":"2024090600500530000_2024.09.03.24313003v1.24","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw075"},{"key":"2024090600500530000_2024.09.03.24313003v1.25","doi-asserted-by":"publisher","DOI":"10.1214\/18-STS646"},{"key":"2024090600500530000_2024.09.03.24313003v1.26","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/1536867X0400400301","article-title":"Multiple Imputation of Missing Values","volume":"4","year":"2004","journal-title":"The Stata Journal"},{"key":"2024090600500530000_2024.09.03.24313003v1.27","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1186\/s13643-018-0915-2","article-title":"The risk of bias in observational studies of exposures (ROBINS-E) tool: concerns arising from application to observational studies of exposures","volume":"7","year":"2018","journal-title":"Systematic Reviews"},{"key":"2024090600500530000_2024.09.03.24313003v1.28","doi-asserted-by":"crossref","unstructured":"Sch\u00fcnemann HJ , Higgins JP , Vist GE , et al. Completing \u2018Summary of findings\u2019 tables and grading the certainty of the evidence. In: Cochrane Handbook for Systematic Reviews of Interventions. John Wiley & Sons, Ltd, 2019: 375\u2013402.","DOI":"10.1002\/9781119536604.ch14"},{"key":"2024090600500530000_2024.09.03.24313003v1.29","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7141"},{"key":"2024090600500530000_2024.09.03.24313003v1.30","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/jrsm.1319","article-title":"Methods to calculate uncertainty in the estimated overall effect size from a random-effects meta-analysis","volume":"10","year":"2019","journal-title":"Res Synth Methods"},{"key":"2024090600500530000_2024.09.03.24313003v1.31","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1164","article-title":"Methods to estimate the between-study variance and its uncertainty in meta-analysis","volume":"7","year":"2016","journal-title":"Res Synth Methods"},{"key":"2024090600500530000_2024.09.03.24313003v1.32","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-017-0630-4"},{"key":"2024090600500530000_2024.09.03.24313003v1.33","first-page":"204","article-title":"What Is an Intracluster Correlation Coefficient?","volume":"2","year":"2004","journal-title":"Crucial Concepts for Primary Care Researchers. Ann Fam Med"},{"key":"2024090600500530000_2024.09.03.24313003v1.34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7142.1455"},{"key":"2024090600500530000_2024.09.03.24313003v1.35","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014508"},{"key":"2024090600500530000_2024.09.03.24313003v1.36","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2019-213808"},{"key":"2024090600500530000_2024.09.03.24313003v1.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.04.003"},{"key":"2024090600500530000_2024.09.03.24313003v1.38","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6782"},{"key":"2024090600500530000_2024.09.03.24313003v1.39","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5732"},{"key":"2024090600500530000_2024.09.03.24313003v1.40","doi-asserted-by":"crossref","first-page":"e0002659","DOI":"10.1371\/journal.pgph.0002659","article-title":"Screening for post-TB lung disease at TB treatment completion: Are symptoms sufficient?","volume":"4","year":"2024","journal-title":"PLOS Global Public Health"},{"key":"2024090600500530000_2024.09.03.24313003v1.41","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m441"},{"key":"2024090600500530000_2024.09.03.24313003v1.42","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/26.1.224"},{"key":"2024090600500530000_2024.09.03.24313003v1.43","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s12916-015-0376-6","article-title":"Feasibility of individual patient data meta-analyses in orthopaedic surgery","volume":"13","year":"2015","journal-title":"BMC Medicine"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2024.09.03.24313003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:11:02Z","timestamp":1768507862000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2024.09.03.24313003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,4]]},"references-count":43,"URL":"https:\/\/doi.org\/10.1101\/2024.09.03.24313003","relation":{},"subject":[],"published":{"date-parts":[[2024,9,4]]},"subtype":"preprint"}}