{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T02:49:55Z","timestamp":1768618195586,"version":"3.49.0"},"reference-count":30,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2017,10,11]]},"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Endobronchial valve placement has potential as a treatment for patients with chronic obstructive pulmonary disease (COPD). However, a robust evidence base will be needed to convince commissioners of healthcare that it is a high-value treatment. We sought to develop the evidence base by performing an individual patient-level analysis of randomised controlled trials in people with heterogeneous emphysema and an absence of collateral ventilation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A literature search (PROSPERO register CRD42016048127) identified two trials meeting these criteria, the BelieVeR-HIFi and STELVIO studies. Anonymised individual patient data were obtained from investigators and analysed. The primary outcome measure was a comparison of change in forced expiratory volume in 1 s (FEV<jats:sub>1<\/jats:sub>) from baseline between the treatment and control groups. Secondary end points were change from baseline in 6\u2009min walk distance (6MWD), Medical Research Council dyspnoea score and St George\u2019s Respiratory Questionnaire (SGRQ).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>114 individuals were treated with 3-month to 6-month follow-up data available for 101 individuals. FEV<jats:sub>1<\/jats:sub> improved by 23.1 (\u00b128.3)% in patients treated with valves with a mean (95%\u2009CI) difference in response between groups of 17.8 (26.5, 9.2)% (p&lt;0.0001). Relative to controls valve placement was associated with a fall in residual volume of 0.64 (0.43, 0.86) L (p&lt;0.0001), a 9.5 (3.5, 15.6) unit fall in SGRQ (p=0.0022) and a 64.2 (94.0, 34.5) m increase in 6MWD. There were three deaths in the treatment arm and the pneumothorax rate was 15%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These data strengthen the evidence that endobronchial valve treatment can produce clinically meaningful improvements in appropriately selected COPD patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2017-000214","type":"journal-article","created":{"date-parts":[[2017,11,2]],"date-time":"2017-11-02T20:13:54Z","timestamp":1509653634000},"page":"e000214","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Endobronchial valves for emphysema: an individual patient-level reanalysis of randomised controlled trials"],"prefix":"10.1136","volume":"4","clinical-trial-number":[{"clinical-trial-number":"isrctn04761234","registry":"10.18810\/isrctn"}],"author":[{"given":"Karin","family":"Klooster","sequence":"first","affiliation":[{"name":"Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk-Jan","family":"Slebos","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaid","family":"Zoumot","sequence":"additional","affiliation":[{"name":"Respiratory and Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Davey","sequence":"additional","affiliation":[{"name":"NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pallav L","family":"Shah","sequence":"additional","affiliation":[{"name":"NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3235-0454","authenticated-orcid":false,"given":"Nicholas S","family":"Hopkinson","sequence":"additional","affiliation":[{"name":"NIHR Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,11,2]]},"reference":[{"key":"2025083109333955000_4.1.e000214.1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-204763"},{"key":"2025083109333955000_4.1.e000214.2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00170111"},{"key":"2025083109333955000_4.1.e000214.3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200407-867OC"},{"key":"2025083109333955000_4.1.e000214.4","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1164\/ajrccm.165.1.2101149","article-title":"Improvement in spirometry following lung volume reduction surgery: application of a physiologic model","volume":"165","author":"Fessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"2025083109333955000_4.1.e000214.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2004.04.003"},{"key":"2025083109333955000_4.1.e000214.6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201103-0455CI"},{"key":"2025083109333955000_4.1.e000214.7","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.14-2-122"},{"key":"2025083109333955000_4.1.e000214.8","doi-asserted-by":"crossref","unstructured":"Greening NJ , Williams JEA , Hussain SF , et al . 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