Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial

Introduction Airway clearance techniques (ACTs) are a gold standard of cystic fibrosis management; however, the majority of research evidence for their efficacy is of low standard; often attributed to the lack of sensitivity from outcome measures (OMs) used historically. This randomised controlled t...

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Main Authors: Gemma Stanford, Diana Bilton, Winston Banya, Jane C Davies, Omar Usmani, Susan Charman, Mandy Jones, Nicholas J Simmonds
Format: Article
Language:English
Published: BMJ Publishing Group 2020-09-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/7/1/e000694.full
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author Gemma Stanford
Diana Bilton
Winston Banya
Jane C Davies
Omar Usmani
Susan Charman
Mandy Jones
Nicholas J Simmonds
author_facet Gemma Stanford
Diana Bilton
Winston Banya
Jane C Davies
Omar Usmani
Susan Charman
Mandy Jones
Nicholas J Simmonds
author_sort Gemma Stanford
collection DOAJ
description Introduction Airway clearance techniques (ACTs) are a gold standard of cystic fibrosis management; however, the majority of research evidence for their efficacy is of low standard; often attributed to the lack of sensitivity from outcome measures (OMs) used historically. This randomised controlled trial (RCT) investigates these standard OMs (sputum weight, forced expiratory volume in 1 s) and new OMs (electrical impedance tomography (EIT), multiple breath washout (MBW) and impulse oscillometry (IOS)) to determine the most useful measures of ACT.Methods and analysis This is a single-centre RCT with crossover design. Participants perform MBW, IOS and spirometry, and then are randomised to either rest or supervised ACT lasting 30–60 min. MBW, IOS and spirometry are repeated immediately afterwards. EIT and sputum are collected during rest/ACT. On a separate day, the OMs are performed with the other intervention. Primary endpoint is difference in change in OMs before and after ACT/rest. Sample size was calculated with 80% power and significance of 5% for each OM (target n=64).Ethics and dissemination Ethics approval was gained from the London–Chelsea Research Ethics Committee (reference 16/LO/0995, project ID 154635). Dissemination will involve scientific conference presentation and publication in a peer-reviewed journal.Trial registration numbers ISRCTN11220163 and NCT02721498.
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spelling doaj-art-1f94608e33704f8f9d5f4f12b03577652024-11-24T07:00:11ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392020-09-017110.1136/bmjresp-2020-000694Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trialGemma Stanford0Diana Bilton1Winston Banya2Jane C Davies3Omar Usmani4Susan Charman5Mandy Jones6Nicholas J Simmonds7Adult Cystic Fibrosis, Royal Brompton Hospital, London, UKRespiratory Medicine, Royal Brompton Hospital, London, UKResearch and Development, Royal Brompton Hospital, London, UK1 Royal Brompton Hospital, London, UKNational Heart and Lung Institute, Imperial College London, London, UKCystic Fibrosis Trust, London, UKBrunel University London, London, UKAdult Cystic Fibrosis, Royal Brompton Hospital, London, UKIntroduction Airway clearance techniques (ACTs) are a gold standard of cystic fibrosis management; however, the majority of research evidence for their efficacy is of low standard; often attributed to the lack of sensitivity from outcome measures (OMs) used historically. This randomised controlled trial (RCT) investigates these standard OMs (sputum weight, forced expiratory volume in 1 s) and new OMs (electrical impedance tomography (EIT), multiple breath washout (MBW) and impulse oscillometry (IOS)) to determine the most useful measures of ACT.Methods and analysis This is a single-centre RCT with crossover design. Participants perform MBW, IOS and spirometry, and then are randomised to either rest or supervised ACT lasting 30–60 min. MBW, IOS and spirometry are repeated immediately afterwards. EIT and sputum are collected during rest/ACT. On a separate day, the OMs are performed with the other intervention. Primary endpoint is difference in change in OMs before and after ACT/rest. Sample size was calculated with 80% power and significance of 5% for each OM (target n=64).Ethics and dissemination Ethics approval was gained from the London–Chelsea Research Ethics Committee (reference 16/LO/0995, project ID 154635). Dissemination will involve scientific conference presentation and publication in a peer-reviewed journal.Trial registration numbers ISRCTN11220163 and NCT02721498.https://bmjopenrespres.bmj.com/content/7/1/e000694.full
spellingShingle Gemma Stanford
Diana Bilton
Winston Banya
Jane C Davies
Omar Usmani
Susan Charman
Mandy Jones
Nicholas J Simmonds
Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial
BMJ Open Respiratory Research
title Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial
title_full Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial
title_fullStr Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial
title_full_unstemmed Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial
title_short Investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis: protocol of a single-centre randomised controlled crossover trial
title_sort investigating outcome measures for assessing airway clearance techniques in adults with cystic fibrosis protocol of a single centre randomised controlled crossover trial
url https://bmjopenrespres.bmj.com/content/7/1/e000694.full
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