Effect of fluticasone propionate/salmeterol plus tiotropium<i>versus</i>tiotropium on walking endurance in COPD
Bibliographic record
Abstract
To the Editor: Exercise intolerance is a hallmark feature of chronic obstructive pulmonary disease (COPD) and is associated with premature mortality [1]. Tiotropium (TIO) is effective in improving cycling exercise tolerance [2, 3] and walking endurance time in COPD [4]; these properties are thought to be associated with reductions in operating lung volume and the perception of dyspnoea during exercise [2, 3, 5]. What is less certain, however, is the extent to which these benefits of TIO on exercise duration can be further improved with the use of additional inhalational therapy. We examined whether the addition of fluticasone propionate/salmeterol combination (FSC) to TIO improved endurance time during the endurance shuttle walking test (ESWT) more than TIO alone in patients with COPD. Our specific objectives were to compare endurance time during the ESWT and evaluate the impact on lung function of TIO alone or in combination with FSC. We hypothesised that the addition of FSC to TIO would improve endurance time during the ESWT compared to TIO alone. This was an 8-week, multicentre, placebo-controlled, double-blind, randomised, parallel group study. Patients received either FSC (Advair/Seretide; GlaxoSmithKline, Research Triangle Park, NC, USA) 250/50 μg administered via DISKUS twice daily plus TIO (Spiriva; Boehringer Ingelheim GmbH and Co.KG, Ingelheim, Germany) 18 μg administered via Handihaler once daily or placebo DISKUS twice daily plus TIO 18 μg once daily. The study was conducted at 24 sites in the USA and Canada between July 19, 2010 and May 2, 2011. Eligible patients were aged ≥40 years and …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".