Relationship between exercise endurance and static hyperinflation in a post hoc analysis of two clinical trials in patients with COPD
Bibliographic record
Abstract
Background: Lung hyperinflation and exercise intolerance are hallmarks of chronic obstructive pulmonary disease (COPD). However, their relationship remains uncertain. A combined analysis of two placebo-controlled, randomized studies examined the effects of the long-acting muscarinic antagonist umeclidinium (Umec) and long-acting β 2 -agonist vilanterol (Vi) separately and in combination on static hyperinflation, exercise endurance time (EET), and their relationship in patients with COPD. Methods: Patients with moderate-to-severe stable COPD and resting functional residual capacity >120% predicted were randomized to Umec/Vi 62.5/25 µg, Umec 62.5 µg, Vi 25 µg, or placebo for 12 weeks. Inspiratory capacity (IC), residual volume (RV), total lung capacity (TLC), and EET in an endurance shuttle-walk test were measured. In this post hoc analysis, IC/TLC, RV/TLC, and IC were used as hyperinflation markers. Results: After 12 weeks, Umec/Vi and Umec and Vi showed significant improvements in hyperinflation versus placebo when measured by absolute change from baseline in IC/TLC (trough and 3 hours postdose [ P ≤0.011]). Umec/Vi showed significant improvements versus Umec and Vi in absolute changes in IC/TLC (trough and 3 hours postdose [ P ≤0.001]). Statistical significance for comparisons with placebo and between treatments for absolute changes in IC and percentage changes in RV/TLC followed similar patterns to those for absolute changes in IC/TLC. Umec/Vi showed significant improvements in EET versus placebo at day 2 and week 12, measured as change from baseline in seconds ( P ≤0.002) and as a percentage from baseline ( P ≤0.005). There was a lack of evidence to suggest a correlation between improvements in static hyperinflation and EET at any time point. Conclusion: Although the dual bronchodilator Umec/Vi demonstrated greater improvements in static hyperinflation markers than Umec or Vi and significant improvements in exercise endurance, no direct relationship was observed between static hyperinflation and exercise endurance. Keywords: bronchodilators, COPD, exercise, hyperinflation
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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 | 0.020 | 0.025 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.011 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".