Chemical pleurodesis versus surgical intervention for persistent and recurrent pneumothoraces in cystic fibrosis
Bibliographic record
Abstract
BACKGROUND: Pneumothorax is a potentially life-threatening complication for people with cystic fibrosis. Spontaneous pneumothorax is the presence of air in the pleural space and can be subdivided into first episode and recurrent. The recurrence of pneumothorax is when it occurs on the same side seven days or more after initial resolution. A pneumothorax is persistent if the air leak lasts for more than five days (Schidlow 1993). Managing spontaneous pneumothoraces is controversial and there is no standard treatment. Medical and surgical intervention are the two main categories for the treatment of recurrent pneumothoraces in people with cystic fibrosis. While surgical interventions are felt to be more effective in people without cystic fibrosis, the complications directly related to the procedure, as well as the post-operative complications make surgical interventions riskier for people with cystic fibrosis. Additionally, these interventions have the potential to make people with cystic fibrosis ineligible for lung transplantation in the future. Therefore, the benefits and side effects or disadvantages for the medical and surgical treatment of recurrent pneumothoraces in people with cystic fibrosis need to be systematically reviewed. OBJECTIVES: To determine the clinical efficacy and safety of different treatment interventions for managing spontaneous persistent and recurrent pneumothoraces in people with cystic fibrosis. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings.Date of the most recent search: 19 August 2008. SELECTION CRITERIA: Randomised and quasi-randomised controlled trials which compared the use of chemical pleurodesis to surgical interventions for the treatment of persistent and recurrent pneumothoraces in CF. DATA COLLECTION AND ANALYSIS: No relevant trials were identified. MAIN RESULTS: No trials were included in this review AUTHORS' CONCLUSIONS: Pneumothorax is a potentially life-threatening complication for people with cystic fibrosis and the management of spontaneous pneumothoraces remains a topic of considerable controversy. Medical and surgical intervention are the two main categories for the treatment of recurrent pneumothoraces in this population. However, it is disappointing that neither intervention has been assessed by randomised controlled trials. This systematic review identifies the need for a multicentre randomised controlled trial assessing both efficacy and possible adverse effects of the use of chemical pleurodesis versus surgical interventions for the treatment of persistent and recurrent pneumothoraces in people with cystic fibrosis.
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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 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.012 | 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".