“I have to breathe”: A Mixed-Methods Pilot Study to Assess the Feasibility, Acceptability, Cost, and Effectiveness of an Intervention for Post-Tuberculosis Lung Disease
Bibliographic record
Abstract
BACKGROUND: Many tuberculosis patients who are successfully treated according to microbiologic endpoints experience sequelae that adversely affect quality of life and increase mortality. Prior research in Peru revealed an important burden of respiratory symptoms after successful treatment of tuberculosis. We present a pilot intervention of 8 weeks of pulmonary rehabilitation and inhaled pharmacotherapy for people with respiratory symptoms after successful tuberculosis treatment. We examine the feasibility, acceptability, and cost of the intervention. METHODOLOGY: This was a mixed methods study conducted in Lima, Peru. We recruited adults with respiratory symptoms within three months of successful completion of tuberculosis treatment. At baseline, we recorded demographic characteristics, vital signs, medical history, and chest X-ray findings. At baseline and end of study, we evaluated respiratory symptoms, quality of life, lung function, fitness, strength, and fatigue. RESULTS: We enrolled 40 participants. Spirometry-defined COPD was detected in 3 (7.5%). In 10 (25%) and 9 (22.5%) participants, FEV1 and FVC, respectively, was below age-, sex-, height- standardized lower limits of normal. Participants completed 11 (IQR: 5,15) of 16 pulmonary rehabilitation sessions. Participants generally appreciated the virtual intervention and associated flexibility; for some this was inadequate to guarantee completion. Differences in lung function were not apparent while improvement in quality-of-life was detected after intervention. Some providers normalized post-TB symptoms. Feasibility findings included that limited guidance and facilities for post-TB lung disease should not preclude its implementation. CONCLUSIONS: A brief pulmonary rehabilitation intervention was feasible and acceptable for people with respiratory symptoms following successful TB treatment in Peru. There is some evidence for improved symptomatology. With an estimated 155 million TB survivors, the potential impact of improved interventions is enormous.
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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 | 0.015 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".