Summary of findings 2. CCPT versus extrapulmonary mechanical percussion.
| CCPT compared with extrapulmonary mechanical percussion for cystic fibrosis | ||||||
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Patient or population: children and adults with cystic fibrosis Settings: outpatient Intervention: CCPT Comparison: extrapulmonary mechanical percussion | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Extrapulmonary mechanical percussion | CCPT | |||||
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FEV1: rate of decline in FEV1 % predicted Follow‐up: 1.3–2.8 years |
There was no difference in rate of decline in FEV1 % predicted between groups. | Not available | 151 (1) |
⊕⊝⊝⊝ Very lowa,b |
There were no data available to enter into our analysis for the medium‐ or long‐term studies. We reported narratively from the original long‐term paper (Sontag 2010). 2 short‐term studies reported no difference In FEV1 % predicted (MD −2.10, 95% CI −5.49 to 1.29; P = 0.23) (Arens 1994; Bauer 1994). |
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FVC: rate of decline in FVC % predicted. Follow‐up: 1.3–2.8 years |
There was no difference in rate of decline in FVC % predicted between groups. | Not available | 151 (1) |
⊕⊝⊝⊝ Very lowa,b |
There were no data available to enter into our analysis for the medium‐ or long‐term studies. We reported narratively from the original long‐term paper (Sontag 2010). 2 short‐term studies reported no difference in FVC % predicted (MD −3.86, 95% CI −8.05 to 0.33; P = 0.07) (Arens 1994; Bauer 1994). |
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FEF25–75: rate of decline in FEF25–75 Follow‐up: 1.3–2.8 years |
The annual rate of decline in FEF25–75 was greater with HFCC than with CCPT. | Not available | 151 (1) |
⊕⊝⊝⊝ Very lowa,b |
There were no data available to enter into our analysis for the medium‐ or long‐term studies. We reported narratively from the original long‐term paper (Sontag 2010). 2 short‐term studies reported no difference In FEF25–75, MD 0.49 (95% CI −2.53 to 3.52; P = 0.75) (Arens 1994; Bauer 1994). |
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Respiratory exacerbations: time to first treatment with IV antibiotics Follow‐up: 1.3–2.8 years |
There was no difference in time to first IV antibiotics between groups (P = 0.59). | Not available | 151 (1) |
⊕⊝⊝⊝ Very lowa,b |
Results taken directly from the original paper as no results were available in a format that we could enter into our analyses. 2 short‐term studies included in the review reported the number of days in hospital for respiratory exacerbations and showed that there were fewer days in hospital in the extrapulmonary mechanical percussion group (MD 0.90 days, 95% CI 0.69 to 1.10) (Arens 1994; Bauer 1994). |
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QoL: change in CFQ score Follow‐up: 1.3–2.8 years |
There was no difference between groups for any of the 12 HRQoL domain scores. | Not available | 151 (1) |
⊕⊝⊝⊝ Very lowa,b |
Results reported narratively from the original paper (Sontag 2010). | |
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Adherence to therapy and individual preference (change in adherence rate and TSS score) Follow‐up: 1.3–2.8 years |
There was no difference in adherence rate between groups (P = 0.09). TSS scores were lower in the CCPT group (P < 0.05). |
Not available | 131 (1) |
⊕⊝⊝⊝ Very lowa,b |
Results reported narratively from the original paper (Sontag 2010). | |
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Mucus weight Follow‐up: NA |
This outcome was not reported in the medium or long term. | Results of 1 short‐term study showed that sputum production (wet or dry weight) was similar between groups after 24 hours (Arens 1994). | ||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CCPT: conventional chest physiotherapy; CFQ: Cystic Fibrosis Questionnaire; CI: confidence interval; FEF25–75: average forced expiratory flow between 25% and 75% of FVC; FEV1: forced expiratory volume at 1 second; FVC: forced vital capacity; HFCC: high‐frequency chest compression; HRQoL: health‐related quality of life; IV: intravenous; MD: mean difference; NA: not applicable; QoL: quality of life; TSS: Treatment Satisfaction Survey. | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
a Downgraded twice due to risk of bias within the 1 study reporting this outcome. There were particular concerns around incomplete outcome data reporting and withdrawals being biased towards CCPT. b Downgraded once due to imprecision from small numbers of participants from only 1 study.