for the main comparison.
| Singing compared with control for chronic obstructive pulmonary disease (COPD) | ||||||
|
Patient or population: people with stable COPD Settings: hospital and community Intervention: singing Comparison: control | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Singing | |||||
|
Health‐related quality of life (respiratory specific) St George's Respiratory Questionnaire (SGRQ; total score) Scale from 0‐100 Lower value post intervention is favourable, indicating improvement in health‐related quality of life Follow‐up: end of intervention (range 6 to 24 weeks) |
The mean change in SGRQ (total score) ranged across control groups from ‐5.0 to ‐0.4 | The mean change in SGRQ (total score) in the intervention groups was 0.8 units higher (3.0 units lower to 4.7 units higher) | 58 (2 studies) | ⊕⊕⊝⊝ low1,2 | The minimal important difference is 4 units lower | |
|
Health‐related quality of life (generic) SF‐36 (Physical Component Summary (PCS) score) Scale from 0‐100 Higher value post intervention is favourable, indicating improvement in health‐related quality of life Follow‐up: end of intervention (range 6 to 8 weeks) |
The mean change in SF‐36 (PCS score) ranged across control groups from ‐3.8 to ‐2.5 | The mean change in SF‐36 (PCS score) in the intervention groups was 12.6 units higher (5.5 units higher to 19.8 units higher) | 52 (2 studies) | ⊕⊕⊝⊝ low3,4 | The minimal important difference is 4 units higher | |
|
Health‐related quality of life (generic) SF‐36 (Mental Component Sumary (MCS) score) Scale from 0‐100 Higher value post intervention is favourable, indicating improvement in health‐related quality of life Follow‐up: end of intervention (range 6‐8 weeks) |
The mean change in SF‐36 (MCS score) ranged across control groups from ‐3.2 to 4.3 | The mean change in SF‐36 (MCS score) in the intervention groups was 5.4 units higher (3.9 units lower to 14.7 units higher) | 52 (2 studies) | ⊕⊕⊝⊝ low2,4 | The minimal important difference is 4 units higher | |
|
Dyspnoea Basal Dyspnea Index (BDI) (score) Scale from 0‐12 Higher value post intervention is favourable, indicating improvement in dyspnoea Follow‐up: end of intervention (24 weeks) |
The mean change in BDI (score) was 0.3 | The mean change in BDI (score) in the intervention groups was 0.4 units higher (0.7 units lower to 1.5 units higher) | 30 (1 study) | ⊕⊝⊝⊝ very low5,6 | The minimal important difference is 1 unit higher | |
| *The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 One study showed limitations in design: selection and detection bias unknown (risk of bias ‐1)
2 Meta‐anlaysis was limited to few studies with small sample sizes and wide confidence intervals (imprecision ‐1)
3 Meta‐analysis was limited to few studies with small sample sizes (imprecision ‐1)
4 One study showed reporting bias (risk of bias ‐1)
5 Study showed limitations in design: selection and detection bias unknown (risk of bias ‐1)
6 No meta‐analysis as only one study (imprecision ‐2)