Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a guideline (underpinned by a systematic review) that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes. However this is uncertain and new evidence could change this in the future.
Population: Adults with chronic lung disease (ILD or COPD) ᵃ who have severe chronic resting room air hypoxaemia
Intervention: Long-term oxygen therapy (LTOT)
Comparison: No LTOT
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
LTOT (not further defined) versus room air in people with ILD | ||
Mortality: at 12, 24 and 36 months ᵇ | No statistically significant difference | Very Low |
LTOT prescribed for at least 15 hours/day versus no LTOT in people with COPD | ||
5-year mortality risk | Favours intervention | Moderate |
Hospitalisations over 3 years | Favours intervention | Low |
Recommendations as stated in the source guideline The guideline panel recommends that for adults with ILD who have severe chronic resting room air hypoxaemia, LTOT is prescribed for at least 15 hours per day (Strong recommendation, very low quality evidence).
Note The overall evidence rating for this table reflects that the evidence for effectiveness comes from an indirect population of people with COPD. Included in this table is randomised controlled trial (RCT) evidence comparing LTOT with no LTOT. For people with COPD the guideline also included two non-randomised studies and one RCT that compared LTOT prescribed for 24 hours a day with nocturnal LTOT. See guideline for more details. ᵃ The guideline panel noted that there were no published studies that met their inclusion criteria for people with ILD. They found one unpublished randomised controlled trial (62 people; 49 with Idiopathic Pulmonary Fibrosis) which did report on outcomes of interest. Due to the lack of published evidence answering this question, the guideline panel chose to consider indirect evidence from trials of people with Chronic Obstructive Pulmonary Disease (COPD), along with their clinical experience, other published guidelines and ethical issues around withholding LTOT, when making the above recommendation for people with ILD. Please see the guideline for more details. ᵇ Defined as a critical outcome by the guideline panel; no evidence was found for the important outcomes of dyspnea, fatigue, HRQL, physical activity in daily life, healthcare resource use, exercise capacity, and safety.
This evidence table is related to the following section/s:
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