Domiciliary oxygen for chronic obstructive pulmonary disease

Josephine M Cranston; Alan Crockett; John Moss; John H Alpers

doi:10.1002/14651858.CD001744.pub2

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Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Analysis 1.1

Comparison 1 Continuous oxygen therapy versus nocturnal oxygen therapy, Outcome 1 Mortality.

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Analysis 2.1

Comparison 2 Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia, Outcome 1 Mortality at 60 months.

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Analysis 2.2

Comparison 2 Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia, Outcome 2 Change in weight.

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Analysis 2.3

Comparison 2 Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia, Outcome 3 Change in FEV1.

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Analysis 2.4

Comparison 2 Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia, Outcome 4 Change in FVC.

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Analysis 2.5

Comparison 2 Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia, Outcome 5 Change in PaO2.

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Analysis 2.6

Comparison 2 Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia, Outcome 6 Change in PaCO2.

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Analysis 2.7

Comparison 2 Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia, Outcome 7 Change in packed cell volume.

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Analysis 3.27

Comparison 3 Nocturnal oxygen therapy versus room air with mild to moderate hypoxaemia; change from baseline, Outcome 27 Mortality at 36 months for Fletcher and mortality for Chaouat (mean follow‐up 35.6 months).

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Analysis 4.1

Comparison 4 Long term oxygen therapy versus no oxygen therapy in mild to moderate hypoxaemia, Outcome 1 Mortality (maximum follow‐up 85 months for the Gorecka study and 36 months for the Haidl study).

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Analysis 4.2

Comparison 4 Long term oxygen therapy versus no oxygen therapy in mild to moderate hypoxaemia, Outcome 2 Mortality between oxygen >15hrs per day and <15hrs per day.

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Analysis 4.3

Comparison 4 Long term oxygen therapy versus no oxygen therapy in mild to moderate hypoxaemia, Outcome 3 End exercise dyspnoea score.

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Analysis 4.4

Comparison 4 Long term oxygen therapy versus no oxygen therapy in mild to moderate hypoxaemia, Outcome 4 Endurance time.

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Comparison 1. Continuous oxygen therapy versus nocturnal oxygen therapy

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality Show forest plot	1		Peto Odds Ratio (Peto, Fixed, 95% CI)	Subtotals only

1.1 at 12 months	1	203	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.53 [0.25, 1.11]
1.2 at 24 months	1	203	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.45 [0.25, 0.81]
2 Change in right atrial pressure	0		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
2.1 Rest	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Legs up	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Exercise	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Change in pulmonary artery pressure	0		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
3.1 Rest	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Legs up	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 Exercise	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Change in pulmonary wedge pressure	0		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
4.1 Rest	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Legs up	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 Exercise	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Change in cardiac index	0		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
5.1 Rest	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Exercise	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Change in stroke volume index	0		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
6.1 Rest	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Exercise	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Change in pulmonary vascular resistance	0		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
7.1 Rest	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Exercise	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Change in right ventricular stroke work index	0		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
8.1 Rest	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Exercise	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. Continuous oxygen therapy versus nocturnal oxygen therapy

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Comparison 2. Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality at 60 months Show forest plot	1	87	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.42 [0.18, 0.98]

2 Change in weight Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

2.1 Dying between 180 and 500 days	1	22	Mean Difference (IV, Fixed, 95% CI)	‐3.36 [‐8.01, 1.29]
2.2 Survivng over 500 days	1	39	Mean Difference (IV, Fixed, 95% CI)	1.08 [‐0.54, 2.70]
3 Change in FEV1 Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

3.1 Dying between 180 and 500 days	1	21	Mean Difference (IV, Fixed, 95% CI)	‐0.11 [‐0.27, 0.05]
3.2 Surviving over 500 days	1	40	Mean Difference (IV, Fixed, 95% CI)	0.08 [0.04, 0.12]
4 Change in FVC Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

4.1 Dying between 180 and 500 days	1	21	Mean Difference (IV, Fixed, 95% CI)	0.56 [0.12, 1.00]
4.2 Survivng over 500 days	1	40	Mean Difference (IV, Fixed, 95% CI)	0.05 [‐0.89, 0.99]
5 Change in PaO2 Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

5.1 Dying between 180 and 500 days	1	19	Mean Difference (IV, Fixed, 95% CI)	4.56 [‐1.04, 10.16]
5.2 Surviving 500 days	1	40	Mean Difference (IV, Fixed, 95% CI)	1.07 [‐1.24, 3.38]
6 Change in PaCO2 Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

6.1 Dying between 180 and 500 days	1	19	Mean Difference (IV, Fixed, 95% CI)	‐0.96 [‐8.53, 6.61]
6.2 Surviving over 500 days	1	39	Mean Difference (IV, Fixed, 95% CI)	‐2.16 [‐4.04, ‐0.28]
7 Change in packed cell volume Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

7.1 Dying between 180 and 500 days	1	20	Mean Difference (IV, Fixed, 95% CI)	1.32 [‐6.22, 8.86]
7.2 Surviving over 500 days	1	40	Mean Difference (IV, Fixed, 95% CI)	‐0.44 [‐1.52, 0.64]

Comparison 2. Long‐term oxygen therapy versus no oxygen therapy in severe hypoxaemia

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Comparison 3. Nocturnal oxygen therapy versus room air with mild to moderate hypoxaemia; change from baseline

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
27 Mortality at 36 months for Fletcher and mortality for Chaouat (mean follow‐up 35.6 months) Show forest plot	2	114	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.97 [0.41, 2.31]

Comparison 3. Nocturnal oxygen therapy versus room air with mild to moderate hypoxaemia; change from baseline

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Comparison 4. Long term oxygen therapy versus no oxygen therapy in mild to moderate hypoxaemia

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Mortality (maximum follow‐up 85 months for the Gorecka study and 36 months for the Haidl study) Show forest plot	2	163	Peto Odds Ratio (Peto, Fixed, 95% CI)	1.39 [0.74, 2.59]

2 Mortality between oxygen >15hrs per day and <15hrs per day Show forest plot	1	68	Peto Odds Ratio (Peto, Fixed, 95% CI)	1.67 [0.62, 4.47]

3 End exercise dyspnoea score Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐1.20 [‐2.47, 0.07]

4 Endurance time Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	2.20 [‐0.73, 5.13]

Comparison 4. Long term oxygen therapy versus no oxygen therapy in mild to moderate hypoxaemia

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