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Centre for Evidence-
Based Medicine

Systematic Reviews: Clinical Scenario

Mary Ann O'Brien Email: maobrien@fhs.mcmaster.ca

You receive a referral for a 65-year-old woman with a diagnosis of chronic obstructive pulmonary disease (COPD). She tells you that her main problems are breathlessness, fatigue, and general weakness. She feels her quality of life has been getting worse because she is too tired to leave the house and visit friends and family. A friend has been to an in-patient exercise program in the hospital and she wonders if this type of program would help her. Together you formulate a question: "In a patient with chronic obstructive pulmonary disease, does an in-patient pulmonary rehabilitation program improve strength, endurance, and quality of life?"

You search MEDLINE using the terms 'pulmonary rehabilitation' and 'chronic obstructive airways disease' and find a promising systematic review.

Lacasse Y, Wong E, Guyatt GH, King D, Cook DJ, Goldstein RS. Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. Lancet 1996;348:1115-9.

Read the article and decide:

  1. Is the evidence from this systematic review valid?
  2. Is this valid evidence from this systematic review important?
  3. Can you apply this valid and important evidence from this systematic review in caring for your patient?

Continue to completed worksheet