Sara Souto-Miranda

Introduction: Physiotherapy has been proven to be highly cost‐effective in managing some health conditions, reducing the demand for surgery, pharmacological treatment, hospitalisations, and long‐term care. Several organisations and policymakers have already acknowledged that physiotherapy is essential in any health care system, but services need improvement. However, improving physiotherapy services requires efficient collection of real‐world data and more in‐depth data management. Electronic Health Records (EHRs) have proven to be reliable in managing data in various health care service settings, yet there continues to be little investment in these platforms, especially in physiotherapy. This scoping review aims to map the evidence on the multiple uses of EHRs in physiotherapy, to better understand their applicability in this field. Methodology: This protocol will follow the Joanna Briggs Institute methodological guidelines for scoping reviews. Original studies and grey literature from 2010 onwards, written in English, Portuguese, or Spanish, concerning the characteristics, development, implementation process, and outcomes of Physiotherapy registry platforms will be included. Search will be conducted on four electronic databases (PubMed, Scopus, Science Direct, and Web of Science). Two independent reviewers will assess and select the articles. Data extracted will include information regarding EHRs main characteristics (e.g., types of users, type of data collected, functions, context), development and implementation processes, and outcomes of registry platforms, in all fields of physiotherapy. The information will be registered, aggregated by categories, and displayed in tables and charts mapping the distribution of studies alongside a narrative summary. Discussion: The proposed scoping review will synthesise key knowledge to provide significant literature‐based insights into the steps, strategies, and procedures necessary for developing and implementing physiotherapy EHRs.

Background: Patients’ goal attainment has been defined as a core outcome to be measured in pulmonary rehabilitation (PR) of COPD patients. However, it is unknown which measurement instrument is more suitable to assess patients’ goals before and after PR. Methods: A systematic review was conducted in 2 steps following the COnsensus-based Standards for the selection of health Measurement INstruments: 1) identification of all patient-reported outcome measures (PROMs) used to assess goal attainment in COPD patients after any intervention; 2) a review of the psychometric properties of the identified PROMs. Pubmed, Science Direct and Scopus databases were searched using the PICO strategy and a PubMed search filter designed for identifying studies on measurement properties. Exclusion criteria comprised qualitative studies and unpublished work. Record screening was performed by SS-M and GR. Results: 374 records were retrieved in Step 1 and after duplicate removal and full-text screening, one article was retrieved. The Goal Attainment Scaling (GAS) was identified as a measure for assessing patient goal attainment after a pharmacological intervention. Step 2 of the systematic review retrieved no studies on psychometric properties of the GAS. Conclusion: Patient goal attainment should be measured before and after PR to ensure the delivery of a patient-centered intervention. However, PROMs have been rarely developed or studied for this purpose. Future studies should evaluate the psychometric properties of GAS for its use in the context of PR, or develop a new instrument, if needed.

Introduction There is high heterogeneity of outcomes and measures reported in pulmonary rehabilitation (PR) trials of people with chronic obstructive pulmonary disease (COPD). This hinders study comparability and benchmarking of PR. We have developed a core outcome set (COS) to overcome these challenges. Methods This study was informed by a systematic review and two qualitative studies and had patient involvement since its inception. A two-round Delphi survey was available in seven languages. Outcomes (n=63) scored 7–9 (crucial) by ≥70% of the participants and 1–3 (not that important) by ≤15% of participants from both groups in the Likert scale were automatically included in the COS, while outcomes that were considered crucial by only one of the groups were further discussed by the authors in a meeting. Results A total of 299 people (n=229 healthcare professionals/researchers/policy-makers; n=70 people with COPD and informal caregivers) participated in the survey (83% retention), which covered 29 countries/five continents. After the second round, six outcomes were included and three were added in the meeting. The final COS contains dyspnoea, fatigue, functional exercise capacity, health-related quality of life, health behaviours/lifestyle, knowledge about the disease, lower limb muscle function, personal goals and problematic activities of daily living. Conclusion A COS for PR of people with COPD is now available and can be used by different stakeholders to improve consistency and comparability of studies, benchmark PR and improve the quality of care provided. Future research should establish the core measures and investigate the uptake of this COS.

There is high heterogeneity of outcomes and measures reported in pulmonary rehabilitation (PR) trials of people with COPD, which hinders study comparability and benchmarking of PR. We developed a core outcome set (COS) in an attempt to overcome these challenges. This study was informed by a systematic review and 2 qualitative studies. Outcomes (n=63) were scored in a 2-round modified Delphi survey responded by 2 groups - G1: people with COPD and informal carers and G2: healthcare professionals, researchers, and policy makers. A 9-point Likert scale was used. Outcomes scored 7-9 (crucial) by ≥70% and 1-3 (not that important) by ≤15% of participants from both groups were included in the COS, whilst outcomes that were considered crucial only by one group were further voted in a consensus meeting. 299 people (G1: n=229; G2: n=70) participated in the survey (83% retention), which covered 29 countries/5 continents. After the second round, 6 outcomes were included and 3 were added in the consensus meeting. The final COS contains dyspnoea, exercise capacity, fatigue, health-related quality of life, health behaviours/lifestyle, knowledge about the disease, lower limb muscle function, personal goals, and problematic activities of daily living (Fig.1). This COS can now be used by different stakeholders. Future research should establish the core measures and investigate the uptake of this COS.

It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of the laboratory-based science, clinical trials and qualitative research that were presented during the 2022 European Respiratory Society International Congress within the sessions from the five groups of Assembly 1 (Respiratory Clinical Care and Physiology). Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, mobile/electronic health (m-health/e-health), clinical respiratory physiology, exercise and functional imaging.