Intended for healthcare professionals


Stable chronic obstructive pulmonary disease

BMJ 2000; 320 doi: (Published 29 January 2000) Cite this as: BMJ 2000;320:312

Incomplete evidence based reviews may condemn by omission

  1. M C Steiner, research fellow (,
  2. S Singh, director of rehabilitation,
  3. M D L Morgan, consultant physician
  1. Glenfield Hospital, Leicester LE3 9QP
  2. Department of Medicine, University of Auckland, Auckland, New Zealand
  3. Department of Pulmonary Diseases, University Hospital Groningen, PO Box 30 001, 9700 RB Groningen, Netherlands

    EDITOR—The review by Kerstjens published in the BMJ on behalf of Clinical Evidenceclaims to be an evidence based account of treatment for stable chronic obstructive pulmonary disease.1 Unfortunately, the author restricted his analysis to drug treatments and therefore omitted non-pharmacological treatments, which may be of great benefit to patients with the disease.

    In particular, pulmonary rehabilitation provides benefits to patients in terms of exercise capacity and quality of life, outcomes that were clearly included in the aims of the review. The benefits of pulmonary rehabilitation have been validated in well designed and executed randomised controlled trials.2 3 Indeed,the clinical efficacy of rehabilitation is greater than that of many drug treatments.4 Evidence based guidelines for pulmonary rehabilitation have been published.5

    Provision of pulmonary rehabilitation in the United Kingdom …

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