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Paediatr Respir Rev. 2013 May;14 Suppl 1:10-2. doi: 10.1016/j.prrv.2013.01.008. Epub 2013 Mar 26.

What is the best airway clearance technique in cystic fibrosis?

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Portex Department, 6th Floor, Cardiac Wing, Institute of Child Health, University College London, 30 Guilford Street, London WCIN 1EH.


The global development of airway clearance techniques (ACTs) for cystic fibrosis (CF) and corresponding research spans over four decades. Five Cochrane reviews synthesising the evidence from a plethora of early short and medium term studies have not uncovered any superior method. Four recent long term RCT studies exposed fundamental shortcomings in the standard RCT trial design and the insensitivity of FEV1 in physiotherapy studies. Strong patient preference, lack of blinding and the requirement for effortful and demanding participation over long intervals will continue to derail efforts to find the best ACT for CF, unless they are addressed in future clinical trials.

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