Sputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysis

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dc.contributor.authorSpies, Ruan
dc.contributor.authorPotter, Matthew
dc.contributor.authorHollamby, Ruan
dc.contributor.authorvan der Walt, Stefan
dc.contributor.authorHohlfeld, Ameer
dc.contributor.authorOchodo, Eleanor
dc.contributor.authorvan Zyl-Smit, Richard N
dc.date.accessioned2021-10-08T14:18:21Z
dc.date.available2021-10-08T14:18:21Z
dc.date.issued2021-07-27
dc.date.updated2021-08-01T03:15:00Z
dc.description.abstractBackground Chronic obstructive pulmonary disease (COPD) is a major cause of years of life lost globally. Acute exacerbations of COPD (AECOPD) drive disease progression, reduce quality of life and are a source of mortality in COPD. Approximately 50% of AECOPD are due to bacterial infections. Diagnosing bacterial infection as the aetiology of AECOPD however remains challenging as investigations are limited by practicality, accuracy and expense. Clinicians have traditionally used sputum colour as a marker of bacterial infection in AECOPD, despite the lack of high-quality evidence for this practice. The aim of this systematic review and meta-analysis is to determine the diagnostic accuracy of sputum colour in the diagnosis of bacterial causes of AECOPD. Methods Articles will be searched for in electronic databases (MEDLINE, Google Scholar Scopus, Web of Science, Africa-Wide, CINAHL and Health Source Nursing Academy) and we will conduct a review of citation indexes and the grey literature. Two reviewers will independently conduct study selection, against pre-defined eligibility criteria, data extraction and quality assessment of included articles using the QUADAS-2 tool. We will perform a meta‐analysis using a bivariate logistic regression model with random effects. We will explore heterogeneity through the visual examination of the forest plots of sensitivities and specificities and through the inclusion of possible sources of heterogeneity as covariates in a meta-regression model if sufficient studies are included in the analysis. We also perform a sensitivity analysis to explore the effect of study quality on our findings. The results of this review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement and will be submitted for peer-review and publication. Discussion The findings of this review will assist clinicians in diagnosing the aetiology of AECOPD and may have important implications for decision making in resource-limited settings, as well as for antimicrobial stewardship. Systematic review registration PROSPERO CRD42019141498en_US
dc.identifier.apacitationSpies, R., Potter, M., Hollamby, R., van der Walt, S., Hohlfeld, A., Ochodo, E., & van Zyl-Smit, R. N. (2021). Sputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysis. <i>Systematic Reviews.</i>, 10(1), 211. http://hdl.handle.net/11427/35135en_ZA
dc.identifier.chicagocitationSpies, Ruan, Matthew Potter, Ruan Hollamby, Stefan van der Walt, Ameer Hohlfeld, Eleanor Ochodo, and Richard N van Zyl-Smit "Sputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysis." <i>Systematic Reviews.</i> 10, 1. (2021): 211. http://hdl.handle.net/11427/35135en_ZA
dc.identifier.citationSpies, R., Potter, M., Hollamby, R., van der Walt, S., Hohlfeld, A., Ochodo, E. & van Zyl-Smit, R.N. 2021. Sputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysis. <i>Systematic Reviews..</i> 10(1):211. http://hdl.handle.net/11427/35135en_ZA
dc.identifier.ris TY - Journal Article AU - Spies, Ruan AU - Potter, Matthew AU - Hollamby, Ruan AU - van der Walt, Stefan AU - Hohlfeld, Ameer AU - Ochodo, Eleanor AU - van Zyl-Smit, Richard N AB - Background Chronic obstructive pulmonary disease (COPD) is a major cause of years of life lost globally. Acute exacerbations of COPD (AECOPD) drive disease progression, reduce quality of life and are a source of mortality in COPD. Approximately 50% of AECOPD are due to bacterial infections. Diagnosing bacterial infection as the aetiology of AECOPD however remains challenging as investigations are limited by practicality, accuracy and expense. Clinicians have traditionally used sputum colour as a marker of bacterial infection in AECOPD, despite the lack of high-quality evidence for this practice. The aim of this systematic review and meta-analysis is to determine the diagnostic accuracy of sputum colour in the diagnosis of bacterial causes of AECOPD. Methods Articles will be searched for in electronic databases (MEDLINE, Google Scholar Scopus, Web of Science, Africa-Wide, CINAHL and Health Source Nursing Academy) and we will conduct a review of citation indexes and the grey literature. Two reviewers will independently conduct study selection, against pre-defined eligibility criteria, data extraction and quality assessment of included articles using the QUADAS-2 tool. We will perform a meta‐analysis using a bivariate logistic regression model with random effects. We will explore heterogeneity through the visual examination of the forest plots of sensitivities and specificities and through the inclusion of possible sources of heterogeneity as covariates in a meta-regression model if sufficient studies are included in the analysis. We also perform a sensitivity analysis to explore the effect of study quality on our findings. The results of this review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement and will be submitted for peer-review and publication. Discussion The findings of this review will assist clinicians in diagnosing the aetiology of AECOPD and may have important implications for decision making in resource-limited settings, as well as for antimicrobial stewardship. Systematic review registration PROSPERO CRD42019141498 DA - 2021-07-27 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Systematic Reviews. KW - COPD KW - Acute exacerbation of COPD KW - Sputum colour KW - Sputum purulence KW - Chronic bronchitis KW - Emphysema LK - https://open.uct.ac.za PY - 2021 T1 - Sputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysis TI - Sputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysis UR - http://hdl.handle.net/11427/35135 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13643-021-01767-6
dc.identifier.urihttp://hdl.handle.net/11427/35135
dc.identifier.vancouvercitationSpies R, Potter M, Hollamby R, van der Walt S, Hohlfeld A, Ochodo E, et al. Sputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysis. Systematic Reviews.. 2021;10(1):211. http://hdl.handle.net/11427/35135.en_ZA
dc.language.rfc3066en
dc.publisher.departmentDepartment of Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceSystematic Reviews.en_US
dc.source.journalissue1en_US
dc.source.journalvolume10en_US
dc.source.pagination211en_US
dc.source.urihttps://systematicreviewsjournal.biomedcentral.com/
dc.subjectCOPDen_US
dc.subjectAcute exacerbation of COPDen_US
dc.subjectSputum colouren_US
dc.subjectSputum purulenceen_US
dc.subjectChronic bronchitisen_US
dc.subjectEmphysemaen_US
dc.titleSputum colour as a marker for bacteria in acute exacerbations of COPD: protocol for a systematic review and meta-analysisen_US
dc.typeJournal Articleen_US
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