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AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

Topic Suggestion Description

View Topic Suggestion Disposition (PDF) 127 kB

1. Your Nomination - Please briefly describe in your own words the question about a health care test or treatment that interests or concerns you:

COPD is common and respiratory failure due to COPD is an increasingly common disorder. Use of non-invasive positive pressure ventilation (NPPV) for patients with respiratory failure due to exacerbatons of COPD. Several trials and systematic reviews/meta-analyses indicate that when used in research settings, NPPV early in the course of treatment improves healthcare utilization, mortality, and reduces costs comapred to standard care in which intubation and mechanical ventilation is used as the primary strategy of respiratory support. Whether such benefits accrue in real world settings with typical providers, average patients is less clear. Use of NPPV requires adequate staff and physician training and can lead to complications (e.g., aspiration, delays in appropriate care) Use of NPPV also requires intensive patient monitoring and support, which may not be available in clinical settings.
2. Why do you think your question is important? (you may select more than one category if appropriate)

My question relates to a very common disease or problem

People with this disease or problem have considerable health or financial hardships

There is uncertainty about how well the test, treatment, or intervention works

There is significant potential for side effects/harms using this test, treatment, or intervention

Funding of this test, treatment, or intervention is uncertain or variable

There is unequal access or application of this health care intervention across providers

There is potential for cost savings from better information on this subject

This is a new technology/development

There is new evidence of clinical and/or cost effectiveness for this test, treatment, or intervention


Other, please specify

3. What illness or health condition is related to your question? (You can also specify a particular health-promoting activity, such as breast-feeding)

Respiratory failure from COPD

4. What group(s) or patients does your question apply to?

Adults, particularly older adults with COPD, a group at higher risk of respiratory failure.

5. What is the specific purpose of the health care test or treatment you have a question about? (mark all that you think apply)

Identification of a disease or condition:

Screening or diagnosis/identification for a particular disease, or risk assessment for a disease

Risks or harms that can come from a disease identification tool or test

Diagnostic tests and tools

Diagnosis of co-occurring diseases

Treatment of a particular disease or condition:

Intervention (such as a drug treatment, therapy, device)

Management of a condition or particular system of care

Delivery of a health service


Risks or harms associated with treatment of a disease or condition

Prevention of a particular disease or condition:

Prevention or health promotion

Specific population health concerns, such as ethnic group or gender



Don't know

Other, please specify:

If you aren't certain about which category to select, you may select 'don't know'

6. Does your question include a comparison of different health care approaches?



If yes, please list what you would like to see compared:

Non-invasive vs. invasive positive pressure ventilation.

7. Desired Health Improvements: If you question focuses on:

Identification of a particular disease or condition, what improvements in identification or diagnosis would you like to see?

Treatment of a particular disease or condition, what improvements in patient symptoms or problems would you like to see?

Health care utilization (length of hospital stay, health care costs, number of ventilator-free days, discharge to home rather than to another health care facility) Mortality Patient comfort

8. Harms: Are there risks, side effects, or harms you are concerned about? If yes, please specify what those are:

Aspiration pneumonia Aspiration Facial skin ulceration

9. Based on your answers to the previous questions, what research question(s) would you like to have answered?

What is the comparitive effectiveness of non-invasive vs. invasive positive pressure ventilation in patients with respiratory failure from COPD?

10. Are there health-care focused, disease-focused, or patient-focused organizations that you see as being relevant to this issue? Who do you think we should contact as we consider your nomination?

American Thoracic Society American College of Chest Physicians Society for Critical Care Medicine Insurers

11. Other Information About You (OPTIONAL)
In order to help us understand the context of your health care question, it would be helpful to know more about you. The answers you give will not influence the progress of your suggestion. Thank you.

a. Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

Administrator - hospital or other organization

Continuous quality improvement group

Health benefits plan/Insurance carrier

Health Care industry (device)

Health Care industry (drug)

Health Care industry (other)

Health Care Payer/Purchaser (employer)

Health Care Payer/Purchaser (federal government)

Health Care Payer/Purchaser (state government)



Other Health Care Professional

Patient/consumer (individual)

Patient/consumer (organization)



Professional Society

Public Policymaker


b. Is there any other information about you that is relevant to your question?

c. Are you making a suggestion as an individual or on behalf of an organization?