The effect of bronchoscopic lung volume reduction using endobronchial valves for individuals with emphysematous COPD: a protocol for a systematic review and meta-analysis

Introduction Endobronchial valves (EBVs) are used for targeted lung volume reduction of emphysematous lung tissue. The primary aim of the proposed review is to evaluate the effect of bronchoscopic lung volume reduction using any EBV on functional capacity, health-related quality of life, pulmonary function, and adverse events for individuals with emphysematous COPD. The secondary aim is to perform subgroup analyses comparing the treatment effects between open-label and sham-controlled trials, and between industry and independently funded trials, as well as a sensitivity analysis of risk of bias assessment items.Methods We will search five databases for trials that evaluate the effect of EBV therapy in participants with emphysematous COPD compared to no EBV therapy. We will perform subgroup analyses comparing open-label to sham-controlled trials, and industry to independently funded trials. We will also conduct a sensitivity analysis based on risk of bias assessment items. Selective reporting bias and publication bias will also be explored.Conclusion This protocol outlines a systematic review evaluating EBV therapy that involves robust assessment of risk of bias of the included studies; subgroup analyses based on funding source and use of sham controls; sensitivity analysis of risk of bias items; and thorough assessment of selective outcome reporting.