Publications
24 results found
Kelly JL, Ben Messaoud R, Joyeux-Faure M, et al., 2022, Diagnosis of sleep apnoea using a mandibular monitor and machine learning analysis: one-night agreement compared to in-home polysomnography, Frontiers in Neuroscience, Vol: 16, Pages: 1-10, ISSN: 1662-453X
Background: The capacity to diagnose obstructive sleep apnoea (OSA) must be expanded to meet an estimated disease burden of nearly one billion people worldwide. Validated alternatives to the gold standard polysomnography (PSG) will improve access to testing and treatment. This study aimed to evaluate the diagnosis of OSA, using measurements of mandibular movement (MM) combined with automated machine learning analysis, compared to in-home PSG.Methods: 40 suspected OSA patients underwent single overnight in-home sleep testing with PSG (Nox A1, ResMed, Australia) and simultaneous MM monitoring (Sunrise, Sunrise SA, Belgium). PSG recordings were manually analysed by two expert sleep centres (Grenoble and London); MM analysis was automated. The Obstructive Respiratory Disturbance Index calculated from the MM monitoring (MM-ORDI) was compared to the PSG (PSG-ORDI) using intraclass correlation coefficient and Bland-Altman analysis. Receiver operating characteristic curves (ROC) were constructed to optimise the diagnostic performance of the MM monitor at different PSG-ORDI thresholds (5, 15, and 30 events/hour).Results: 31 patients were included in the analysis (58% men; mean (SD) age: 48 (15) years; BMI: 30.4 (7.6) kg/m2). Good agreement was observed between MM-ORDI and PSG-ORDI (median bias 0.00; 95% CI −23.25 to + 9.73 events/hour). However, for 15 patients with no or mild OSA, MM monitoring overestimated disease severity (PSG-ORDI < 5: MM-ORDI mean overestimation + 5.58 (95% CI + 2.03 to + 7.46) events/hour; PSG-ORDI > 5–15: MM-ORDI overestimation + 3.70 (95% CI −0.53 to + 18.32) events/hour). In 16 patients with moderate-severe OSA (n = 9 with PSG-ORDI 15–30 events/h and n = 7 with a PSG-ORD > 30 events/h), there was an underestimation (PSG-ORDI > 15: MM-ORDI underestimation −8.70 (95% CI −28.46 to + 4.01) events/hour). ROC optimal cut-off values for PSG-ORDI thresholds of 5, 15, 30 events/hour were: 9.53, 12.65 and 24.81
Wimms AJ, Kelly JL, Turnbull CD, et al., 2020, Continuous positive airway pressure versus standard care for the treatment of people with mild obstructive sleep apnoea (MERGE): a multicentre, randomised controlled trial, The Lancet Respiratory Medicine, Vol: 8, Pages: 349-358, ISSN: 2213-2600
BACKGROUND: The evidence base for the treatment of mild obstructive sleep apnoea is limited and definitions of disease severity vary. The MERGE trial investigated the clinical effectiveness of continuous positive airway pressure in patients with mild obstructive sleep apnoea. METHODS: MERGE, a multicentre, parallel, randomised controlled trial enrolled patients (≥18 years to ≤80 years) with mild obstructive sleep apnoea (apnoea-hypopnoea index [AHI] ≥5 to ≤15 events per h using either AASM 2007 or AASM 2012 scoring criteria) from 11 UK sleep centres. Participants were assigned (1:1) to either 3 months of continuous positive airway pressure plus standard care (sleep counselling), or standard care alone, by computer-generated randomisation; neither participants nor researchers were blinded. The primary outcome was a change in the score on the Short Form-36 questionnaire vitality scale in the intention-to-treat population of patients with mild obstructive sleep apnoea diagnosed using the American Academy of Sleep Medicine 2012 scoring criteria. The study is registered with ClinicalTrials.gov, NCT02699463. FINDINGS: Between Nov 28, 2016 and Feb 12, 2019, 301 patients were recruited and randomised. 233 had mild obstructive sleep apnoea using AASM 2012 criteria and were included in the intention-to-treat analysis: 115 were allocated to receive continuous positive airway pressure and 118 to receive standard care. 209 (90%) of these participants completed the trial. The vitality score significantly increased with a treatment effect of a mean of 10·0 points (95% CI 7·2-12·8; p<0·0001) after 3 months of continuous positive airway pressure, compared with standard care alone (9·2 points [6·8 to 11·6] vs -0·8 points [-3·2 to 1·5]). Using the ANCOVA last-observation-carried-forward analysis, a more conservative estimate, the vitality score also significantly increased with a treatment effect of a
Wimms A, Kelly JL, Calverley PM, et al., 2019, The MERGE Study: The Effect of Continuous Positive Airway Pressure on Energy and Vitality in Patients with Mild Obstructive Sleep Apnea, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Hopkinson NS, tanner, 2017, Redefining cut-points for high symptom burden of the global initiative for chronic obstructive lung disease classification in 18,577 patients with chronic obstructive pulmonary disease, Journal of the American Medical Directors Association (JAMDA): long-term care: management, applied research and clinical issues, Vol: 18, Pages: 1097.e11-1097.e24, ISSN: 1525-8610
BackgroundPatients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting cut-points for Global initiative for chronic Obstructive Lung Disease (GOLD) symptom measures, with an modified Medical Research Council dyspnea grade of 2 or higher as point of reference.MethodsAfter a computerized search, data from 41 cohorts and whose authors agreed to provide data were pooled. COPD studies were eligible for analyses if they included, at least age, sex, postbronchodilator spirometry, modified Medical Research Council, and COPD Assessment Test (CAT) total scores.Main outcomesReceiver operating characteristic curves and the Youden index were used to determine the best calibration threshold for CAT, COPD Clinical Questionnaire, and St. Georges Respiratory Questionnaire total scores. Following, GOLD A/B/C/D frequencies were calculated based on current cut-points and the newly derived cut-points.FindingsA total of 18,577 patients with COPD [72.0% male; mean age: 66.3 years (standard deviation 9.6)] were analyzed. Most patients had a moderate or severe degree of airflow limitation (GOLD spirometric grade 1, 10.9%; grade 2, 46.6%; grade 3, 32.4%; and grade 4, 10.3%). The best calibration threshold for CAT total score was 18 points, for COPD Clinical Questionnaire total score 1.9 points, and for St. Georges Respiratory Questionnaire total score 46.0 points.ConclusionsThe application of these new cut-points would reclassify about one-third of the patients with COPD and, thus, would impact on individual disease management. Further validation in prospective studies of these new values are needed.
Lord VM, Hume VJ, Kelly JL, et al., 2014, Singing classes for chronic obstructive pulmonary disease: a randomized controlled trial (vol 12, 69, 2012), BMC PULMONARY MEDICINE, Vol: 14, ISSN: 1471-2466
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- Citations: 3
Kelly JL, Jaye J, Pickersgill RE, et al., 2014, Randomized trial of 'intelligent' autotitrating ventilation versus standard pressure support non-invasive ventilation: Impact on adherence and physiological outcomes, RESPIROLOGY, Vol: 19, Pages: 596-603, ISSN: 1323-7799
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- Citations: 46
Shaikh ZF, Kelly JL, Shrikrishna D, et al., 2014, Patent Foramen Ovale Is Not Associated with Hypoxemia in Severe Chronic Obstructive Pulmonary Disease and Does Not Impair Exercise Performance, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 189, Pages: 540-547, ISSN: 1073-449X
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- Citations: 14
Boutou AK, Shrikrishna D, Tanner RJ, et al., 2013, Lung function indices for predicting mortality in COPD, EUROPEAN RESPIRATORY JOURNAL, Vol: 42, Pages: 616-625, ISSN: 0903-1936
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- Citations: 69
Jackson AS, Shrikrishna D, Kelly JL, et al., 2013, Vitamin D and skeletal muscle strength and endurance in COPD (vol 41, pg 309, 2013), EUROPEAN RESPIRATORY JOURNAL, Vol: 41, Pages: 998-998, ISSN: 0903-1936
Jackson AS, Shrikrishna D, Kelly JL, et al., 2013, Vitamin D and skeletal muscle strength and endurance in COPD, EUROPEAN RESPIRATORY JOURNAL, Vol: 41, Pages: 309-316, ISSN: 0903-1936
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- Citations: 35
Elia D, Kelly JL, Martolini D, et al., 2013, Respiratory Muscle Fatigue following Exercise in Patients with Interstitial Lung Disease, RESPIRATION, Vol: 85, Pages: 220-227, ISSN: 0025-7931
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- Citations: 10
Kelly JL, Elkin SL, Fluxman J, et al., 2013, Breathlessness and Skeletal Muscle Weakness in Patients Undergoing Lung Health Screening in Primary Care, COPD: Journal of Chronic Obstructive Pulmonary Disease, Vol: 0
Lord VM, Hume VJ, Kelly JL, et al., 2012, Singing classes for chronic obstructive pulmonary disease: a randomized controlled trial, BMC Pulmonary Medicine, Vol: 12, ISSN: 1471-2466
BackgroundThere is some evidence that singing lessons may be of benefit to patients with chronic obstructive pulmonary disease (COPD). It is not clear how much of this benefit is specific to singing and how much relates to the classes being a group activity that addresses social isolation.MethodsPatients were randomised to either singing classes or a film club for eight weeks. Response was assessed quantitatively through health status questionnaires, measures of breathing control, exercise capacity and physical activity and qualitatively, through structured interviews with a clinical psychologist.ResultsThe singing group (n=13 mean(SD) FEV1 44.4(14.4)% predicted) and film group (n=11 FEV1 63.5(25.5)%predicted) did not differ significantly at baseline. There was a significant difference between the response of the physical component score of the SF-36, favouring the singing group +12.9(19.0) vs -0.25(11.9) (p=0.02), but no difference in response of the mental component score of the SF-36, breathing control measures, exercise capacity or daily physical activity. In the qualitative element, positive effects on physical well-being were reported in the singing group but not the film group.ConclusionSinging classes have an impact on health status distinct from that achieved simply by taking part in a group activity.
Wieboldt J, Atallah L, Kelly JL, et al., 2012, Effect of acute exacerbations on skeletal muscle strength and physical activity in cystic fibrosis, JOURNAL OF CYSTIC FIBROSIS, Vol: 11, Pages: 209-215, ISSN: 1569-1993
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- Citations: 22
Kelly JL, Bamsey O, Smith C, et al., 2012, Health Status Assessment in Routine Clinical Practice: The Chronic Obstructive Pulmonary Disease Assessment Test Score in Outpatients, RESPIRATION, Vol: 84, Pages: 193-199, ISSN: 0025-7931
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- Citations: 74
Elia D, Kelly JL, Martolini D, et al., 2011, RESPIRATORY MUSCLE FATIGUE FOLLOWING EXERCISE IN PATIENTS WITH INTERSTITIAL LUNG DISEASE, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A54-A54, ISSN: 0040-6376
Drew CM, Colleran S, Zijp M, et al., 2011, Preparation and Medical Outcomes of Nepalese Staff and Porters Compared with Foreign Nationals on the Annapurna Trekking Circuit, HIGH ALTITUDE MEDICINE & BIOLOGY, Vol: 12, Pages: 349-356, ISSN: 1527-0297
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- Citations: 7
Boutou AK, Shrikrishna D, Tanner RJ, et al., 2011, TRANSFER FACTOR AND ARTERIAL OXYGEN PARTIAL PRESSURE ARE PREDICTORS OF SURVIVAL IN HOSPITAL OUTPATIENTS WITH COPD, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A157-A157, ISSN: 0040-6376
Falzon C, Elkin SL, Kelly JL, et al., 2011, Can financial incentives for improvements in healthcare quality enhance identification of COPD in primary care?, THORAX, Vol: 66, Pages: 630-630, ISSN: 0040-6376
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- Citations: 8
Kelly JL, Crowley O, Smith C, et al., 2011, Determinants Of The COPD Assessment Test (CAT) Score In Clinical Practice, Publisher: AMER THORACIC SOC, ISSN: 1073-449X
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- Citations: 1
Lord VM, Cave P, Hume VJ, et al., 2010, Singing teaching as a therapy for chronic respiratory disease - a randomised controlled trial and qualitative evaluation, BMC PULMONARY MEDICINE, Vol: 10, ISSN: 1471-2466
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- Citations: 75
Atallah L, Zhang J, Lo BPL, et al., 2010, Validation Of An Ear Worn Sensor For Activity Monitoring In COPD, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 181, ISSN: 1073-449X
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- Citations: 5
Shrikrishna D, Kelly JL, Mendoza L, et al., 2009, MULTIPLE-FREQUENCY BIOELECTRICAL IMPEDANCE ANALYSIS AND QUADRICEPS STRENGTH IN PATIENTS WITH COPD, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A134-A134, ISSN: 0040-6376
Kelly JL, Mehta P, Shrikrishna D, et al., 2009, EFFECT OF GOLD STAGE ON RATE OF DECLINE IN GAS TRANSFER AND SPIROMETRY IN COPD, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A159-A159, ISSN: 0040-6376
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