title: Brazilian studies on pulmonary function in COPD patients: what are the gaps?
abstract: BACKGROUND
  COPD is a major cause of death and morbidity worldwide, and is characterized by persistent airflow obstruction. The evaluation of obstruction is critically dependent on sensitive methods for lung-function testing. A wide body of knowledge has been accumulated in recent years showing that these methods have been significantly refined and seems promising for detection of early disease.
  
  
  OBJECTIVE
  This review focuses on research on pulmonary function analysis in COPD performed in Brazil during this century.
  
  
  METHODS
  The literature was searched using a systematic search strategy limited to English language studies that were carried out in Brazil from the year 2000 onward, with study objectives that included a focus on lung function.
  
  
  RESULTS
  After we applied our inclusion and exclusion criteria, 94 articles addressed our stated objectives. Among the new methods reviewed are the forced-oscillation technique and the nitrogen-washout test, which may provide information on small-airway abnormalities. Studies investigating the respiratory muscles and thoracoabdominal motion are also discussed, as well as studies on automatic clinical decision-support systems and complexity measurements. We also examined important gaps in the present knowledge and suggested future directions for the cited research fields.
  
  
  CONCLUSIONS
  There is clear evidence that improvements in lung-function methods allowed us to obtain new pathophysiological information, contributing to improvement in our understanding of COPD. In addition, they may also assist in the diagnosis and prevention of COPD. Further investigations using prospective and longitudinal design may be of interest to elucidate the use of these new methods in the diagnosis and prevention of COPD.
authors.affiliation: Pulmonary Function Laboratory, State University of Rio de Janeiro; Pulmonary Rehabilitation Laboratory, Augusto Motta University Center.
authors.forename: Agnaldo José
authors.initials: AJ
authors.lastname: Lopes
authors.affiliation: Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Pedro Lopes
authors.initials: PL
authors.lastname: de Melo
mesh_terms: D001938:Brazil; D019317:Evidence-Based Medicine; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D011237:Predictive Value of Tests; D000071836:Professional Practice Gaps; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D015203:Reproducibility of Results; D012107:Research Design; D012129:Respiratory Function Tests; D012720:Severity of Illness Index
keywords: COPD; automatic clinical decision-support systems; complexity measurements; dynamic lung hyperinflation; oscillation mechanics; thoracoabdominal motion