CHEST Guidelines-Response

Response_chest (23)

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The documents discuss correspondence regarding a meta-analysis on the association between gastroesophageal reflux disease (GERD) and idiopathic pulmonary fibrosis (IPF). Salvatore Corrao and colleagues critique the meta-analysis, suggesting the results are inconclusive and call for more stringent future studies with better methodologies to avoid biases. They used trial sequential analysis (TSA) which showed an inconclusive association, indicating that further studies are necessary. <br /><br />In response, Yves Lacasse and colleagues acknowledge the heterogeneity in diagnostic criteria among studies and the resulting limitations. They emphasize that their primary finding was not establishing a direct association between GERD and IPF, but highlighting how such an association might be overestimated. They argue that smoking acts as a confounding factor often overlooked in research. Through meta-regression analysis, they established that once smoking was accounted for, the statistical significance of the GERD-IPF association diminished. Furthermore, they found a correlation between the imbalance in smoking proportions in study subjects and the strength of the association between GERD and IPF claimed in studies.<br /><br />Lacasse et al. agree that future studies should aim to reduce selection bias, but they stress the importance of addressing confounding factors like smoking. Both teams call for further research to clarify the relationship between GERD and IPF, citing confounding issues and inconsistencies in existing literature. The correspondence underscores the complexity of establishing causal links in observational studies and the necessity of rigorous methodology to improve research validity.

Keywords

meta-analysis

GERD

idiopathic pulmonary fibrosis

trial sequential analysis

smoking confounder

research methodology

causal links

observational studies

selection bias

meta-regression analysis