Meta-analysis topic ideas in respiratory medicine

Respiratory medicine combines big, well-reviewed areas, like inhaled therapy in asthma and COPD, with many practical questions where trials are small: ventilation strategies, rehabilitation, inhaler devices and sleep apnoea treatment.

Often the open topics are about how a treatment is delivered or who it is delivered to, rather than whether the drug class works.

Find a respiratory medicine topic that has not been done

SynthGap searches the published literature, checks each candidate against existing systematic reviews, and proposes topics with the primary studies behind them. The free plan includes 3 discovery runs a month.

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Where gaps tend to hide in respiratory medicine

Biologics and phenotypes

Treatments for specific asthma or COPD phenotypes (for example by eosinophil level) are studied in varied trials, and pooled results by phenotype may not exist.

Pulmonary rehabilitation and self-management

Format, setting and duration vary between trials, so a review of one format or population can be new.

Inhaler devices and technique

Comparisons of devices and of education on inhaler technique are small and often not pooled.

Non-invasive support and critical care

High-flow oxygen, non-invasive ventilation and weaning strategies are tested in many small randomized trials.

Sleep-disordered breathing

Treatment adherence and outcomes beyond sleep scores, such as blood pressure and daytime function, are studied in varied trials.

Children and older adults

Evidence in these groups is often extrapolated from adults.

Outcomes and effect measures that pool well in respiratory medicine

Exacerbations: a count outcome. Pool rate ratios rather than treating them as a yes or no event, and report the definition of an exacerbation.
FEV1: mean difference. State whether it was measured before or after a bronchodilator, and at what time point.
Quality of life (for example the St George's Respiratory Questionnaire): mean difference. A change of about 4 points is commonly used as the minimal clinically important difference for this questionnaire.
Apnoea-hypopnoea index and sleepiness scores: mean difference.
Mortality and need for intubation in critical care: risk ratio at a stated time point.

Common traps in respiratory reviews

Statistically significant but clinically tiny FEV1 differences. Always compare with a meaningful threshold.
Mixing the proportion of patients with an exacerbation and the exacerbation rate in one estimate.
Inclusion thresholds for phenotypes (such as eosinophil counts) that differ between trials.
Crossover trials, common in asthma, need a paired analysis, not a comparison of independent groups.

Check before you commit

Before committing months to a topic, check that nobody has beaten you to it. Search PubMed with its systematic review filter, the Cochrane Library, the PROSPERO register (for reviews that are registered but not yet published) and Epistemonikos. Look at how recent the latest review is and whether new trials have appeared since its search date. Step-by-step guide.

Starting points to try in SynthGap

These are areas to explore, not claims that they are open. Some may already be well covered, and finding that out quickly is the point.

High-flow nasal oxygen versus standard oxygen in a specific respiratory failure population
Pulmonary rehabilitation delivered at home for chronic obstructive pulmonary disease
Inhaler technique education to reduce asthma exacerbations in children

Questions

Where are the gaps in asthma and COPD research?

Look at phenotype-specific questions, delivery and self-management, children and older adults, and outcomes other than lung function, since the main inhaler questions are heavily reviewed.

Should I pool exacerbation rates or proportions?

Pool rate ratios when trials report event rates, and risk ratios when they report the proportion with at least one exacerbation. Do not combine them.

How should I handle crossover trials?

Use a paired analysis if the data allow, or use only the first period. Treating the two periods as independent groups overstates precision.

Other specialties

This page is general methodological guidance, not medical advice, and it does not list specific unreviewed topics. SynthGap's suggestions are AI-generated from the published literature, so verify them before registering a protocol.