Pulmonary function testing in pediatric allogeneic stem cell transplant recipients to monitor for Bronchiolitis obliterans syndrome: a systematic review

Table 5 Evidence profile of post-transplant outcomes for patients undergoing post-transplant surveillance PFT versus patients who did not receive post-transplant surveillance PFT (PICO 2)

Quality assessment							No. of patients	Result	Quality	Importance
No. of studies	Design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other	No. of patients	Result	Quality	Importance
Timing of BOS diagnosis
21	Cohort studies	Serious*	None	None	None	None	1895	Surveillance: Most studies report median time to BOS diagnosis = 6–12 mos No surveillance: Median time to BOS diagnosis = 6–24 mos	Low	Critical
FEV1 decline at the time of diagnosis
21	Cohort studies	Serious*	Serious^†	None	None	None	1895	Surveillance: 38–84% predicted; 2 studies reported 4 patients being asymptomatic at BOS diagnosis No surveillance: 44–57% predicted and in one study FEV1 Z-score time of diagnosis − 3.62 (-4.77, -2.48)	Very Low	Critical

*Wide range of BOS severity among studies; some studies only included patients with BOS. Some studies only described obstructive airway disease without sub-classifying them into BOS. Confounding variables such as conditioning regimens and pre-existing abnormal lung function tests were not controlled in most studies
†Wide range of FEV1 Z-score/percent predicted at diagnosis between studies

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