***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: This review includes eight studies with a total of 250 participants comparing nebuliser versus pMDI plus spacer treatment. We identified no studies comparing DPI with nebulisers. We found two studies assessing the primary outcome of 'change in forced expiratory volume in one second (FEV1) one hour after dosing'. We could not pool these studies, but both showed a non-significant difference in favour of the nebuliser group, with similar frequencies of serious adverse events. For the secondary outcome, 'change in FEV1 closest to one hour after dosing': we found a significant difference of 83 ml (95% CI 10 to 156, P = 0.03) in favour of nebuliser treatment. For the secondary outcome of adverse events, we found a non-significant odds ratio of 1.65 (95% CI 0.42 to 6.48) in favour of the pMDI plus spacer group. There is a lack of evidence in favour of one mode of delivery over another for bronchodilators during exacerbations of COPD. We found no difference between nebulisers versus pMDI plus spacer regarding the primary outcomes of FEV1 at one hour and safety. For the secondary outcome 'change in FEV1 closest to one hour after dosing' during an exacerbation of COPD, we found a greater improvement in FEV1 when treating with nebulisers than with pMDI plus spacers. A limited amount of data are available (eight studies involving 250 participants). These studies were difficult to pool, of low quality and did not provide enough evidence to favour one mode of delivery over another. No data of sufficient quality have been published comparing nebulisers versus DPIs in this setting. More studies are required to assess the optimal mode of delivery during exacerbations of COPD.
Output:

We found eight studies including 250 participants in a search of the available studies up to 1 July 2016. All of the studies took place in a hospital. The primary outcomes of the review showed no difference between the inhaler with a spacer and the nebuliser. However, in our secondary outcomes, we found some evidence that nebuliser treatment improves lung function more than inhalers with a spacer, but the quality and quantity of the data is limited. We found no difference between the therapies in terms of side effects or for reducing breathlessness. There are no studies available testing dry powder inhalation against a nebuliser. Due to the low quality and quantity of the data, it is not clear whether nebulisers or inhalers with spacers are better for lung attacks. We found no difference between an inhaler with a spacer and the nebuliser in lung function after one hour or in unwanted side effects during lung attacks of COPD. The secondary outcome for lung function did favour nebulisers over inhalers with a spacer.