173 6 Cochrane review on integrated disease management for COPD 2.2 Functional exercise capacity - medium-term Thirteen studies with a total population of 2071 participants provided data on the 6MWD after a medium-term follow-up period (between 6 and 15 months) (Engstrom 1999; Fernandez 2009; Gottlieb 2011; Güell 2000; Jimenez- Reguera 2020; Kalter-Leibovici 2018; Kessler 2018; Ko 2016; Littlejohns 1991; Vasilopoulou 2017; Wakabayashi 2011; Wang 2017; Zhang 2020). Pooled MD showed a statistically and clinically signi cant e ect of 44.69 in favour of IDM. The observed e ect was statistically signi cant (95% CI 24.01. to 65.37) and exceeded the MCID of 35 meters. Sensitivity analysis showed that our results were robust (MD 40.49, 95% CI 9.71 to 71.27). However, heterogeneity remained substantial (I² = 92%). The heterogeneity among high-quality studies and the large con dence interval for the pooled results of all studies indicate there may be substantial methodological or clinical di erences between studies. Pre-de ned and post-hoc subgroup analyses were performed to further investigate the existing heterogeneity (see below).
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