On 2015 Feb 14, Satyanarayan Hegde commented:

Interesting observation. Authors do not mention the patient's FEV1 at other time points prior to starting HFCWO which they probably did not have access to. How do we know the modest increase in FEV1 (~400ml) after starting HFCWO is not because of resolution of an exacerbation? If the patient were to have neutrophillic inflammation, he would not respond to systemic steroids. Patient reported symptoms as a measure of disease severity can be notoriously unreliable. Authors should have attempted in obtaining more objective data such as frequency of systemic steroid use, unscheduled physician office visits, ED/hospitalization rates, missed work days and medication refill history. Nevertheless, they describe another mode of potential therapy for a select group of patients.

On 2015 Feb 14, Satyanarayan Hegde commented:

Interesting observation. Authors do not mention the patient's FEV1 at other time points prior to starting HFCWO which they probably did not have access to. How do we know the modest increase in FEV1 (~400ml) after starting HFCWO is not because of resolution of an exacerbation? If the patient were to have neutrophillic inflammation, he would not respond to systemic steroids. Patient reported symptoms as a measure of disease severity can be notoriously unreliable. Authors should have attempted in obtaining more objective data such as frequency of systemic steroid use, unscheduled physician office visits, ED/hospitalization rates, missed work days and medication refill history. Nevertheless, they describe another mode of potential therapy for a select group of patients.