Barely Significant
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Improved care of acute exacerbation of chronic obstructive pulmonary disease in two academic emergency departments.

Int J Emerg Med · 2009 · PMC2700228 · PMID 20157453

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a decreasing trendno p-value reported
The prescription of systemic corticosteroids at discharge, however, was not high in either time period (< 60%), and no significant changes were observed during the study period. With respect to ED management that is not guideline recommended, there was a decreasing trend in the use of acute spirometry, but this was not statistically significant.

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