Evaluation of the effectiveness of manual chest physiotherapy techniques on quality of life at six months post exacerbation of COPD (MATREX): a randomised controlled equivalence trial.

BMC Pulm Med · 2012 · PMC3425255 · PMID 22748085

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an increasing trendno p-value reported

Anecdotal evidence suggests there has been an increasing trend for admitted patients to be very sick with end stage disease and multiple co-morbidities.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.