NETT

About the Trial

The National Emphysema Treatment Trial randomized 1,218 patients with severe emphysema to lung volume reduction surgery plus pulmonary rehabilitation or to rehabilitation and medical therapy alone. An early analysis identified a high risk group with very low lung function in whom surgery increased mortality, and these patients were excluded. Overall, surgery did not improve survival, but patients with upper lobe predominant emphysema and low exercise capacity lived longer and functioned better after surgery. The trial was jointly organized with Medicare, which tied coverage to the results, an early model of coverage with evidence development, and its subgroup findings still guide patient selection for lung volume reduction.