1. What is the comparative effectiveness of different approaches to implementing use of spirometry in primary care to confirm the diagnosis of COPD (e.g., increased reimbursements, use of EMRs and other tools) 2. What is the comparative effectiveness of using symptoms vs. spirometry in increasing patient and adherence to COPD treatment guidelines? 3. What is the comparative effectiveness of using a fixed FEV1/FVC ratio ...more »
Medical marijuana and COPD
What are the subtypes of chronic obstructive lung disease that share a common pathogenesis and can be a basis for precision medicine?
What is the impact of screening for depression on outcomes of patients with COPD?
There should be a study for prevention of Airflow Obstruction Progression. Rationale: All diseases have a prodrome followed by an early face of disease progression. Complex medical chronic diseases can only be slowed through the addition of several interventions all of which contribute to a final improvement of prognosis (witness CV diseases). Definition of “Early Disease”: Would be aimed at patients with airflow obstruction ...more »
COPD hospitalizations a. Define the pathobiological changes that lead to severe exacerbations that cause hospitalizations b. Define novel clinical and biological phenotypic characterizations of hospitalized patients who fail treatment that results in death or early readmission c. Explore new or understudied therapies for treatment of acute COPD hospitalizations: antioxidant, non-steroidal anti-inflammatory (STATIN or ...more »
How can guideline recommendations be implemented into community practice in a way that is feasible, usable, relevant, and cost-effective? (examples are use of care management, translation of chronic care model, and EMR based tools)
Society is ageing and chronic degenerative diseases including COPD are increasingly occurring together. The critical question is whether certain diseases occur together by chance or are they occurring together because they share pathobiological commonalities and mechanisms? This leads to a series of practical consequences and questions 1. Which diseases are occurring concurrent with COPD more than chance alone would ...more »
Define the pathobiology of the disorder (COPD)
a. Mechanisms of lung injury
b. Mechanisms of lung repair
c. Balance of lung and systemic pathobiologic manifestations and mechanisms
What defines COPD disease severity?
a. Spirometric classification is inadequate
b. Patient-centered outcomes should be central to this classification
c. The need for suitable instruments
What factors serve as barriers / facilitators for patient adherence to pulmonary rehabilitation for COPD care?
Subjects with both COPD and asthma are typically excluded from clinical trials, but they represent an important segment of the chronic airflow obstruction population. Defining this combination diagnosis is difficult, but requiring a significant smoking history (e.g. 10 pack years), chronic airflow obstruction (GOLD stage 2 or greater after bronchodilator), age > 45, and childhood onset of asthma could identify the relevant ...more »