Progress toward a six-sigma level of safety (already achieved in commercial aviation) has been slow in medicine and surgery. The best cardiac surgery program operates at only 3.5 sigma level. In order to acceletate this process, it is critical to leveage recent advances in information technology, including but not limited to natural language processing (NLP), advanced speech recognition, artificial intelligence.
Goal 3: Advance Translational Research
Integrate real time data acquired from or through mobile health care applications (apps) and devices into asthma and allergy management.
Clinical trials involving administration of antioxidants such as vitamin C or vitamin E as therapeutic strategies for cardiovascular diseases associated with oxidant stress have proven to be surprisingly disappointing. A particularly attractive alternative approach is direct upregulation of endogenous antioxidant defenses such as NRF2 via dietary approaches. NRF2 is a master antioxidant and cell protective transcription ...more »
How can we create precision diagnostics for COPD in practice settings that will help inform the transition from screening to better diagnosis and treatment strategies and that will help identify patients or communities at highest risk for unrecognized or over diagnosed COPD.
What are the best inroads for the NHLBI to support innovative approaches in the next 5-10 years, especially blood cell therapies based on hematopoietic stem cell and novel gene therapy approaches to control or even cure HIV infection?
Systematically examine the contribution of unconventional beliefs and negative attitudes to inadequate clinical outcomes for asthma.
Budesonide/fomoterol controller/reliever therapy ('smart' therapy) in large US studies - adults
More involvement of patients and patient advocates in the process of research at the NHLBI should be encouraged.
The clinical use of extracorporeal photopheresis (ECP) is expanding. It is known that dendritic cells plays critical role key to its efficacy, but exactly how ECP impacts other immune components and their interactions is not fully understood. There are many unanswered questions such as: “ What are the critical factors in ECP that result in a shift of the dendritic cell population from immune activating to immune tolerant? ...more »
What is the impact of an organized, comprehensive, COPD patient education program, on medication delivery effectiveness, care plan adherence, appropriate use of LTOT and Pulmonary Rehabilitation? Metrics could include incidence and severity of exacerbations, and health care resource consumption.
As indicated in two influential papers we have published, there are many potential contributing factors to obesity beyond those commonly discussed and studied and some of these are potentially modifiable. Increased research to understand whether these putative factors are really influential and whether they can be modified to produce benefits with respect to obesity are in order.
Many pharma companies are developing inhaled antibiotics for patients with bronchiectasis, recognizing the increasing market (over 110,000 patients in the US). These drugs cost thousands of dollars per year and will be heavily marketed and heavily used, as there are limited options for these patients. It is unknown if rotating oral antibiotics (cost is a fraction of the inhaled ABx) would yield similar results. A Cochrane ...more »
Incorporation of patient-centeredness in all research.
There is a need to move beyond the use of self-report for dietary intake quantification towards funding the development of new technology and broader use of objective measures. There is no question that the effects of diet on health, quality of life, and longevity are of great interest to many and plausibly of great importance. Because of that, tremendous research resources have been provided to study this topic. Given ...more »
There is a need to develop “designer platelets” and “designer red cells,” as well as facilitate large-scale production of these products for therapeutic and diagnostic use.
There is a need for greater evidence-based research over the next 5-10 years to reduce healthcare costs, reduce hospitalizations, and support older persons with significant heart, lung, blood, sleep conditions to remain in their private homes if feasible, if technology is utilized that fosters clinical and epidemiologic research.