Strategic Goal: Goal 3: Advance Translational Research

Asthma self-management

Study patient-provider communication of asthma self-management requirements to see where gaps in communication may contribute to suboptimal self-management decisions. Examine patients’ decision-making in the home management of asymptomatic and acute. Compare different approaches to the delivery of asthma self-management education and best practices for supporting the patient as they gain competency in this area.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society

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Strategic Goal: Goal 3: Advance Translational Research

Chronobiology in Chronic Lung Diseases

In the new era of once a day inhalers for Asthma and COPD, there is critical need to determine whether delivery of drugs to the lung at night or day have different therapeutic effects and/or side effect profile.

Submitted by (@alejandrocomellas)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Understanding whether a delivery of a LAMA, LABA and/or ICS at different times of the day has a potential critical impact in symptom control and preservation of lung function

Feasibility and challenges of addressing this CQ or CC :

This question can ben addressed via the use of Pragmatic Clinical Trials.

Name of idea submitter and other team members who worked on this idea : Alejandro Comellas

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11 net votes
22 up votes
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Strategic Goal: Goal 2: Reduce Human Disease

Triple-combination inhaler therapy

ICS/LABA/tiotropium fixed triple-combination inhaler therapy

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society

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Strategic Goal: Goal 3: Advance Translational Research

Asthma Treatment Recommendations for Blacks

Considering the fact that Blacks bear a disproportionate degree of asthma morbidity and mortality, should treatment recommendations be different for Blacks vs. Caucasians?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society

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Strategic Goal: Goal 3: Advance Translational Research

Unconventional beliefs and negative attitudes to 'smart' asthma therapy

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

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

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Strategic Goal: Goal 3: Advance Translational Research

To Improve Clinical Practice Recommendations for Asthma

What are the strategies to improve the use of evidence-based clinical practice recommendations and thereby increase the quality of care and improve outcomes for people with asthma? • Lack of provider awareness, knowledge, agreement, and/or self-efficacy in using the guidelines • Inconsistent use of guidelines-based asthma care in clinical practice. • Scarce/limited resources and limited access to target audiences. • ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Asthma is a chronic lung disease that affects 26 million people in the U.S., including more than 7 million children, at an estimated cost to the nation of $56 billion. Asthma accounts for 14.2 million missed work days, 10.5 million missed school days, 10.6 million physician office visits, and 1.8 million emergency department visits, and 439,000 hospitalizations each year.

• Despite widespread availability of evidence-based clinical practice guidelines for the diagnosis and management of asthma, only about half of individuals with asthma in the U.S. receive guidelines-based care.

• Identifying strategies to improve use of evidence-based clinical practice recommendations would 1) increase the number of people with asthma who receive evidence-based clinical care, 2) increase the number of health care providers who use (implement) evidence-based clinical practice recommendations, 3) increase the quality of care of people with asthma, and 4) improve outcomes and quality of life for people with asthma.

Feasibility and challenges of addressing this CQ or CC :

• Investigators could evaluate guidelines-based implementation strategies in implementation settings such as community and regional health systems, private medical practices, federally qualified health centers and other safety-net clinics, and hospitals throughout the U.S.

• Documented successful and sustainable implementation strategies could be shared more broadly and applied to future efforts to improve asthma care and control as well as reduce asthma disparities.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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6 up votes
5 down votes
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Strategic Goal: Goal 1: Promote Human Health

THE RELEVANCE OF PREVENTION TRIALS

Prevention trials, implemented to reduce or delay progression to overt disease in a population at risk to the disease, are an important approach to health promotion. Therapies shown to reduce disease severity in patients with a specific disease are obvious, but not the only, candidates for a prevention trial in populations at high risk for prevalent diseases (such as heart failure, diabetes, COPD, asthma in children). ...more »

Submitted by (@media0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

The impact of implementing such trials is considerable. They will clearly address an important component of NHLBI’s mission with respect to effectiveness of therapies and behavioral interventions, and it has minimal and clearly definable overlap with commercial trials of specific therapeutic products. It will also provide an important public health focus – preventing disease or reducing the impact of disease processes, thus potentially reducing chronic care costs and increasing years of useful life.

Feasibility and challenges of addressing this CQ or CC :

The biggest challenge in designing and implementing prevention trials is identifying the target, “at risk” population most likely to develop the clinical disease from known biomarkers or early signs/symptoms. Increasing availability of large, population-based registries or databases maintained for other purposes provides a very cost-efficient mechanism to electronically screen and identify “at risk” individuals. The same mechanism may also facilitate implementation of pragmatic, electronically managed, cost efficient trials.

Name of idea submitter and other team members who worked on this idea : Sonja McKinlay other Team Members: Susan Assmann and Paul Stark

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7 net votes
10 up votes
3 down votes
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Strategic Goal: Goal 2: Reduce Human Disease

Novel Mechanism underlying airway hypersensitivity and asthma

Molecular mechanism controlling airway hypersensitivity and remodeling

Submitted by (@sc2290)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

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Strategic Goal: Goal 2: Reduce Human Disease

exercises for asthmatics

There are lots of exercise regimens for COPD, but none that I can find for asthmatics

Submitted by (@bluemizloo)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

ASthma regimens are entirely environment and drug focused. Surely there is room for personal action.

Name of idea submitter and other team members who worked on this idea : Lou Phillips

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Strategic Goal: Goal 3: Advance Translational Research

Community-based participatory dissemination and implementation of research initiatives in rural settings

More effective strategies for community-based participatory dissemination and implementation of research initiatives in rural settings.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : Asthma and Allergy Foundation of America (AAFA)

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Strategic Goal: Goal 3: Advance Translational Research

Including subjects with both COPD and asthma in clinical trials

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 »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

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Strategic Goal: Goal 2: Reduce Human Disease

Airway remodeling

What are the features of airway remodeling about which we consistently agree and in whom are they most likely to occur?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : ATS Member

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