Goal 3: Advance Translational Research

Translation of scientific information into clinical and public health asthma and allergies practices and programs

More evidence-based, scientifically proven interventions to ensure that scientific information is translated into clinical and public health practices and programs to reduce the burden of asthma and allergies on individuals, families and society

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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1 net vote
1 up votes
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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
11 down votes
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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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Goal 3: Advance Translational Research

Access to healthcare for treatment/management of asthma and allergies, and funding of research on asthma and allergies

It is essential that people with asthma and allergies have access to affordable, quality healthcare for the treatment and management of asthma and allergies, and that research is funded to address prevention, screening, and lifestyle interventions to reduce the incidence and adverse effects of asthma and allergies. These conditions impose significant costs on the overall health care system and on patients and their families. ...more »

Submitted by (@nhlbiforumadministrator)

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

Details on the impact of addressing this CQ or CC :

Currently, more people than ever are struggling to live normal and healthy lives in the face of the daily limits that asthma and allergic diseases create. More than 25 million Americans have asthma, 15 million have food allergies, and 50 million have other allergic conditions. AAFA urges the National Institutes of Health (NIH) to continue to focus and accelerate research on asthma and allergies, which are life threatening chronic conditions for which there are no cures.

 

While asthma affects all populations, the burden of asthma falls disproportionately on the black and Hispanic/Latino—largely Puerto Rican—populations, and especially on minority children. Asthma is the third leading cause of hospitalization among children under the age of 15 and is a leading cause of school absences from chronic disease – accounting for over 10.5 million lost school days in 2008. Asthma costs our healthcare system over $50.1 billion annually and indirect costs from lost productivity add another $5.9 billion. Asthma claimed the lives of more than 3,400 Americans in 2010. According to the American College of Allergy, Asthma & Immunology, allergic diseases, which include asthma, are the fifth most prevalent chronic diseases in all ages, and the third most common in children.

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

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1 net vote
1 up votes
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Goal 2: Reduce Human Disease

Pulmonary Complications of Sickle Cell Disease

What is the effectiveness and safety of treatment of the co-morbid condition of asthma with medications known to improve asthma outcomes in individuals without SCD?

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 :

We and others have demonstrated that a doctor diagnosis of asthma is associated with increased morbidity and mortality in those with SCD. While doctor diagnosis of asthma is the issue for children, wheezing symptoms even without a diagnosis is the risk factor for adults.

 

This suggests either that asthma is under diagnosed in adults or that the disease patterns shifts from childhood to adulthood.

 

Making a diagnosis of asthma in individuals with SCD is difficult, as SCD by itself causes respiratory symptoms that can be similar to asthma in general populations, but diagnostic criteria are being proposed. There is concern about the value of treatment of the co-morbid of asthma in prevention of symptoms and even more so in reducing morbidity of pain and ACS episodes. There is also concern with regard to the potential side effects of inhaled corticosteroids by themselves increasing pain episodes and also having adverse effects on bone density, which can be affected by SCD itself.

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

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2 net votes
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Goal 2: Reduce Human Disease

Sublingual Immunotherapy for Treatment of Asthma

As the current chair of the Research and Training Division, I would like to convey that the AAAAI membership would like the NHLBI to consider the following in the development of its strategic plan: What role should sublingual immunotherapy play in the treatment of asthma?


Submitted by (@wheeze)

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 : Mitchell Grayson on behalf of the American Academy of Allergy, Asthma, and Immunology

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-9 net votes
5 up votes
14 down votes
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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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1 net vote
1 up votes
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Goal 2: Reduce Human Disease

Diagnosis and Treatment of the Asthma-COPD Overlap Syndrome

Asthma-COPD overlap syndrome is common and associated with increased morbidity and greater healthcare costs. However, ACOS patients are usually excluded from studies of either disease. There is a compelling need for research in order to define objective diagnostic criteria for ACOS.

Submitted by (@craighersh)

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

Details on the impact of addressing this CQ or CC :

Better diagnostic criteria as well as biomarkers will allow for efficient targeting of specific therapies for ACOS, such as biologic therapies developed for asthma.

Feasibility and challenges of addressing this CQ or CC :

Since ACOS subjects are usually excluded from COPD or asthma trials, this will require identification of study populations that did not exclude ACOS and/or enrollment of ACOS subjects into a new study.

Name of idea submitter and other team members who worked on this idea : C. Hersh

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30 net votes
31 up votes
1 down votes
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Goal 2: Reduce Human Disease

The treatment of asthma in patients with SCD prevents the development of ACS and VOS.

Does the aggressive treatment of asthma prevent the developement of acute chest syndrome (ACS) and vaso-occlusive syndrome (VOS) in patients with sickle cell disease (SCD)?

Submitted by (@nhlbiforumadministrator)

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

Details on the impact of addressing this CQ or CC :

Improvement of health for persons with SCD.

Decreased hospitalizations and use of health resources.

Better understanding of the role of bronchospastic/inflammatory airway disease and hypoxemia as causes of acute chest syndrome and VOC.

Feasibility and challenges of addressing this CQ or CC :

Feasible but stumbling block could be enrollment of patients since many patients with SCD are not seen by asthma specialists. Study could be a multicenter study with two hospitals in one major city and in one center, patients with SCD receive usual care and at another center they receive aggressive treatment and monitoring of their lung disease.

Name of idea submitter and other team members who worked on this idea : Scott Schroeder

Voting

13 net votes
27 up votes
14 down votes
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