Goal 3: Advance Translational Research

To facilitate innovation and accelerate research translation, knowledge dissemination, and implementation science that enhances public health.

Goal 3: Advance Translational Research

Inhaled antibiotics for patients with bronchiectasis

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 »

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

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Novel therapeutics for patients with severe acute lung injury

Can novel therapeutics including cell-based therapy be tested in patients with severe acute lung injury (P/F <200) and shock (need for vasopressors) since these are the patients with the highest mortality (> 30%) based on NHLBI ARDS Network data?

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 : American Thoracic Society member

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Novel extracorporeal devices that remove carbon dioxide

Can novel extracorporeal devices that remove carbon dioxide be tested to limit or avoid positive pressure ventilation in patients with acute respiratory failure from COPD?

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 : American Thoracic Society member

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Effectiveness of pulmonary rehabilitation

1. Does pulmonary rehabilitation (PR) reduce mortality risk? 2. Does PR in the post-hospitalization period reduce subsequent health care utilization? 3. Can the principles of PR be applied more broadly across the disease spectrum to reduce morbidity, mortality, and health care expenditures in patients with COPD? 4. Does early PR following hospitalization for acute exacerbation reduce mortality and readmission rates ...more »

Submitted by (@nhlbiforumadministrator)

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

Feasibility and challenges of addressing this CQ or CC :

Does improved sleep following pulmonary rehabilitation contribute to improvement in symptoms and quality of life in these patients?

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

Voting

2 net votes
2 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Early detection and treatment of COPD

Early detection and treatment of COPD

a. Best tests to detect

b. Impact of early treatment

c. Impact of early treatment on disease progression

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

Voting

2 net votes
2 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Smoking cessation

Smoking cessation

a. Enhance our understanding of the behavioral issues that lead to smoking addiction

b. Explore effective behavioral and pharmacological and non-pharmacological mechanisms to reverse smoking addiction

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

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 3: Advance Translational Research

High cost, high risk and unclear benefits of current COPD care

Challenge the unspoken of high cost, high risk and unclear benefits of current COPD care a. PRCT of lung transplantation vs. optimized medical care b. Noninvasive ventilation for treatment of chronic severe respiratory failure c. Chronic combined vs. de-escalation of chronic bronchodilator therapy to as needed for GOLD stages III-IV d. Self management programs in COPD e. Telemedicine in outpatient management of severe ...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

Voting

2 net votes
2 up votes
0 down votes
Active

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

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Implementation of checklist to improve outcomes of COPD patients with acute exacerbations

Implementation of checklist to improve outcomes of COPD patients with acute exacerbations

 

• Does implementation of a checklist designed to improve the care of patients with COPD exacerbations result in greater adherence to guideline recommendations?

 

• Does implementation of a checklist designed to improve the care of patients with  COPD exacerbations results in improved patient outcomes?

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

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Integrated healthcare strategies during transitions in COPD care

Integrated healthcare strategies during transitions in COPD care

 

• What is cost effectiveness of multi-component COPD programs?

 

• Will early admission to a Pulmonary Rehabilitation program following a hospitalization for COPD reduce the likelihood of readmission within the following year?

 

• What is the most effective time to implement the transition from hospitalization following a COPD exacerbation admission?

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

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 3: Advance Translational Research

Challenges for future clinical trials in COPD

There are two broad issues that any future clinical trials in COPD need to seriously consider, that of the challenges of timely and efficient subject recruitment and the need to increase the participation of low to middle income countries that experience a disproportionate burden of COPD in evidence generation. My specific suggestions are as follows: 1) Address the optimal medical management of multiple physical and psychological ...more »

Submitted by (@nhlbiforumadministrator)

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

Feasibility and challenges of addressing this CQ or CC :

1) Address optimal medical management of multiple comorbidities associated with COPD using advanced mathematical modeling techniques in parallel with conducting clinical trials which usually can only enroll a limited number of subjects barring reliable subgroup analyses. Perhaps this could be done within existing large networks of health service delivery systems that already have the data sharing/exchange infrastructure, e.g. HMO research networks, PBRNs, instead of limiting the research to populations served by academic medical centers.

2) We need greater attention on the basic science of the connection between psychiatric illnesses such as depression and COPD severity/outcome. Preliminary data from our ongoing NHLBI funded RO1 suggests that nearly 2/3 of patients come into the illness with a strong history of depression prior to developing COPD and that depression history is associated with worse symptoms.  Health care expenditures for patients with co-morbid depression are nearly twice as much as those without depression.  If we are to improve care and reduce costs for this vulnerable population, we need to address this new “risk factor” for COPD.

3) Take advantage of “natural experiments” in the form of policy changes in the US or abroad to study the effects of air pollution on disease progression and exacerbations. There is very little work in this area. The interaction between air pollution, physical activity and risk of COPD exacerbations is prime for investigation.

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

Voting

2 net votes
2 up votes
0 down votes
Active