The meeting agenda provided an update on research activities and future plans for the REG Interstitial Lung Disease Working Group. David Price discussed ongoing and upcoming research studies, publications, and events. Future plans included a revised staffing structure, working group and council structure, and upcoming events in 2015 and 2016. The meeting also discussed driving quality standards, perspectives from industry supporters, and new funding opportunities like PCORI. An open discussion period concluded the meeting to gather feedback and ideas.
This document summarizes a workshop on cost-effectiveness analysis for respiratory health technologies. The workshop objectives were to introduce cost-effectiveness modeling, discuss what can and cannot be done with these models, and review current evidence gaps. The document then summarizes a cost-effectiveness model developed for ivacaftor treatment of cystic fibrosis. The model found ivacaftor to be cost-effective compared to usual care. Key gaps in COPD and asthma cost-effectiveness studies were identified. Finally, forming a working group to address these evidence gaps through additional research was discussed.
REG Technologies Working Group Meeting 26/09/15Zoe Mitchell
This document provides an agenda and notes from a meeting of the Technologies Working Group of the Respiratory Effectiveness Group (REG). The meeting objectives were to agree terms of reference for the group, discuss initial seed projects, and identify 1-2 longer term projects. Under terms of reference, the group will focus on technology-based solutions for chronic respiratory conditions, with a focus on monitoring and behavioral change. Initial seed project ideas discussed included evaluating practices for developing technology solutions, a literature review on using health information to change patient behavior, and optimizing technology interfaces for older patients. Preliminary data from a PhD student's survey of stakeholder attitudes towards smart inhalers was also presented. The group discussed potential future projects and grant opportunities.
REG ACOS Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for a proof of concept study to estimate the prevalence of Asthma-COPD Overlap Syndrome (ACOS) using different population datasets and case definitions. It describes four population groups - COPD diagnosis, ACOS diagnosis, asthma diagnosis, and no diagnosis of asthma or COPD - that will be analyzed in eight available databases to compare ACOS prevalence between definitions. The Optimum Patient Care Research Database pilot data will also be used as a case study to categorize patients as COPD, asthma, or ACOS based on coded consultation reasons to identify overlap between the conditions.
REG PCORI Grant Planning Meeting 26/09/15Zoe Mitchell
The document outlines an agenda for a planning meeting between the Respiratory Effectiveness Group (REG) and the Patient-Centered Outcomes Research Institute (PCORI) to discuss potential comparative effectiveness research collaborations. Key items on the agenda include aligning the missions of REG and PCORI, discussing what comparative effectiveness research entails, engaging stakeholders, and generating ideas for potential research topics that could be funded through PCORI. The meeting aims to identify topics of interest to both organizations that incorporate patient-centered outcomes research.
REG IPF/ILD Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for two diagnostic studies in interstitial lung disease (ILD). [1] Phase I will characterize ILD diagnostic practices globally, especially in underrepresented regions, to inform the design of [2] Phase II which will evaluate agreement and accuracy of ILD multidisciplinary team diagnoses across sites. The studies aim to establish best practice recommendations for optimizing the pathway to accurate ILD diagnosis.
An overview of the work and initial results of the REG-EAACI Taskforce assessing the quality of literature in the field of real-world respiratory medicine.
This document summarizes the minutes from a technology working group meeting. It provides updates on recent publications and ongoing studies. One study is using healthcare claims data to characterize frequent exacerbators of asthma and identify risk factors for future exacerbations. Another proposed study would develop checklists to guide developers in creating relevant respiratory technologies. Additional proposed studies include examining behavior change theories for digital health solutions and optimizing triple therapy for COPD patients. The group discussed prioritizing future research projects and ensuring selected priorities are pursued through funding.
REG Adherence Working Group Meeting 26/09/15Zoe Mitchell
This document provides a summary of an upcoming meeting on asthma treatment adherence. The meeting will take place on September 26th in Amsterdam. It will be chaired by Eric van Ganse and focus on a bidirectional adherence study being conducted by an international research team. The study is analyzing the relationship between adherence to asthma treatment and asthma-related health outcomes using data from an electronic health records database. The agenda includes updates on the study design, measures of adherence and health outcomes, and initial analyses. Next steps for the study and opportunities to present preliminary findings are also discussed.
This document summarizes a workshop on cost-effectiveness analysis for respiratory health technologies. The workshop objectives were to introduce cost-effectiveness modeling, discuss what can and cannot be done with these models, and review current evidence gaps. The document then summarizes a cost-effectiveness model developed for ivacaftor treatment of cystic fibrosis. The model found ivacaftor to be cost-effective compared to usual care. Key gaps in COPD and asthma cost-effectiveness studies were identified. Finally, forming a working group to address these evidence gaps through additional research was discussed.
REG Technologies Working Group Meeting 26/09/15Zoe Mitchell
This document provides an agenda and notes from a meeting of the Technologies Working Group of the Respiratory Effectiveness Group (REG). The meeting objectives were to agree terms of reference for the group, discuss initial seed projects, and identify 1-2 longer term projects. Under terms of reference, the group will focus on technology-based solutions for chronic respiratory conditions, with a focus on monitoring and behavioral change. Initial seed project ideas discussed included evaluating practices for developing technology solutions, a literature review on using health information to change patient behavior, and optimizing technology interfaces for older patients. Preliminary data from a PhD student's survey of stakeholder attitudes towards smart inhalers was also presented. The group discussed potential future projects and grant opportunities.
REG ACOS Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for a proof of concept study to estimate the prevalence of Asthma-COPD Overlap Syndrome (ACOS) using different population datasets and case definitions. It describes four population groups - COPD diagnosis, ACOS diagnosis, asthma diagnosis, and no diagnosis of asthma or COPD - that will be analyzed in eight available databases to compare ACOS prevalence between definitions. The Optimum Patient Care Research Database pilot data will also be used as a case study to categorize patients as COPD, asthma, or ACOS based on coded consultation reasons to identify overlap between the conditions.
REG PCORI Grant Planning Meeting 26/09/15Zoe Mitchell
The document outlines an agenda for a planning meeting between the Respiratory Effectiveness Group (REG) and the Patient-Centered Outcomes Research Institute (PCORI) to discuss potential comparative effectiveness research collaborations. Key items on the agenda include aligning the missions of REG and PCORI, discussing what comparative effectiveness research entails, engaging stakeholders, and generating ideas for potential research topics that could be funded through PCORI. The meeting aims to identify topics of interest to both organizations that incorporate patient-centered outcomes research.
REG IPF/ILD Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for two diagnostic studies in interstitial lung disease (ILD). [1] Phase I will characterize ILD diagnostic practices globally, especially in underrepresented regions, to inform the design of [2] Phase II which will evaluate agreement and accuracy of ILD multidisciplinary team diagnoses across sites. The studies aim to establish best practice recommendations for optimizing the pathway to accurate ILD diagnosis.
An overview of the work and initial results of the REG-EAACI Taskforce assessing the quality of literature in the field of real-world respiratory medicine.
This document summarizes the minutes from a technology working group meeting. It provides updates on recent publications and ongoing studies. One study is using healthcare claims data to characterize frequent exacerbators of asthma and identify risk factors for future exacerbations. Another proposed study would develop checklists to guide developers in creating relevant respiratory technologies. Additional proposed studies include examining behavior change theories for digital health solutions and optimizing triple therapy for COPD patients. The group discussed prioritizing future research projects and ensuring selected priorities are pursued through funding.
REG Adherence Working Group Meeting 26/09/15Zoe Mitchell
This document provides a summary of an upcoming meeting on asthma treatment adherence. The meeting will take place on September 26th in Amsterdam. It will be chaired by Eric van Ganse and focus on a bidirectional adherence study being conducted by an international research team. The study is analyzing the relationship between adherence to asthma treatment and asthma-related health outcomes using data from an electronic health records database. The agenda includes updates on the study design, measures of adherence and health outcomes, and initial analyses. Next steps for the study and opportunities to present preliminary findings are also discussed.
This document summarizes the agenda and key discussion points for several committee meetings taking place on September 26th in Amsterdam. The Research Review committee will discuss priorities for funding respiratory research studies in 2015/2016. They will also evaluate the process for soliciting and reviewing research ideas. The Accreditation committee will discuss accrediting researchers. The Manuscript Review committee will examine their publication process and output over the past year. Overall, the meetings aim to strategize how the organization can best support high-quality respiratory research through prioritizing ideas, funding studies, and disseminating results.
This document summarizes the proceedings of the Small Airways Working Group Meeting held on September 9th, 2017 in Milan. It includes the agenda, list of attendees, and progress updates on several studies. Multiple studies comparing the effectiveness of extra-fine particle inhaled corticosteroids to fine particle ICS have been published or are underway. Preliminary results suggest extra-fine ICS may achieve better asthma control at lower doses and with fewer side effects like pneumonia. The group discussed potential future studies on flexible dosing strategies, metabolic effects of high dose ICS, and the impact of particle size in patients with obesity or GERD. Priority research areas and ongoing protocols were reviewed for continued relevance and feasibility.
Child Health Working Group and Small Airways Study Group Joint MeetingZoe Mitchell
This document provides an agenda and background information for a meeting of the Small Airways & Child Health Working Group. The agenda includes discussions on ongoing publications regarding chest nomenclature and a systematic review on ICS particle size. Presentations will cover pre-school asthma wheeze, new ideas for the group focusing on implications of ICS particle size on GERD and ACOS, and an oscillometry study overview. Background information is provided on the chest commentary and systematic review, including results showing extra-fine ICS have higher odds of asthma control and lower exacerbation rates than fine particle ICS. A proposed study on pre-school asthma will compare outcomes of EF ICS to NEF ICS, LTRA,
This document provides details of an upcoming allergy working group update meeting, including the date, time, location, chair, and agenda. The agenda includes discussions on research ideas like nasal hyper-responsiveness and urticaria. Proposed actions and studies on these topics are described. New data collection opportunities through adding questions to an existing questionnaire are outlined. Potential integration of questions into an Australian pharmacy study is also discussed.
The document provides details about an upcoming annual general meeting for the Respiratory Effectiveness Group (REG). The meeting will take place on September 26th at the Wyndham Apollo Hotel in Amsterdam. David Price will chair the meeting, which will review REG's activities from 2013 to 2015 and look ahead to future opportunities. Some of the key accomplishments highlighted include establishing a global network of over 270 collaborators across 38 countries, running numerous research studies and task forces, publishing several papers and abstracts, and hosting successful summits in 2014 and 2015. The meeting aims to further develop REG's working groups and collaborative activities to generate real-world evidence that can guide clinical practice and policy.
Small Airways Study Group Meeting 25/09/15Zoe Mitchell
The document outlines a planned study comparing the effectiveness of extra-fine particle inhaled corticosteroids (ICS) to non-extra fine ICS, leukotriene receptor antagonists (LTRAs), and short-acting beta agonists (SABAs) as step-up therapy options for preschool children with asthma or wheezing. The study will use data from UK primary care records to conduct a descriptive analysis of treatment patterns and a comparative effectiveness analysis over 1-year and exploratory 5-year outcome periods. The goal is to test if extra-fine ICS achieve better outcomes than alternatives as a step
REG COPD Control Working Group MeetingZoe Mitchell
1. The REG COPD Control Working Group met on May 17th in Denver, Colorado to discuss plans to validate the concept of control in COPD through several research studies.
2. These included a non-interventional database study using the UK OPCRD, two Spanish pilot studies on changes in control versus severity and symptoms, and an international prospective study to validate the concept of control.
3. The group discussed objectives, timelines, and plans for implementation of these validation studies, as well as identifying new areas of research and disseminating results. The goal was to establish control as a valid concept that could help guide treatment decisions and motivate patients.
ATS Symposium: Leukotriene Antagonists As First-line Asthma Controller For St...Zoe Mitchell
ATS Symposium session presented by Prof. David Price:
Leukotriene Antagonists As First-line Asthma Controller For Step 2
Presented May 2015 at ATS 2015, Denver, Colorado, USA
REG Child Health Working Group Meeting 26/09/15Zoe Mitchell
This document provides details of a child health working group meeting, including the agenda, completed work, publication status, and a presentation on a comparative effectiveness study of extra-fine particle inhaled corticosteroids and alternative guideline-recommended step-up options in preschool children with asthma. The meeting will take place on September 26th in Amsterdam, chaired by Steve Turner, and will discuss a real-life MASCOT study, abstracts previously presented, the publication status of three papers, and a proposed comparative effectiveness study using the Optimum Patient Care Research Database to compare outcomes of different treatment approaches for preschool wheeze/asthma.
REG Interstitial Lung Disease Working Group MeetingZoe Mitchell
The meeting agenda included:
1) Introductions of working group members and REG supporters in attendance.
2) An overview of the Respiratory Effectiveness Group (REG) and its mission to conduct real-world respiratory research.
3) A discussion of potential research ideas led by Luca Richeldi, including characterizing healthcare utilization prior to ILD diagnosis, using electronic lung sounds for early diagnosis, and evaluating consistency of ILD diagnoses across multidisciplinary teams.
4) A final group discussion on other opportunities for collaboration within the ILD working group.
Severe Asthma/Biomarkers Working Group ERS 2017Kathryn Brown
The document summarizes a meeting of the Severe Asthma/Biomarkers Joint Working Group. It includes an agenda for presentations on recent and ongoing projects related to using biomarkers like FeNO and blood eosinophils to predict outcomes in severe asthma. Presentations covered recent publications on these topics, updates on registry initiatives like ISAR and available data sources like OPCRD, and ideas for new projects. Attendees also discussed previous ideas around further evaluating biomarkers as predictors of treatment response and clinical outcomes.
This document discusses evidence-based practice in emergency medical services (EMS). It begins with background on EMS developing globally with variations in practice and the need for standardization. It discusses how EMS personnel should base practice on protocols informed by the best available evidence. The document then covers knowledge translation from research to practice and evaluating different types of medical studies. It provides guidance on applying evidence-based practice in EMS through formulating focused clinical questions, acquiring and evaluating relevant evidence, applying results to patients, and assessing impact on EMS protocols, guidelines, algorithms and practice.
This document summarizes the agenda and attendees for an IPF/ILD working group meeting. The meeting will discuss developing and providing feedback on a questionnaire to characterize diagnostic practices for interstitial lung disease globally. Next steps that will be discussed include identifying national leads, translating and adapting the questionnaire for different regions, disseminating the questionnaire through working group networks, and addressing any missing global regions. The goal is to understand real-world diagnostic practices to inform the design of a future study on diagnostic agreement for IPF.
The document summarizes discussions from an IPF/ILD Working Group meeting. It provides updates on several studies, including one characterizing the clinical features and healthcare utilization of IPF patients in the years before diagnosis. The study found increased healthcare resource use in the 2 years prior to an IPF diagnosis. Another study aims to evaluate diagnostic agreement across global sites. The working group discussed priorities for future research, including a Phase II study using digitized patient cases to assess diagnostic accuracy across different healthcare settings.
SNIIRAM: PRIMARY AND SECONDARY CARE RESOURCE USE IN FRANCEZoe Mitchell
This document summarizes information from the SNIIRAM database in France. It discusses:
- SNIIRAM is a national database containing medical claims data from primary, secondary, and tertiary care.
- It allows linkage of data between different levels of care to study patient pathways.
- Examples of studies using SNIIRAM data include analyzing inhaled corticosteroid use patterns in asthma patients, comparing effectiveness of allergen immunotherapy in children with rhinitis, and assessing montelukast's impact on asthma control in infants.
This document summarizes the agenda and key discussion points for several committee meetings taking place on September 26th in Amsterdam. The Research Review committee will discuss priorities for funding respiratory research studies in 2015/2016. They will also evaluate the process for soliciting and reviewing research ideas. The Accreditation committee will discuss accrediting researchers. The Manuscript Review committee will examine their publication process and output over the past year. Overall, the meetings aim to strategize how the organization can best support high-quality respiratory research through prioritizing ideas, funding studies, and disseminating results.
This document summarizes the proceedings of the Small Airways Working Group Meeting held on September 9th, 2017 in Milan. It includes the agenda, list of attendees, and progress updates on several studies. Multiple studies comparing the effectiveness of extra-fine particle inhaled corticosteroids to fine particle ICS have been published or are underway. Preliminary results suggest extra-fine ICS may achieve better asthma control at lower doses and with fewer side effects like pneumonia. The group discussed potential future studies on flexible dosing strategies, metabolic effects of high dose ICS, and the impact of particle size in patients with obesity or GERD. Priority research areas and ongoing protocols were reviewed for continued relevance and feasibility.
Child Health Working Group and Small Airways Study Group Joint MeetingZoe Mitchell
This document provides an agenda and background information for a meeting of the Small Airways & Child Health Working Group. The agenda includes discussions on ongoing publications regarding chest nomenclature and a systematic review on ICS particle size. Presentations will cover pre-school asthma wheeze, new ideas for the group focusing on implications of ICS particle size on GERD and ACOS, and an oscillometry study overview. Background information is provided on the chest commentary and systematic review, including results showing extra-fine ICS have higher odds of asthma control and lower exacerbation rates than fine particle ICS. A proposed study on pre-school asthma will compare outcomes of EF ICS to NEF ICS, LTRA,
This document provides details of an upcoming allergy working group update meeting, including the date, time, location, chair, and agenda. The agenda includes discussions on research ideas like nasal hyper-responsiveness and urticaria. Proposed actions and studies on these topics are described. New data collection opportunities through adding questions to an existing questionnaire are outlined. Potential integration of questions into an Australian pharmacy study is also discussed.
The document provides details about an upcoming annual general meeting for the Respiratory Effectiveness Group (REG). The meeting will take place on September 26th at the Wyndham Apollo Hotel in Amsterdam. David Price will chair the meeting, which will review REG's activities from 2013 to 2015 and look ahead to future opportunities. Some of the key accomplishments highlighted include establishing a global network of over 270 collaborators across 38 countries, running numerous research studies and task forces, publishing several papers and abstracts, and hosting successful summits in 2014 and 2015. The meeting aims to further develop REG's working groups and collaborative activities to generate real-world evidence that can guide clinical practice and policy.
Small Airways Study Group Meeting 25/09/15Zoe Mitchell
The document outlines a planned study comparing the effectiveness of extra-fine particle inhaled corticosteroids (ICS) to non-extra fine ICS, leukotriene receptor antagonists (LTRAs), and short-acting beta agonists (SABAs) as step-up therapy options for preschool children with asthma or wheezing. The study will use data from UK primary care records to conduct a descriptive analysis of treatment patterns and a comparative effectiveness analysis over 1-year and exploratory 5-year outcome periods. The goal is to test if extra-fine ICS achieve better outcomes than alternatives as a step
REG COPD Control Working Group MeetingZoe Mitchell
1. The REG COPD Control Working Group met on May 17th in Denver, Colorado to discuss plans to validate the concept of control in COPD through several research studies.
2. These included a non-interventional database study using the UK OPCRD, two Spanish pilot studies on changes in control versus severity and symptoms, and an international prospective study to validate the concept of control.
3. The group discussed objectives, timelines, and plans for implementation of these validation studies, as well as identifying new areas of research and disseminating results. The goal was to establish control as a valid concept that could help guide treatment decisions and motivate patients.
ATS Symposium: Leukotriene Antagonists As First-line Asthma Controller For St...Zoe Mitchell
ATS Symposium session presented by Prof. David Price:
Leukotriene Antagonists As First-line Asthma Controller For Step 2
Presented May 2015 at ATS 2015, Denver, Colorado, USA
REG Child Health Working Group Meeting 26/09/15Zoe Mitchell
This document provides details of a child health working group meeting, including the agenda, completed work, publication status, and a presentation on a comparative effectiveness study of extra-fine particle inhaled corticosteroids and alternative guideline-recommended step-up options in preschool children with asthma. The meeting will take place on September 26th in Amsterdam, chaired by Steve Turner, and will discuss a real-life MASCOT study, abstracts previously presented, the publication status of three papers, and a proposed comparative effectiveness study using the Optimum Patient Care Research Database to compare outcomes of different treatment approaches for preschool wheeze/asthma.
REG Interstitial Lung Disease Working Group MeetingZoe Mitchell
The meeting agenda included:
1) Introductions of working group members and REG supporters in attendance.
2) An overview of the Respiratory Effectiveness Group (REG) and its mission to conduct real-world respiratory research.
3) A discussion of potential research ideas led by Luca Richeldi, including characterizing healthcare utilization prior to ILD diagnosis, using electronic lung sounds for early diagnosis, and evaluating consistency of ILD diagnoses across multidisciplinary teams.
4) A final group discussion on other opportunities for collaboration within the ILD working group.
Severe Asthma/Biomarkers Working Group ERS 2017Kathryn Brown
The document summarizes a meeting of the Severe Asthma/Biomarkers Joint Working Group. It includes an agenda for presentations on recent and ongoing projects related to using biomarkers like FeNO and blood eosinophils to predict outcomes in severe asthma. Presentations covered recent publications on these topics, updates on registry initiatives like ISAR and available data sources like OPCRD, and ideas for new projects. Attendees also discussed previous ideas around further evaluating biomarkers as predictors of treatment response and clinical outcomes.
This document discusses evidence-based practice in emergency medical services (EMS). It begins with background on EMS developing globally with variations in practice and the need for standardization. It discusses how EMS personnel should base practice on protocols informed by the best available evidence. The document then covers knowledge translation from research to practice and evaluating different types of medical studies. It provides guidance on applying evidence-based practice in EMS through formulating focused clinical questions, acquiring and evaluating relevant evidence, applying results to patients, and assessing impact on EMS protocols, guidelines, algorithms and practice.
This document summarizes the agenda and attendees for an IPF/ILD working group meeting. The meeting will discuss developing and providing feedback on a questionnaire to characterize diagnostic practices for interstitial lung disease globally. Next steps that will be discussed include identifying national leads, translating and adapting the questionnaire for different regions, disseminating the questionnaire through working group networks, and addressing any missing global regions. The goal is to understand real-world diagnostic practices to inform the design of a future study on diagnostic agreement for IPF.
The document summarizes discussions from an IPF/ILD Working Group meeting. It provides updates on several studies, including one characterizing the clinical features and healthcare utilization of IPF patients in the years before diagnosis. The study found increased healthcare resource use in the 2 years prior to an IPF diagnosis. Another study aims to evaluate diagnostic agreement across global sites. The working group discussed priorities for future research, including a Phase II study using digitized patient cases to assess diagnostic accuracy across different healthcare settings.
SNIIRAM: PRIMARY AND SECONDARY CARE RESOURCE USE IN FRANCEZoe Mitchell
This document summarizes information from the SNIIRAM database in France. It discusses:
- SNIIRAM is a national database containing medical claims data from primary, secondary, and tertiary care.
- It allows linkage of data between different levels of care to study patient pathways.
- Examples of studies using SNIIRAM data include analyzing inhaled corticosteroid use patterns in asthma patients, comparing effectiveness of allergen immunotherapy in children with rhinitis, and assessing montelukast's impact on asthma control in infants.
This document provides an overview and agenda for the 2015 REG Winter Summit. It begins with a welcome from David Price, the REG Chairman. It then reviews some of REG's accomplishments in 2014, including publishing papers in a supplement, having proposals accepted at conferences, and growing its network of collaborators and supporters. It discusses REG formalizing its structure with new committees and working groups. It highlights some of REG's research from 2014 focusing on asthma control and severity. It outlines plans and opportunities for REG in 2015, including sessions at respiratory conferences and completing current studies. It closes by welcoming attendees and looking forward to the opportunities to share ideas and strengthen relationships at the summit.
This document discusses Denmark's national health registries and their use for epidemiological research. It notes that Denmark assigns unique personal identification numbers to all citizens, allowing accurate linkage between various health registries. This enables large population-based cohort studies with long-term follow up. The registries contain information on healthcare utilization, prescriptions, and diagnoses. Several studies are described that use the registries to study topics like MMR vaccination and autism, quality of diabetes care, and blood pressure control. Challenges with using registry data include ensuring validity of diagnoses and missing data. However, strengths include no selection bias, large sample sizes, and prospectively collected data.
The document summarizes discussions from the Respiratory Effectiveness Group's 2015 Winter Summit held in Rotterdam, Netherlands from January 22-24, 2015. Key topics discussed included maximizing the use of respiratory disease databases for research, identifying new data resources, and the work of the Small Airways Study Group and Adherence Working Group. Presentations were also given on extra-fine inhaled corticosteroids and the emerging area of asthma-COPD overlap syndrome.
Using CPCSSN Data for Primary Care Research in CanadaZoe Mitchell
CPCSSN provides de-identified primary care data from across Canada for research purposes. It holds data on demographics, diagnoses, medications, lab results, and other clinical information on over 368,000 patients from 329 physicians. The data requires cleaning and standardization. Research opportunities include epidemiological studies, clinical effectiveness research, quality improvement studies, and examining associations. Researchers must submit a letter of intent outlining their study for approval before gaining access to the de-identified data.
REG Biomarkers Working Group Meeting 26/09/15Zoe Mitchell
This document summarizes the agenda and discussion topics for a biomarker working group meeting on September 25th in Amsterdam. The group will discuss publishing updates, including a perspective article comparing NICE and GINA statements on FeNO and a review on the role of eosinophils in airways disease. They will also discuss potential research ideas using data from the Optimum Patient Care Research Database (OPCRD), including evaluating FeNO and eosinophils as predictors of outcomes in COPD. Additional biomarker data will be added to OPCRD, including IgE testing. The group agreed to further discuss selecting some initial research projects and set a date for their next meeting.
REG COPD Control Working Group Meeting 25/9/15Zoe Mitchell
- The document summarizes a COPD control working group meeting discussing two observational pilot studies in Spain validating the concept of COPD control.
- The first study compares changes in control status to changes in severity over 6 months. The second compares control status to respiratory symptoms.
- It also summarizes a UK database pilot study characterizing COPD patients by control status and its clinical implications using the Optimum Patient Care Research Database.
- The study found that only 3.19% of 2,788 COPD patients were considered controlled based on the defined criteria. Uncontrolled patients were more likely to experience exacerbations.
Information System for the Enhancement of Research in Primary CareZoe Mitchell
This document describes SIDIAP, a database created in 2010 to promote primary care research using clinical data from electronic medical records of over 5.8 million patients in Catalonia, Spain. SIDIAP contains socio-demographic, clinical, prescription, and hospitalization data. It adds value through high population coverage, validated data, and symbiosis with health providers. Researchers can apply to use de-identified data for studies. Limitations include some unavailable variables, but improvements are being made. Examples of respiratory research include COPD prescription patterns and identifying gaps in alpha-1 antitrypsin deficiency diagnosis.
The study aims to compare the effectiveness of different step 2 asthma management approaches in pre-school children using a retrospective cohort design. The primary outcome is asthma exacerbations over 1 year as defined by ATS/ERS criteria. Secondary outcomes include acute respiratory events, risk domain asthma control, and reliever medication use. Eligible children aged 5 or under will be identified from UK clinical databases based on wheezing episodes or oral steroid prescriptions in the prior year. They will be matched and compared based on initial step 2 treatment of either EF ICS, NEF ICS, LTRA, or SABA alone. Subgroup analyses are planned based on atopy and demographic factors. An exploratory analysis will also assess outcomes over
Validation of Real-World Thoracic CT Scanes for Quantitative Analysis of COPDZoe Mitchell
This study evaluated the reproducibility of quantitative CT (QCT) metrics of emphysema using clinical CT scans from multiple centers. The study found that QCT metrics like low attenuation area (LAA) and lung density (LD) were reproducible across different scanners when corrected for actual lung volume. Metrics were more reproducible when corrected for measured total lung capacity (TLC) than predicted TLC. Contrast media was found to alter QCT metrics in a predictable way such that contrast and non-contrast scans could be compared using correction factors. Validating these findings in other cohorts and understanding the lung volume changes with contrast media were identified as important future directions.
The document summarizes a meeting of the REG Collaborators at the ERS 2013 conference in Barcelona. The purpose of the meeting was to: 1) provide updates on current REG research activities and quality standards work; 2) generate ideas for new REG activities, including addressing guidelines; and 3) allow collaborators to share information on other projects. The agenda included presentations on ongoing asthma and COPD studies, quality standards highlights, working with guidelines, and an open ideas session for collaborators to discuss other initiatives. The meeting concluded by welcoming new REG collaborators from over 20 countries.
This document provides a summary of the Respiratory Effectiveness Group (REG) Collaborators' Meeting held at the 2013 European Respiratory Society Congress in Barcelona. The meeting agenda included updates on current REG activities like publications, research studies, and quality standards. Presentations were given on new data from studies on asthma and COPD phenotypes, smoking cessation, and validating real-life asthma endpoints. There was also discussion of developing standards for real-life research, engaging with guidelines, and new initiatives from collaborators. The research update highlighted studies on asthma control and adherence, oral steroid burden in refractory asthma, and predicting asthma risk.
Ron Dandurand presented at the Respiratory Effectiveness Group Summit in Lyon, France on April 15, 2016. His objectives were to prove the non-inferiority of spirometry compared to oscillometry, raise reasonable doubt that spirometry should be abandoned, and present a novel approach to spirometry analysis. He discussed the history and advantages/disadvantages of spirometry versus oscillometry. While oscillometry provides more data points, it is not fair to directly compare the two without accounting for their different information levels. Spirometry, if analyzed beyond typical indices, may be able to approximate small airway function tests and detect disease at earlier stages.
This document discusses current and future innovation in the pharmaceutical industry from the perspective of Merck Research Laboratories. It outlines Merck's strategy to discover, develop, and bring innovative medicines to market by pursuing promising science, prioritizing key opportunities, and adapting to a changing landscape. Statistics are provided on Merck's 2018 clinical trial operations, and the relationships between product development teams, clinical sub-teams, and clinical trial teams. Considerations for clinical trial planning, site selection, and protocol design are examined. Pembrolizumab clinical development across many tumor types is reviewed, as are challenges developing a treatment for all genotypes of Hepatitis C.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Improving Care: More Method, Less Uncertainty, Impact summit 30 October 2013NHS Improving Quality
Improving Care: More Method, Less Uncertainty, Impact summit
30 October 2013
Improving Care: More Method, Less Uncertainty – Impact Summit, the second full day event in the Measurement Masterclass series, took place at the Central Hall Westminster in London on 30 October. The event was opened by Professor Sir Bruce Keogh and NHS IQ’s own Professor Moira Livingston, and included contributions from experts from across England and a virtual appearance by Dr Bob Lloyd.
This series for senior clinical leaders was developed to help increase the understanding of the principles of measurement for improvement. Designed to stimulate and challenge, it is supporting clinical leads in holding influential discussions with policy makers and data collectors.
To take the series forward and promote measurement for improvement more widely, NHS Improving Quality is setting up an advisory group to design and develop more learning resources for senior clinicians and their teams
More information: http://www.nhsiq.nhs.uk/capacity-capability/measurement-masterclass.aspx
The document summarizes the process of crowdsourcing input from Allied Health Professionals (AHPs) in the UK to develop a strategy and mandate for change in the NHS. Over 1,900 AHPs from across the UK and other countries provided over 16,000 contributions online over two phases to identify key challenges and priorities. Analysis of the input revealed four ways AHPs can impact the health system and four commitments, as well as four themes and 16 specific enablers to realize their potential. The crowdsourcing approach engaged more people than traditional methods and generated valuable insights to inform the upcoming "#AHPsmandate" strategy to be launched in October 2016.
The NIHR Research Design Service provides support to NHS staff and academics preparing research proposals for submission to peer-reviewed funding competitions for applied health or social care research.
This document summarizes a project by the Green Park Collaborative to develop guidance on clinical drug trials in oncology where high rates of treatment switching are expected. The project brought together stakeholders from payers, regulatory agencies, universities, and patient groups. Through literature reviews, interviews, and workshops, they developed 18 recommendations across 5 areas to help ensure trials with treatment switching can still generate valid evidence for decision-makers. The final guidance document was released in October 2016.
This document provides guidance for the Clinical Outcomes Publication (COP) program, which publishes quality measures from National Clinical Audits at the consultant, team, and unit level. It covers topics like quality measures, data quality, outlier identification and management, legal considerations, and more. The goal of COP is to improve clinical quality and support transparency by learning from high performers and celebrating excellence. Participating audits are expected to report risk-adjusted mortality as well as additional specialty-specific quality measures of importance to patients.
Oral presentation ICC-PBM 2018 @ G-I-N conference Manchester (UK) 2018CEBaP_rkv
The document describes how an international consensus conference on patient blood management (ICC-PBM) integrated the GRADE approach and a formal consensus methodology. A scientific committee formulated 17 questions to guide 3 topics of interest. A 2-day conference included 200 medical experts from 10 disciplines who reviewed evidence using GRADE. It included open sessions for evidence presentation, discussion, and closed executive sessions where decision-making panels drafted recommendations. The process aimed to develop transparent, evidence-based consensus guidelines for optimizing patient blood management.
Report on the progress of NAAF’s Patient-Reported Outcome (PRO) Consortium to develop a single, consensus-defined PRO instrument that can be shared across industry partners and other ongoing initiatives to incorporate the voice of the patient in alopecia areata research.
The document summarizes the proceedings of the Allergy Working Group Meeting. It includes:
1) An agenda covering a progress update, priorities for future research including potential studies, and additional items.
2) Results from an active study quantifying the burden of acute versus chronic rhinosinusitis in primary care showing most patients received antibiotics.
3) Discussion of two potential projects on characterizing oral steroid use in asthma and validating an app for rhinosinusitis and asthma patients. The group discussed setting priorities for allergy research by collaborating with patients and pursuing the most important projects.
Cadth symposium 2015 d3 pro presentation apr 2015 - for debCADTH Symposium
This document summarizes a presentation on implementing patient reported outcomes (PROs) to improve patient-centered care. It discusses collecting PRO data through distress screening tools and patient satisfaction surveys, analyzing the data, and using it to select and evaluate quality improvement initiatives. PROs are outcomes that patients report on issues like symptoms, experience of care, and quality of life. The presentation outlines the benefits of PROs, Saskatchewan Cancer Agency's implementation including two PRO tools and progress to date, and lessons learned around using a phased approach and technology to gather and apply PRO evidence to enhance care.
Writing A Phase I Protocol: A Multidisciplinary Team ApproachSGS
The document discusses the importance of a multidisciplinary team approach to developing clinical trial protocols. It emphasizes that protocol development requires significant time and input from various experts, including medical, statistical and pharmacokinetic experts. Developing a stable protocol synopsis with input from the core team takes at least 4 additional weeks. The full protocol can then be developed from the synopsis in a minimum of 6 weeks for a simple early phase study if the synopsis is stable, but more time is needed if the study design must be developed.
The document discusses the role and activities of the UK National Screening Committee (UK NSC). It provides that the UK NSC sets policy for systematic population screening programs in the UK based on criteria for effectiveness, acceptability, and cost. The document outlines challenges facing the UK NSC, including governance, membership, defining screening programs, and evidence review processes. It also discusses recent approvals of new screening programs and evidence reviews currently underway.
Keeping It Real:Resources for Implementing Evidence-based Public Health Progr...MargaretFarrell
Through this workshop, participants will
not only become familiar with how to use the tools they need to identity and address health outcomes, but
understand the benefits of virtual communities of practice as a means to engage researchers and practitioners around implementing cancer control programs.
will introduce participants to the Cancer Control P.L.A.N.E.T portal and the Research to Reality Community of Practice. (#NCIR2R)
Presentation given at the NATIONAL HEALTH OUTREACH CONFERENCE (#NHOC) Promoting Connections to Create Healthy Individuals, Families and Communities May 8, 2015
ScHARR Health Economics and Decision Sciencs (HEDS) Newsletter- Summer 2015ScHARR HEDS
The Health Economics and Decision Science department at the University of Sheffield is developing a new patient-reported outcome measure called Recovering Quality of Life (ReQoL) to assess quality of life for people with mental health difficulties. ReQoL will consist of seven themes identified from a literature review and patient interviews. Over 1,000 patients will help validate an initial pool of 61 questions across clinical settings. Psychometric analysis will produce short and long versions of ReQoL. Validation work will continue into 2016, with the goal of providing a new tool for evaluating mental healthcare outcomes in both clinical practice and economic studies.
This document summarizes a meeting to discuss a proof of concept study on asthma-COPD overlap syndrome (ACOS) using electronic medical records. The study aims to test various smoking-related ACOS population definitions across databases to evaluate prevalence and agreement. The meeting reviewed results from a UK pilot study using one database and definitions based on clinical diagnoses over 2 years. Prevalence of ACOS varied from 8-32% depending on the source population. The meeting also discussed expanding the study to other eligible databases and characterizing clinical implications of different definitions.
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This document summarizes opportunities and challenges for real-time research in Singapore public primary care institutions. It provides an overview of the Singapore healthcare system and SingHealth Polyclinics' (SHP) role in primary care. SHP has integrated electronic health records and databases that can be used for research. However, challenges include integrating different databases, ensuring data access compliance, limited staff research capacity, and competing for research grants. The future includes staff database training, streamlining data access processes while complying with privacy laws, configuring systems to facilitate data mining, and establishing collaborations to expand SHP's research capacity.
This document discusses maximizing patient outcomes in respiratory care. It outlines the founding principles of the Respiratory Effectiveness Group (REG), which aims to better integrate real-world evidence from sources like observational studies and pragmatic trials into clinical practice guidelines. Currently, guidelines are often based primarily on randomized controlled trials, which have limitations and may not generalize to most patients. The document calls for considering a diversity of evidence and tailoring care to individual patient needs and characteristics. It also discusses how databases could help achieve more personalized care by providing real-world data on topics like disease prevalence, treatments, and outcomes across different healthcare systems.
Utilising real-world evidence to achieve precision medicine in COPDZoe Mitchell
This document discusses precision medicine approaches to tailoring COPD management to individual patient needs and phenotypes. It reviews current guidelines for COPD pharmacotherapy and how to optimize therapy for the specific patient. It provides an overview of treatable traits and phenotypes in COPD and examples of targeting treatment based on a patient's profile, such as using ICS for an eosinophilic phenotype. The document also discusses two case scenarios - one involving a patient with recurrent exacerbations and how to determine the best treatment approach, and another involving optimizing therapy for a returning patient.
Safety and Affordabilty: Quantifying the impact of real-world evidenceZoe Mitchell
This document discusses assessing drug safety and risks using real-world evidence from outside of clinical trials. It begins by examining what can be learned about risks and safety from randomized controlled trials (RCTs), noting their limitations in detecting uncommon or long-term adverse events. The document then explores how real-life studies can help evaluate risks in pulmonary diseases by studying more diverse populations over longer time periods. Examples are provided of real-world studies assessing safety issues for COPD and asthma medications. Unmet needs in respiratory medicine are also identified where further safety data is required.
Simple Steps to Make Her Choose You Every DayLucas Smith
Simple Steps to Make Her Choose You Every Day" and unlock the secrets to building a strong, lasting relationship. This comprehensive guide takes you on a journey to self-improvement, enhancing your communication and emotional skills, ensuring that your partner chooses you without hesitation. Forget about complications and start applying easy, straightforward steps that make her see you as the ideal person she can't live without. Gain the key to her heart and enjoy a relationship filled with love and mutual respect. This isn't just a book; it's an investment in your happiness and the happiness of your partner
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
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Basics of Electrocardiogram
CONTENTS
●Conduction System of the Heart
●What is ECG or EKG?
●ECG Leads
●Normal waves of ECG.
●Dimensions of ECG.
● Abnormalities of ECG
CONDUCTION SYSTEM OF THE HEART
ECG:
●ECG is a graphic record of the electrical activity of the heart.
●Electrical activity precedes the mechanical activity of the heart.
●Electrical activity has two phases:
Depolarization- contraction of muscle
Repolarization- relaxation of muscle
ECG Leads:
●6 Chest leads
●6 Limb leads
1. Bipolar Limb Leads:
Lead 1- Between right arm(-ve) and left arm(+ve)
Lead 2- Between right arm(-ve) and left leg(+ve)
Lead 3- Between left arm(-ve)
and left leg(+ve)
2. Augmented unipolar Limb Leads:
AvR- Right arm
AvL- Left arm
AvF- Left leg
3.Chest Leads:
V1 : Over 4th intercostal
space near right sternal margin
V2: Over 4th intercostal space near left sternal margin
V3:In between V2 and V4
V4:Over left 5th intercostal space on the mid
clavicular line
V5:Over left 5th intercostal space on the anterior
axillary line
V6:Over left 5th intercostal space on the mid
axillary line.
Normal ECG:
Waves of ECG:
P Wave
•P Wave is a positive wave and the first wave in ECG.
•It is also called as atrial complex.
Cause: Atrial depolarisation
Duration: 0.1 sec
QRS Complex:
•QRS’ complex is also called the initial ventricular complex.
•‘Q’ wave is a small negative wave. It is continued as the tall ‘R’ wave, which is a positive wave.
‘R’ wave is followed by a small negative wave, the ‘S’ wave.
Cause:Ventricular depolarization and atrial repolarization
Duration: 0.08- 0.10 sec
T Wave:
•‘T’ wave is the final ventricular complex and is a positive wave.
Cause:Ventricular repolarization Duration: 0.2 sec
Intervals and Segments of ECG:
P-R Interval:
•‘P-R’ interval is the interval
between the onset of ‘P’wave and onset of ‘Q’ wave.
•‘P-R’ interval cause atrial depolarization and conduction of impulses through AV node.
Duration:0.18 (0.12 to 0.2) sec
Q-T Interval:
•‘Q-T’ interval is the interval between the onset of ‘Q’
wave and the end of ‘T’ wave.
•‘Q-T’ interval indicates the ventricular depolarization
and ventricular repolarization,
i.e. it signifies the
electrical activity in ventricles.
Duration:0.4-0.42sec
S-T Segment:
•‘S-T’ segment is the time interval between the end of ‘S’ wave and the onset of ‘T’ wave.
Duration: 0.08 sec
R-R Interval:
•‘R-R’ interval is the time interval between two consecutive ‘R’ waves.
•It signifies the duration of one cardiac cycle.
Duration: 0.8 sec
Dimension of ECG:
How to find heart rhytm of the heart?
Regular rhytm:
Irregular rhytm:
More than or less than 4
How to find heart rate using ECG?
If heart Rhytm is Regular :
Heart rate =
300/No.of large b/w 2 QRS complex
= 300/4
=75 beats/mins
How to find heart rate using ECG?
If heart Rhytm is irregular:
Heart rate = 10×No.of QRS complex in 6 sec 5large box = 1sec
5×6=30
10×7 = 70 Beats/min
Abnormalities of ECG:
Cardiac Arrythmias:
1.Tachycardia
Heart Rate more than 100 beats/min
Cancer treatment has advanced significantly over the years, offering patients various options tailored to their specific type of cancer and stage of disease. Understanding the different types of cancer treatments can help patients make informed decisions about their care. In this ppt, we have listed most common forms of cancer treatment available today.
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
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The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
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Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
1. Saturday May 16th, 16.30-18.00 (MST)
Altitude Room; Crowne Plaza, Denver, Colorado
REG Interstitial Lung Disease Working
Group Meeting
2. Agenda
Time Item Lead
7.30–7.40 Welcome & Introductions Richard Martin (Co-Chair)
7.40–7.55 REG Research: update & call for participation David Price
7.55-8.05
Future Plans: staffing & events update
David Price, Thao Le,
Alison Chisholm
• Revised staffing structure: who are your key contacts?
• Working Group & Council Structure: who does what?
• 2015/16 Events: when will we see you next?
o EAACI Events
o ERS Events – AGM & Council Meeting
o 2016 REG Summit
8.05–8.20
Driving Quality Standards
• What else should we be doing?
• ERS Vision – “Real Life Evidence”
Nicolas Roche & Group
Discussion
8.20–8.35
A word from REG’s Supporters
invited Industry perspectives on REG activities & real-life
research priorities
REG supporters
8.35–8.50
PCORI: New funding source for comparative
effective research
Followed by discussion of additional funding opportunities
Jerry Krishnan
(Co-Chair)
8.50-9.00 Open Discussion: Feedback & Ideas Forum Group Discussion
9.00 CLOSE
4. David Price (REG Chairman)
7.40-7.55am
Research & Activity Update
& Call for participation
5. Protocol
development
Data extraction
Phase I
(or baseline)
Phase II
(or results)
Publication
✔ ✔
✔ ✔ ✔ ✔
✔ ✔
✔ ✔ ✔ ✔
✔ ✔ ✔ ✔
✔ ✔
✔ ✔ ✔ ✔
✔ ✔ ✔ ✔ ✔
2013/14 Initiated Studies
Independent risk predictors modeled; risk
predictor tool in development. 1 x abstract
Characteristics that predict step-up
treatment choice – published. CE outcomes
manuscript in print. 3 x abstracts to date
Mapping of different adherence measures over
3 years – complete; bidirectional relationship
between adherence & outcomes to commence
3 abstracts to date
Analysis complete. Manuscript outline
in development: “predictive quality of
database outcomes”. 3 x abstracts
Analysis complete; manuscript
outline reviewed by steering
committee; draft paper by June
Cross-sectional analysis of comorbidities in
refractory asthma patients – complete & ms
written. Longitudinal analysis of comorbidities
associated with os use still to be completed
Collaboration with UK Department
of Health. Paper published in
Lancet Respiratory Medicine
Diagnostic opportunities
Analysis complete. Manuscript in draft;
paediatric abstract presented at REG
Regional Summit; Full report at EAACI 2015
6. Protocol
development
Data
extraction
Phase I
(or baseline)
Phase II
(or results)
Publication
✔ ✔
✔
✔ ✔ ✔ ✔
✔ ✔ ✔
COPD
control
2014/15 Initiated Studies
COPD Triple Therapy
Protocol developed;
Seeking Funding…?
Final voting underway;
publication to follow
shortly
Working group meeting tomorrow to
plan protocol delivery
REALISE
ASIA
Longitudinal Asthma Steps.
Protocol developed; Funding
discussions underway
Proposal to item reduce and
validate a reduced item EXACT-
PRO. Funding under discussion
Supported Asthma UK to
quantify prescribing “Errors” as
defined by national asthma
deaths registry. 1 x abstract
COPD RISK PREDITCORS:
spin off of COPD
eosinophils. Ms in final
pre-submission stages
7. Pin board – funding awards
REG CORE FUNDING TO
COVER TOP 2 RANKED
RESEARCH STUDIES
REG CORE FUNDING TO COVER
DATA EXTRACTION (ONLY) FOR
FURTHER 2 HIGHLY-RANKED
STUDIES
8. • Voted REG 2014 Research Pinboard: #1 priority
• Lead Investigator: Jonathan Grigg
• The particle size and delivery characteristics of extra-fine
hydrofluoroalkane beclomethasone [EF HFA-BDP] aerosol may be
particularly relevant for young children in whom a greater proportion
of airways are classified as small
(<2mm in diameter)1 and airways resistance is low.
• There are evidence to suggestion that EF HFA BDP is equivalent to
CFC fliuticasone (FP) in terms of efficacy and safety in adults and
children (5–12 years) with mild-to-moderate asthma.2,3
• Evidence remains lacking as to the role that ICS particle size may
play in the management of asthma/wheeze in younger, pre-school
(<5 years) children.
1. Leach CL, et al. Eur Respir J. 1998;12:1346–1353.
2. Aubier M, et al. Respir Med. 2001;95:212–220.
3. Fairfax A, et al. Ann Allergy Asthma Immunol. 2001;86:575–582.
9. Aims & Objectives
• Aim: to improve understanding of the prescribing of guideline
recommended management approaches, and their
comparative effectiveness, in the routine care of UK children
with wheezing illness in their early (pre-school) years.
• Phase I: a descriptive analysis of treatment patterns in
children aged ≤5 years with wheezing illness
• Part II: a comparative effectiveness analysis of guideline-
recommended treatment options in pre-school children newly
initiating Step 2 therapies:
o 3 x 2-way matched comparative effectiveness analysis: EF
ICS, NEF ICS and LTRA vs SABA
o Relative benefit of EF ICS vs SABA over alternatives
10. Study Design
Outcome Measures:
• Exacerbations
• Database Asthma
control measures
• Acute respiratory
events
• SABA usage
Index Date:
Date of first asthma /
wheeze prescription
Baseline year:
12-months prior to first Step 2
treatment prescription for asthma /
wheeze; patient characterisation and
confounder definition
Secondary (exploratory) 5-year outcome period
Primary 1-year outcome period
EF HFA BDP
Ciclesonide
LTRA
NEF BDP
FP
Eligible patients must:
• Have diagnostic evidence of asthma /
wheeze
• be aged ≤5 years
EF ICS
Control
NEF ICS
11. • Voted REG 2014 Research Pinboard: #2 priority
• Lead Investigator: Nikos Papadopoulos; Clare Murray
• Does the addition of (oral) antibiotics to oral
corticosteroids in an acute asthma exacerbation offer
benefit in terms of:
o Time to next unscheduled GP visit with asthma;
o Time to next oral corticosteroid prescription and use
of SABA of the following 6 months?
• Stratified by antibiotic class
12. • Voted REG 2014 Research Pinboard: #3 priority
• Lead Investigator: Karin Lisspers on behalf of IPCRG’s UNLOCK
• Are pharmacological RCTs relevant to real life asthma
populations?
• Aim: Explore to what extent are the inclusion criteria for people with
asthma in RTCs representative of real life primary care populations
with asthma.
• Method: Compare data from primary care asthma populations at
treatment step 2/3 with those meeting the inclusion criteria for the
RCTs that underpin key asthma guidelines (i.e. GINA, BTS/SIGN,
CTS, AAH).
13. • Voted REG 2014 Research Pinboard: #6 priority
• Lead Investigator: Björn Ställberg on behalf of IPCRG’s UNLOCK
• The prevalence of comorbidities in COPD patients and their
impact on the quality of life and COPD symptoms in primary
care patients
• Aim: To enhance knowledge in terms of prevalence of comorbidities
in COPD patients and their impact on the quality of life and on
COPD symptoms in primary care patients.
• Method: Retrospective cross sectional analysis of primary care data
from different countries. Analysis will include descriptive statistics,
null hypothesis tests such as Chi-Square, factorial analysis of
variance and predictive binary logistic regression models.
14. Call for participation: Checklist
• Delphi to develop an optimum &
minimum checklist for
“research-ready” databases
o Optimum checklist
developed in Rotterdam –
wider validation required
o Delphi item reduction
required to confirm minimum
mandatory criteria
15. Events in 2015: Rotterdam & Singapore
REG 2015 Global Summit
Date: 22–24 January 2015
Rotterdam
REG 2015 Regional Summit
Date: 25–26 April 2015
Singapore
16. Publications in 2015
• Small Airways Working Group:
o Increased Dose of ICS vs. ICS/LABA for Step-Up Therapy in
Asthma1
o Differential effects of ICS in smokers/ex-smokers and non-
smokers with asthma2
o Small-particle ICS as first-line or step-up controller therapy in
childhood asthma3
• Child Health Working Group:
o Initial step-up treatment changes in asthmatic children already
prescribed inhaled corticosteroids: a historical cohort study4
• Breathe Review:
o Commissioned review following REG’s 2014
ERS Symposium: Real-world research and its importance in
respiratory medicine.5
• REG 2015 Rotterdam Summit Abstract Book6
• ARCH Supplement now OPEN ACCESS
1Israel E, et al. Ann Am Thorac Soc 2015 Mar 10. [Epub ahead of print];
2Roche N, et al. Am J Respir Crit Care Med 2015;191:960-964; 3Accepted at JACI: In Practice 23 Apr 2015; 4Price D, et al. Breathe.
2015;11:26-38; 5Accepted at Nature, Primary Care Respiratory Journal. 7 Apr 2015; 6Pragmatic and Observational Research. 2015;
6:13—38; 7Ann Am Thorac Soc. 2014;11:Supplement 2
ALL PUBLICATIONS ARE BEING POSTED ONLINE –
VISIT THE WEBSITE FOR ON-GOING UPDATES &
AUTHOR GUIDELINES
17. Symposia activity in 2015
• WAAC: April 2015 – done!
• EAACI: June 2015 – 2 x sessions:
o Efficacy-based to effectiveness-based
guidelines in asthma: a paradigm
shift?
o Harnessing primary care databases to
unpick the complexities of allergic
obstructive airway disease
• 2015 WAO & APSR session
proposals – submitted!
• EAACI 2016 – session accepted
• ERS 2016: 3 x session proposals
submitted
• But First…ATS
symposium this
Wednesday!
18. Agenda
Time Item Lead
7.30–7.40 Welcome & Introductions Richard Martin (Co-Chair)
7.40–7.55 REG Research: update & call for participation David Price
7.55-8.05
Future Plans: staffing & events update
David Price, Thao Le,
Alison Chisholm
• Revised staffing structure: who are your key contacts?
• Working Group & Council Structure: who does what?
• 2015/16 Events: when will we see you next?
o EAACI Events
o ERS Events – AGM & Council Meeting
o 2016 REG Summit
8.05–8.20
Driving Quality Standards
• What else should we be doing?
• ERS Vision – “Real Life Evidence”
Nicolas Roche & Group
Discussion
8.20–8.35
A word from REG’s Supporters
invited Industry perspectives on REG activities & real-life
research priorities
REG supporters
8.35–8.50
PCORI: New funding source for comparative effective
research
Followed by discussion of additional funding opportunities
Jerry Krishnan
(Co-Chair)
8.50-9.00 Open Discussion: Feedback & Ideas Forum Group Discussion
9.00 CLOSE
19. David Price, Thao Le, Alison Chisholm
Future Plans: staffing & events
20. Staffing: who does what?
John
Haughney
David Price
Alison
Chisholm
David
Price
Trevor
Lambert
Nick
May
Thao Le
Linh Hayman
Contracted as
needed
Mylee
Durack
Agency providers
Contracted as needed
Starting June
Zoe
Mitchell
When David steps down as REG
Chairman, we will be looking to
appoint a Chair of Council…
volunteers welcomed!
22. REG Support & Research Funding
RESEARCH IDEA
GENERATION
Working Groups
Identify Research
Priorities in their
respective fields of
expertise
SECURING FUNDING
Nature of funding dictates future study course:
• Single commercial funding source: an investigator
initiated study conducted external to REG
• Non-product/brand specific grant(s): an REG
Collaboration carried by REG or in partnership with
REG
REG
Supporters
Non-supporter
& wider
institutional
grants
OR
REG develops idea
in collaboration
with WG /
collaborators &:
(i) Seeks external
support
(ii) Submits for
REG Core
Funding Grant
REG Grants
awarded
at FY end
REG Core Grants
Awarded to Top
Priority Ideas
(subject to
available funding)
Mid October Core
Grant submission
deadline
Ideas prioritised
by REG
Research
Committee
If insufficient REG Funds, continue to look externally
23. Working
Groups
“At a
Glance”
Terms of reference
drafted; initial project
ideas in development
IPCRG’s
UNLOCK Group
Inaugural Meeting
at EAACI 2015
Well underway –
first paper
accepted in April!
Inaugural Meeting in
Rotterdam; Checklist
Delphi & Registry Work
about to commence
Long-established,
successful group, came
under REG in 2014
Still to be established
Committee Meetings
Held in Rotterdam
REG/EAACI
Taskforce leading
current activities
Meeting 7-9am
tomorrow
Inaugural
meeting 4.30-
6pm today!
Pre-cursor Workshops;
Second Workshop 2-
3pm today
Working Group Meeting
tomorrow 4-6pm
Inaugural Meeting
at EAACI 2015
Met in Rotterdam; study
on-going & Expert
(Taxonomy) Meeting at
EAACI 2015
24. Events: what’s coming next…?
Barcelona
June 2015
First meeting of the Allergy Working Group:
2-3pm June 7th, Barcelona
Working Group Lead: Peter Hellings
First meeting of the Biomarkers Working Group:
5-6pm June 7th, Barcelona
Working Group Lead: Leif Bjermer
Adherence Expert Panel Meeting
One-day focused meeting to develop a
Roadmap for Respiratory Adherence Research
June 11th, Barcelona
Working Group Lead: Gene Colice
25. Adherence Expert Panel Meeting
• International panel of experts to review
key topics within respiratory adherence
research.
• Present and discuss key issues
and challenges in adherence research
• Meeting structure:
o Taxonomy
o Placing adherence behaviours in the context of respiratory care
o Considering specific populations and topics.
o Measurement – of adherence behaviours, determinants and
capturing accurate data
o Opportunities to improve adherence – scalable interventions with
proven effect
• Output: themed issue of:
Adherence Roadmap
26. Events: what’s coming next…?
Friday September 25th
• REG Annual General Meeting
immediately followed by…
• REG Council Meeting
(2016 strategic planning)
+ further
working group
meetings
27. Coming up… REG Summit 2016
• Dovetail 2016 Summit
with final ASTROLAB
symposium
o Day 1: ASTROLAB
o Days 2 & 3:
REG WG Meetings
& Summit
• Venue: Lyon
• Date: Late March /
Early April 2016 (to
avoid ATS) – Thurs-
Saturday:
o 30 March – 2 April
o 7–9 April
o 14-16 April
o 21-23 April
An FP7-supported Project to
investigate the safety of
asthma therapy, with a focus
on adherence
ASTROLAB: Assessment of Safety of
LABAs in Asthma routine Care by
Combining Healthcare Databases
and Direct Patient Follow-up
Compare severe exacerbations rates in patients with asthma
treated by LABAs ± concomitant ICS in routine care
Astrolab Meeting Attendance: 50-100
• Regulators
• Scientific societies
• Patients
• Health Care Professionals
• EU representatives
• Partners and Advisory Boards
28. Agenda
Time Item Lead
7.30–7.40 Welcome & Introductions Richard Martin (Co-Chair)
7.40–7.55 REG Research: update & call for participation David Price
7.55-8.05
Future Plans: staffing & events update
David Price, Thao Le,
Alison Chisholm
• Revised staffing structure: who are your key contacts?
• Working Group & Council Structure: who does what?
• 2015/16 Events: when will we see you next?
o EAACI Events
o ERS Events – AGM & Council Meeting
o 2016 REG Summit
8.05–8.20
Driving Quality Standards
• What else should we be doing?
• ERS Vision – “Real Life Evidence”
Nicolas Roche & Group
Discussion
8.20–8.35
A word from REG’s Supporters
invited Industry perspectives on REG activities & real-life
research priorities
REG supporters
8.35–8.50
PCORI: New funding source for comparative
effective research
Followed by discussion of additional funding opportunities
Jerry Krishnan
(Co-Chair)
8.50-9.00 Open Discussion: Feedback & Ideas Forum Group Discussion
9.00 CLOSE
29. Nicolas Roche (REG European Lead)
8.05-8.20am
Driving Quality Standards:
REG/EAACI Taskforce Update
30. Quality initiatives: REG/EAACI Taskforce
• Review of the CER
asthma literature over the
last 10 years
• Focus on key PICOT
questions that looking at
“gaps” in the evidence
• Development of a quality assessment tool / checklist to
appraise the literature
• Identify CER papers that should be considered by
guideline developers
• Clarify apparent contradictions in the evidence
• Identify as yet unmet research needs
31. What else should we be doing?
• Collaborating with other societies?
32. Agenda
Time Item Lead
7.30–7.40 Welcome & Introductions Richard Martin (Co-Chair)
7.40–7.55 REG Research: update & call for participation David Price
7.55-8.05
Future Plans: staffing & events update
David Price, Thao Le,
Alison Chisholm
• Revised staffing structure: who are your key contacts?
• Working Group & Council Structure: who does what?
• 2015/16 Events: when will we see you next?
o EAACI Events
o ERS Events – AGM & Council Meeting
o 2016 REG Summit
8.05–8.20
Driving Quality Standards
• What else should we be doing?
• ERS Vision – “Real Life Evidence”
Nicolas Roche & Group
Discussion
8.20–8.35
A word from REG’s Supporters
invited Industry perspectives on REG activities & real-life
research priorities
REG supporters
8.35–8.50
PCORI: New funding source for comparative
effective research
Followed by discussion of additional funding opportunities
Jerry Krishnan
(Co-Chair)
8.50-9.00 Open Discussion: Feedback & Ideas Forum Group Discussion
9.00 CLOSE
33. Industries view on real-world research
priorities
8.20-8.35am
A Word from REG’s Supporters
34. Agenda
Time Item Lead
7.30–7.40 Welcome & Introductions Richard Martin (Co-Chair)
7.40–7.55 REG Research: update & call for participation David Price
7.55-8.05
Future Plans: staffing & events update
David Price, Thao Le,
Alison Chisholm
• Revised staffing structure: who are your key contacts?
• Working Group & Council Structure: who does what?
• 2015/16 Events: when will we see you next?
o EAACI Events
o ERS Events – AGM & Council Meeting
o 2016 REG Summit
8.05–8.20
Driving Quality Standards
• What else should we be doing?
• ERS Vision – “Real Life Evidence”
Nicolas Roche & Group
Discussion
8.20–8.35
A word from REG’s Supporters
invited Industry perspectives on REG activities & real-life
research priorities
REG supporters
8.35–8.50
New funding opportunities:
North American Initiatives and Grants for Implementation
Science
Jerry Krishnan
(Co-Chair)
8.50-9.00 Open Discussion: Feedback & Ideas Forum Group Discussion
9.00 CLOSE
35. Jerry Krishnan (REG/ATS Liaison)
8.35-8.50am
PCORI: New funding source for
comparative effectiveness research
36. Agenda
Time Item Lead
7.30–7.40 Welcome & Introductions Richard Martin (Co-Chair)
7.40–7.55 REG Research: update & call for participation David Price
7.55-8.05
Future Plans: staffing & events update
David Price, Thao Le,
Alison Chisholm
• Revised staffing structure: who are your key contacts?
• Working Group & Council Structure: who does what?
• 2015/16 Events: when will we see you next?
o EAACI Events
o ERS Events – AGM & Council Meeting
o 2016 REG Summit
8.05–8.20
Driving Quality Standards
• What else should we be doing?
• ERS Vision – “Real Life Evidence”
Nicolas Roche & Group
Discussion
8.20–8.35
A word from REG’s Supporters
invited Industry perspectives on REG activities & real-life
research priorities
REG supporters
8.35–8.50
New funding opportunities:
North American Initiatives and Grants for Implementation
Science
Jerry Krishnan
(Co-Chair)
8.50-9.00 Open Discussion: Feedback & Ideas Forum Group Discussion
9.00 CLOSE
37. All Collaborators & Attendees
8.50-9.00am
Open discussion:
new ideas & feedback
39. Saturday May 16th, 16.30-18.00 (MST)
Altitude Room; Crowne Plaza, Denver, Colorado
REG Interstitial Lung Disease Working
Group Meeting
Editor's Notes
1.A minor correction –
Slide #21, 835a (to be consistent with #2) should say:
PCORI: New funding source for comparative effective research
Followed by discussion of additional funding opportunities
2. slide #42 – the EAACI Task force / 1300 – I am on that task force? I have 2 conflicts but will try and attend.