2015 ERS EVENTS

DATE: FRIDAY SEPTEMBER 25TH

VENUE: Wyndham Apollo Hotel, AmsterdamROOM: BoardroomTIME: 8:00-9.00AM

CHAIR: Jerry A. Krishnan, Professor of Medicine and Public Health & Associate Vice President for Population Health Sciences, University of Illinois Hospital & Health Sciences System, Chicago, Illinois, USA

PCORI GRANT PLANNING MEETING

Agenda

Alignment of REG & PCORI Missions• REG

o To integrate high-quality, real-life evidence into clinical practice guidelines, policy and budgetary decision-making for the benefit of all stakeholders in respiratory medicine.

o Through: building networks & partnerships, research, setting standards, raising knowledge and awareness

• Patient Centered Outcomes Research Institute (PCORI)o U.S. Affordable Care Act 2010; traditional medical research… hasn’t been able to

answer many of the questions that patients and their clinicians face daily…o Funds patient-centered comparative clinical effectiveness research and

disseminates the results in ways that the end-users will find useful and valuable

o Established a data infrastructure linking EHRs in operating heath systems that provides coverage for ~100M individuals in U.S. (PCORnet)

o Open to co-funding from stakeholders

Comparative Effectiveness Research

- conduct and synthesis of research comparing the benefits and harms of different interventions in “real world” settings.

- to improve health outcomes by developing and disseminating evidence-based information to patients, clinicians, and other decision-makers, responding to their expressed needs, about which interventions are most effective for which patients under specific circumstances. US Recovery Act Spend Plan, Office of the Secretary, DHHS,

2009

Our mandate is to improve the quality and relevance of evidence available to help patients, caregivers, clinicians, employers, insurers, and policy makers make informed health decisions. 

PCORI funding opportunities3 cycles/y (Cycle 3: LOI due 11/2015 then application due 02/2016)

Total direct costs Improving methods for PCOR $750K, 3y Communication and dissemination $1.5M, 3y Improving Healthcare Systems $1.5, 3y to $5M, 5y Prevention, Dx, and Tx options $2M, 3y Addressing disparities $1.5M, 3y

Pragmatic clinical studies $15M, 5y

Cycle 1 LOI due 3/2016, application due 6/2016

Research application criteria

StakeholdersRoles Evidence prioritization

Evidence generation

Evidence synthesis

Evidence dissemination

Evidence implementation

Feedback for future efforts

Types1. Patients and caregivers2. Providers (clinicians,

delivery systems)3. Purchasers (e.g.,

employers)4. Payers (e.g., insurance) 5. Policymakers (federal,

state)6. Product makers (drug

and device manufacturer)

7. Principal investigators (researchers)

Cancannon T, JGIM 2012

Ideas…?• UK “State of the Union” – current asthma morbidity in the UK • Evaluation of the association between duration of antibiotic courses (for respiratory infections) and issuance of

repeat prescriptions • Development, Validation and Evaluation of a Short form of EXACT (Exacerbations of Chronic Pulmonary Disease

Tool) Questionnaire for Clinical Use and Self-(tele) Monitoring • Validation of the COPD UK Risk Prediction Model and development of a claims-based algorithm • Comparative effectiveness of triple (ICS/LABA/LAMA) vs dual therapy (ICS/LABA) in COPD • Development of a Longitudinal Asthma Treatment Step Algorithm and Association with Asthma Outcomes • Towards Optimum Reporting of Pulmonary Effectiveness Databases and Outcomes (TORPEDO) Checklist:

development of a quality checklist for respiratory research databases • Systematic review & meta-analyses of the effect of ICS particle size on real-life asthma outcomes • Metabolic and long-term implications of ICS particle size in obstructive lung disease • Intra and trans-database comparison of “research-ready” definitions of ACOS • Characterizing the primary care pathway to idiopathic pulmonary fibrosis (IPF) diagnosis – a UK database study • Global Characterization of ILD MDT Practice & Agreement and Accuracy of IPF diagnosis evaluation• Evaluating and describing current development practice of technology based solutions • Drawing on existing literature: how should health information be fed back to (positively) change patient

behaviour? • Optimising App interfaces for older people with chronic respiratory diseases • Implications of ICS cessation in COPD – a real-life study • Exploration of the role and associations between nasal and bronchial hyper-reactivity in allergic airways disease • Are COPD patients with serum eos < 2% on inhaled corticosteroids at an increased risk to develop pneumonia? • Role of FeNO as a biomarker in COPD • Comparative decline in FEV1 over time in patients receiving dual vs triple therapy for COPD

Other ideas• Patients often report being on too many medications

o De-escalation studieso Intermittent treatment escalation studies

• Patients have a difficult time remembering to use controllers or difficulty using inhaler deviceso Studies testing adherence promotion strategieso Studies testing strategies to improve inhaler technique (including

limiting the number of different inhaler devices)

• Asthma-COPD Overlap Syndrome

Technologies WG Agenda…?

Next steps

• Topic nomination

• Stakeholder engagemento Prioritize topics (analytic hierarchy process)

o Develop teams to develop different application(s) (PICOTS)

• Jerry Krishnan jakris@uic.edu