A novel strategy for the early diagnosis of COPD in middle-aged adults

• Dr Jennifer Perret

  Project leader

  jennifer.perret@unimelb.edu.au
  

Project Details

In Australia, Chronic Obstructive Pulmonary Disease (COPD) is the leading cause of preventable hospitalisation and third leading cause of total disease burden as it is typically diagnosed in an advanced stage when treatments are poorly effective. Global epidemiological studies that have screened general populations to detect early signs of post-bronchodilator airflow obstruction have found a worryingly high proportion of adults who may have been missed or misdiagnosed with the condition. This can occur if health care professionals rely on clinical symptoms and do not confirm the COPD diagnosis using spirometry as an objective test.

It is now recognised that COPD has a long pre-clinical phase in which early airflow obstruction is present and detectable by using lung function testing (called post-bronchodilator spirometry). This predictable trajectory provides an opportunity to detect affected individuals at a time before medical attention would normally be sought. Active case finding has been advocated by international experts and national COPD guidelines, but the uptake of this practice is not known.

Using world-class cohort data, we are developing a COPD risk calculator that is applicable to middle-aged adults, adapting approaches from other screening programs, and integrating machine learning and software technologies not previously applied to respiratory health. We will closely involve general practitioners (GPs) and consumers through engagement, education, and structured feedback to deliver a user-friendly web application and mobile health App. This intervention aims to promote early COPD detection and good lung health in Australia and potentially beyond.

Researchers

Prof Shyamali Dharmage

Dr Don Vicendese

A/Prof Adrian Bickerstaffe

A/Prof Adrian Lowe

A/Prof Caroline Lodge

Dr Koen Simons

Dr Dinh Bui

Dr Gayan Bowatte

Prof Michael Abramson, Monash University

Prof E Haydn Walters

Collaborators

Dr Cosetta Minelli, Faculty of Medicine, National Heart & Lung Institute, Imperial College London, UK.

Prof Deborah Jarvis, Faculty of Medicine, National Heart & Lung Institute, Imperial College London, UK.

Funding

National Health and Medical Research Council Early Career Fellowship (2019-2022) - CIA Dr Perret

The University of Melbourne, Dyason Fellowship (2020) - CIA Dr Perret and Dr Cosetta Minelli, Imperial College, UK

The University of Melbourne, Research Grant Support Scheme (2021) - CIA Dr Perret

Research Outcomes

PERRET JL, Vicendese D, Simons K, Jarvis DL, Lowe AJ, Lodge CJ, Bui D, Tan D, Burgess J, Erbas B, Bickerstaffe A, Hancock K, Thompson BR, Hamilton GS, Adams R, Benke G, Thomas PS, Frith P, McDonald CF, Blakely T, Abramson MJ, Walters EH, Minelli C, Dharmage S, on behalf of TAHS and ECRHS. Ten-year prediction model for post-bronchodilator airflow obstruction and early detection of COPD: development and validation in two middle-aged population-based cohorts. BMJ Open Respir Res. 2021; 8: e001138

Research Publications

Perret JL, Bui DS, Pistenmaa C, Vicendese D, Khan SS, Han MK, San Jose Estepar R, Lowe AJ, Lodge CJ, Labaki WW, Pham JV, Idrose NS, Senaratna CV, Tan DJ, Hamilton GS, Thompson BR, Munsif M, Arynchyn A, Jacobs DR, Jr., Abramson MJ, Walters EH, Washko GR, Kalhan R, Dharmage SC, on behalf of the AUSCULTATE Investigators. Associations between life-course FEV(1)/FVC trajectories and respiratory symptoms up to middle age: analysis of data from two prospective cohort studies. Lancet Respir Med 2025: 13(2): 130-140

Tan DJ, Lodge CJ, Walters EH, Bui DS, Pham J, Lowe AJ, Bowatte G, Vicendese D, Erbas B, Johns DP, James AL, Frith P, Hamilton GS, Thomas PS, Wood-Baker R, Han MK, Washko GR, Abramson MJ, Perret JL, Dharmage SC (equal senior). “Can We Use Lung Function Thresholds and Respiratory Symptoms to Identify Pre-Chronic Obstructive Pulmonary Disease? A Prospective, Population-based Cohort Study”. Am J Respir Crit Care Med 2024: 209(12): 1431-1440

Perret JL, Yip SWS, Idrose NS, Hancock K, Abramson MJ, Dharmage SC, Walters EH, Waidyatillake N. Undiagnosed and 'overdiagnosed' COPD using postbronchodilator spirometry in primary healthcare settings: a systematic review and meta-analysis. BMJ Open Respir Res 2023: 10(1): e001478

Perret JL, Zwar N, Walters EH, Patsamanis H, Abramson MJ, Dharmage SC, Hancock K. A chronic obstructive pulmonary disease risk assessment tool in preventive lung healthcare. Australian Journal of General Practice 2023: 52(9): 595-598

Perret JL and EH Walters. “Cigarette smoking and lung function decline beyond quitting”. Annals Translational Medicine 2020; 8(22): 1531.  doi: 10.21037/atm-20-3667

Perret JL, Vicendese D, Dharmage SC. "Population-based case-finding to identify airflow obstruction in symptomatic adults at high risk for asthma and COPD." Eur Respir J 2020; 56(5). doi: 10.1183/13993003.03367-2020

Perret JL, Simons K, Vicendese D, Bickerstaffe A, Blakely T, Dharmage SC. Optimizing Prediction of the Lung Function Features of COPD. Chest 2020: 157(3): 738

Matheson MC, Bowatte G, Perret JL, Lowe AJ, Senaratna CV, Hall GL, de Klerk N, Keogh LA, McDonald CF Waidyatillake NT, Sly PD, Jarvis D, Abramson MJ, Lodge CJ, Dharmage SC. (2018). "Prediction models for the development of COPD: a systematic review." Int J Chron Obstruct Pulmon Dis 13: 1927-1935.

Perret JL, Bonevski B, McDonald CF, Abramson MJ. (2016). "Smoking cessation strategies for patients with asthma: improving patient outcomes." J Asthma Allergy 9: 117-128.