A novel strategy for the early diagnosis of COPD in middle-aged adults
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.
Prof Michael Abramson, Monash University
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.
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
This research project is available to PhD students to join as part of their thesis.
Please contact the Research Group Leader to discuss your options.
Perret, J. L., Vicendese, D., Lowe, A. J., Lodge, C. J., Tan, D., Simons, K., Bui, D. S., Bowatte, G., Thompson, B. R., Hamilton, G. S., Minelli, C., Jarvis, D., Hopper, J. L., Thomas, P. S., Blakely, T., Abramson, M. J., Walters, E. H., Dharmage, S. C. "Predicting post-bronchodilator airflow obstruction in middle-age: development of a comprehensive risk prediction model [abstract]." Respirology 2020; 25(Suppl.1): 22-110.
Perret, J.L., Simons, K., Vicendese, D., Bickerstaffe, A., Blakely, T., Dharmage, S. C. “Optimizing the prediction of the lung function features of COPD”. Chest 2020; 157(3): 738 doi: 10.1016/j.chest.2019.10.059
Perret, J.L. and E.H. Walters. “Cigarette smoking and lung function decline beyond quitting”. Annals Translational Medicine 2020; 8(22): 1531. doi: 10.21037/atm-20-3667
Perret, J. L., Vicendese, D., Dharmage, S. C. "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
Bui, D. S., Perret, J. L., Walters, E. H., Abramson, M. J., Burgess, J. A., Bui, M. Q., Bowatte, G., Lowe, A. J., Russell, M. A., Alif, S. M., Thompson, B. R., Hamilton, G. S., Giles, G. G., Thomas, P. S., Morrison, S., Johns, D. P., Knibbs, L. D., Zock, J. P., Marcon, A., Garcia-Aymerich, J., Erbas, B., Jarvis, D., Svanes, C., Lodge, C. J., Dharmage, S. C. (2020). "Lifetime Risk Factors for Pre- and Post-Bronchodilator Lung Function Decline. A Population-based Study." Ann Am Thorac Soc 17(3): 302-312.
Pesce, G., Marcon, A., Calciano, L., Perret, J. L., Abramson, M. J., Bono, R., Bousquet, J., Fois, A. G., Janson, C., Jarvis, D., Jogi, R., Leynaert, B., Nowak, D., Schlunssen, V., Urrutia-Landa, I., Verlato, G., Villani, S., Zuberbier, T., Minelli, C., Accordini, S., on behalf of the Ageing Lungs in European Cohorts (ALEC) study. (2019). "Time and age trends in smoking cessation in Europe." PLoS One 14(2): e0211976.
Alif, S. M., Dharmage, S., Benke, G., Dennekamp, M., Burgess, J. Perret, J. L., Lodge, C., Morrison, S., Johns, D. P., Giles, G., Gurrin, L., Thomas, P. S., Hopper, J. L., Wood-Baker, R., Thompson, B., Feather, I., Vermeulen, R., Kromhout, H., Jarvis, D., Garcia Aymerich, J., Walters, E. H., Abramson, M. J., Matheson, M. C. (2019). "Occupational exposure to solvents and lung function decline: A population based study." Thorax 74(7): 650-658.
Matheson, M. C., Bowatte, G., Perret, J. L., Lowe, A. J., Senaratna, C. V., Hall, G. L., de Klerk, N., Keogh, L. A., McDonald, C. F., Waidyatillake, N. T., Sly, P. D., Jarvis, D., Abramson, M. J., Lodge, C. J., Dharmage, S. C. (2018). "Prediction models for the development of COPD: a systematic review." Int J Chron Obstruct Pulmon Dis 13: 1927-1935.
Perret, J. L. and M. J. Abramson (2018). "Biomass smoke COPD: A phenotype or a different disease?" Respirology 23(2): 124-125.
Bui, D. S., Lodge, C. J., Burgess, J. A., Lowe, A. J., Perret, J., Bui, M. Q., Bowatte, G., Gurrin, L., Johns, D. P., Thompson, B. R., Hamilton, G. S., Frith, P. A., James, A. L., Thomas, P. S., Jarvis, D., Svanes, C., Russell, M., Morrison, S. C., Feather, I., Allen, K. J., Wood-Baker, R., Hopper, J., Giles, G. G., Abramson, M. J., Walters, E. H., Matheson, M. C., Dharmage, S. C. (2018). "Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life." Lancet Respir Med 6(7): 535-544.
Perret, J. L., Bonevski, B., McDonald, C. F., Abramson, M. J. (2016). "Smoking cessation strategies for patients with asthma: improving patient outcomes." J Asthma Allergy 9: 117-128.
Perret, J. L., Walters, E. H., Abramson, M. J., McDonald, C. F., Dharmage, S. C. (2014). "The independent and combined effects of lifetime smoke exposures and asthma as they relate to COPD." Expert Rev Respir Med 8(4): 503-514.
Perret, J. L., Dharmage, S. C., Matheson, M. C., Johns, D. P., Gurrin, L. C., Burgess, J. A., Marrone, J., Markos, J., Morrison, S., Feather, I., Thomas, P. S., McDonald, C. F., Giles, G. G., Hopper, J. L., Wood-Baker, R., Abramson, M. J., Walters, E. H. (2013). "The Interplay between the Effects of Lifetime Asthma, Smoking, and Atopy on Fixed Airflow Obstruction in Middle Age." Am J Respir Crit Care Med 187(1): 42-48.
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