Adequacy of Therapy for People with Both COPD and Heart Failure in the UK: Historical Cohort Study

Purpose: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) often occur concomitantly, presenting diagnostic and therapeutic challenges for clinicians. We examined the characteristics of patients prescribed adequate versus inadequate therapy within 3 months after newly diagnosed comorbid COPD or HF. Patients and Methods: Eligible patients in longitudinal UK electronic medical record databases had pre-existing HF and newly diagnosed COPD (2017 GOLD groups B/C/D) or pre-existing COPD and newly diagnosed HF. Adequate COPD therapy was defined as long-acting bronchodilator(s) with/without inhaled corticosteroid; adequate HF therapy was defined as beta-blocker plus angiotensin-converting enzyme inhibitor and/or angiotensin receptor blocker. Results: Of 2439 patients with HF and newly diagnosed COPD (mean 75 years, 61% men), adequate COPD therapy was prescribed for 726 (30%) and inadequate for 1031 (42%); 682 (28%) remained untreated for COPD. Adequate (vs inadequate) COPD therapy was less likely for women (35%) than men (45%), smokers (36%) than ex-/non-smokers (45%), and non-obese (41%) than obese (47%); spirometry was recorded for 57% prescribed adequate versus 35% inadequate COPD therapy. Of 12,587 patients with COPD and newly diagnosed HF (mean 75 years, 60% men), adequate HF therapy was prescribed for 2251 (18%) and inadequate for 5332 (42%); 5004 (40%) remained untreated for HF. Adequate (vs inadequate) HF therapy was less likely for smokers (27%) than ex-/non-smokers (32%) and non-obese (30%) than obese (35%); spirometry was recorded for 65% prescribed adequate versus 39% inadequate HF therapy. Conclusion: Many patients with comorbid COPD/HF receive inadequate therapy after new diagnosis. Improved equity of access to integrated care is needed for all patient subgroups

Peak Inspiratory Flow and Spirometry Measures in COPD Patients : The POROS Study

This abstract is funded by: AstraZeneca Presented at poster discussion session: B102. CLINICAL TRIALS AND STUDIES IN COPD Monday 21st May 2018.Peer reviewedPostprin

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Real-life effects of switching LABA/ICS dry powder inhalers to formoterol/fluticasone in Korean asthma patients: The Transfform study

Background and Aims: In Korea, the majority of asthma patients are prescribed dry powder inhalers (DPIs). Patients prescribed inhaled corticosteroid/ long-acting beta agonists (ICS/LABA) may benefit from switching from a DPI to a pressurized Metered Dose Inhaler (pMDI), such as formoterol/fluticasone. The primary aim of this study was to evaluate the 'switch success' of changing asthma patients from ICS/LABA DPIs to formoterol/ fluticasone pMDI in a real-world population in Korea. Secondly, we aim to determine if there are any differences in key clinical parameters (e.g. exacerbations, blood eosinophil counts) between patients who switch inhaler and those who continue on the same inhaler. Methods: Historical cohort database study with baseline and outcome period designed to evaluate the proportion of asthma patients that continue to collect prescriptions of formoterol/fluticasone after initial prescription. Data source is the inhouse clinical asthma database of the Ajou University Hospital (Suwon, Korea). Switch success is considered as &gt;70% of the population maintaining their treatment at least 6 months after the switch. The study is powered for the 'switch success' of asthma patients changing their therapy to and continuing on formoterol/fluticasone from existing ICS/LABA DPIs. Both patients switching to formoterol/ fluticasone and those remaining on ICS/LABA DPIs will be fully characterised during baseline period. If sufficient numbers are available (sample size required: 163 per cohort), for all of additional outcomes, the outcome year will be compared to the baseline year within the switch cohort. The additional outcomes include: % non-exacerbating patients of 'switch' cohort at 1 year, compared to baseline, exacerbation rates, asthma control, reliever use, side effects and total ICS use. Results: The protocol has been submitted to ENCePP. Study results (expected end 2016) will provide insights in the real-life effects of switching inhalers. Conclusions: Outcomes of this study are expected to lead to hands-on recommendations for optimal, cost-effective, treatment options for asthma management

Real-life effects of switching LABA/ICS dry powder inhalers to formoterol/fluticasone in Korean asthma patients: The Transfform study

Background and Aims: In Korea, the majority of asthma patients are prescribed dry powder inhalers (DPIs). Patients prescribed inhaled corticosteroid/ long-acting beta agonists (ICS/LABA) may benefit from switching from a DPI to a pressurized Metered Dose Inhaler (pMDI), such as formoterol/fluticasone. The primary aim of this study was to evaluate the 'switch success' of changing asthma patients from ICS/LABA DPIs to formoterol/ fluticasone pMDI in a real-world population in Korea. Secondly, we aim to determine if there are any differences in key clinical parameters (e.g. exacerbations, blood eosinophil counts) between patients who switch inhaler and those who continue on the same inhaler. Methods: Historical cohort database study with baseline and outcome period designed to evaluate the proportion of asthma patients that continue to collect prescriptions of formoterol/fluticasone after initial prescription. Data source is the inhouse clinical asthma database of the Ajou University Hospital (Suwon, Korea). Switch success is considered as >70% of the population maintaining their treatment at least 6 months after the switch. The study is powered for the 'switch success' of asthma patients changing their therapy to and continuing on formoterol/fluticasone from existing ICS/LABA DPIs. Both patients switching to formoterol/ fluticasone and those remaining on ICS/LABA DPIs will be fully characterised during baseline period. If sufficient numbers are available (sample size required: 163 per cohort), for all of additional outcomes, the outcome year will be compared to the baseline year within the switch cohort. The additional outcomes include: % non-exacerbating patients of 'switch' cohort at 1 year, compared to baseline, exacerbation rates, asthma control, reliever use, side effects and total ICS use. Results: The protocol has been submitted to ENCePP. Study results (expected end 2016) will provide insights in the real-life effects of switching inhalers. Conclusions: Outcomes of this study are expected to lead to hands-on recommendations for optimal, cost-effective, treatment options for asthma management