Grant: Catalyst Grant: Personalized Health Catalyst Grants

Chronic Obstructive Pulmonary Disease (COPD) is a very common disease of the lungs. COPD patients frequently experience episodes of worsening of their disease, referred to as acute exacerbations or 'lung attacks'. Severe exacerbations of COPD are the number one reason (aside from child birth) for hospitalizations in Canada. The burden of COPD is comparable to that of other common diseases such as diseases of the heart. Despite this, patients and care providers do not have access to the required decision tools that are available for such diseases (such as Framingham Risk Scores that can be used to estimate the risk of future heart attacks). Such decision tools can be used for shared decision making such that both the patient and the care provider appreciate the level of risk specific to the patient and adjust the level of therapies according to patient preferences. To fill such a gap in COPD, our group has recently undertaken a major step by creating an individualized prediction tool (and associated eHealth platform - a Web App) for lung function decline in COPD (Zafari et. al. CMAJ, 2016). We propose to create an individualized prediction tool for COPD exacerbations. To achieve this, we will 1) use data from several studies (clinical trials and cohort studies) to develop and validate an individualized prediction model for exacerbations; 2) implement the model into a freely accessible Web App; 3) demonstrate the application of the App in helping patients and physicians decide on antibiotic therapy for preventing exacerbations. The Web App will be professionally designed and will be combined with our previously-developed Web Apps to create a suite of eHealth tools for Precision Medicine in COPD. The engagement of both patients and care providers as team members ensures the eHealth tool will be optimized from both perspectives. We have systematically engaged influential organizations as knowledge users to ensure the final product receives widespread visibility.