Linking e-health records, patient-reported symptoms and environmental exposure data to characterise and model COPD exacerbations: protocol for the COPE study

Abstract

IntroductionRelationships between exacerbations of chronic obstructive pulmonary disease (COPD) and environmental factors such as temperature, humidity and air pollution are not well characterised, due in part to oversimplification in the assignment of exposure estimates to individuals and populations. New developments in miniature environmental sensors mean that patients can now carry a personal air quality monitor for long periods of time as they go about their daily lives. This creates the potential for capturing a direct link between individual activities, environmental exposures and the health of patients with COPD. Direct associations then have the potential to be scaled up to population levels and tested using advanced human exposure models linked to electronic health records.Methods and analysisThis study has 5 stages: (1) development and deployment of personal air monitors; (2) recruitment and monitoring of a cohort of 160 patients with COPD for up to 6 months with recruitment of participants through the Clinical Practice Research Datalink (CPRD); (3) statistical associations between personal exposure with COPD-related health outcomes; (4) validation of a time-activity exposure model and (5) development of a COPD prediction model for London.Ethics and disseminationThe Research Ethics Committee for Camden and Islington has provided ethical approval for the conduct of the study. Approval has also been granted by National Health Service (NHS) Research and Development and the Independent Scientific Advisory Committee. The results of the study will be disseminated through appropriate conference presentations and peer-reviewed journals.

Characterising low-cost sensors in highly portable platforms to quantify personal exposure in diverse environments

“…c. A further limitation of all optical methods is their inability to detect particles with diameters below a certain size, typically 200-400 nm (Morawska and Salthammer, 2003).…”

“…The co-locations in China involved 60 PAMs which had been previously deployed to 250 participants of a cardiopulmonary cohort for 1 month during the heating season and 1 month during the non-heating season . The co-location in the UK involved 60 PAMs that have been previously deployed to 150 participants of a COPD cohort for 2 years continuously (Moore et al, 2016). The reproducibility between co-located sensors was very high even when the ambient concentrations were close to the LOD (mean R 2 ≥ 0.80 for EC sensors and R 2 ≥ 0.91 for the OPC; see Fig.…”

“…To do so, the PAM performance was assessed in well-characterised outdoor, indoor and commuting microenvironments across seasons and different geographical settings. The PAM has already been deployed to participants of two large cardiopulmonary cohorts in China ) (AIRLESS-Theme 3 APHH project) (Shi et al, 2019) and the UK (COPE) (Moore et al, 2016), and in a number of smaller international pilot projects in North America, Europe, South and East Asia, and Africa. This is the first of a series of publications that aim to capture total personal exposure to a large number of pollutants at unprecedented detail, and together with medical outcomes, to identify underlying mechanisms of specific air pollutants on health.…”

Effects of AIR pollution on cardiopuLmonary disEaSe in urban and peri-urban reSidents in Beijing: protocol for the AIRLESS study

“…been successfully applied in a panel of subjects in UK for the adverse effect of personal exposure on chronic obstructive pulmonary disease (COPD) exacerbations (Moore et al, 2016). The PAM operates autonomously, continuously and is almost completely silent.…”

response to referee 3

“…To do so, the PAM performance was assessed in well-characterised outdoor, indoor and commuting microenvironments across seasons and different geographical settings. The PAM has already been deployed to participants of two large cardiopulmonary cohorts in China (Han et al, 2019) (AIRLESS-Theme 3 APHH project) (Shi et al, 2019) and the UK (COPE) (Moore et al, 2016), and in a number of smaller international pilot projects in North America, Europe, South and East Asia, and Africa. This is the first of a series of publications that aim to capture total personal exposure to a large number of pollutants at unprecedented detail, and together with medical outcomes, to identify underlying mechanisms of specific air pollutants on health.…”