COPD Clinical Research Network & Clinical Research Skil*

描述（由申请人提供）： 慢性阻塞性肺疾病（COPD）是一种致命的病态疾病，每年有超过60万人住院治疗，1340万人就诊。每年用于COPD的直接医疗费用超过150亿美元，工作效率降低造成的损失约为99亿美元。在美国和世界范围内，与COPD相关的患病率、发病率和死亡率正以惊人的速度增加。越来越多的人认识到，COPD的恶化不仅与患者生活质量的恶化有关，而且直接导致患者住院、死亡率增加和护理成本增加。本项目的目的是参与国家心肺血液研究所（NHLBI）COPD临床研究网络（CRN），以多学科方式研究中重度COPD患者的疾病管理方法。我们还建议开发一个临床研究技能开发核心，以帮助新的临床研究人员在寺开发临床研究项目所需的临床技能。该方案还将用于进一步磨练现有调查人员的技能，以提高其调查地位。COPD临床研究网络的具体目标是：1）通过测试中重度COPD管理的特定方法，加强治疗决策的知识基础; 2）改善COPD相关共病的管理; 3）开发预测个体患者对治疗反应的方法; 4）评估和关联各种结局指标。我们的2项技术提案的具体目标是以满足COPD临床研究网络总体目标的方式解决COPD中的两个重要问题。我们打算：1）确定在表现出夜间氧饱和度下降的中度至重度COPD患者中长期夜间吸氧相对于安慰剂对睡眠质量、功能表现、右心功能、生活质量和COPD恶化频率的影响，以及：2）确定诱发因素、解决模式、疾病管理，以及与高加索人相比，少数民族患者（非裔美国人）中需要住院治疗的COPD急性加重的基因组学。

DESCRIPTION (provided by applicant): Chronic obstructive pulmonary disease (COPD) is a deadly and morbid disorder that accounts annually for more than 600,000 hospitalizations and 13.4 million physician office visits. More than $15 billion are expended per year in direct medical costs for COPD, and approximately $9.9 billion are lost in reduced work productivity. The prevalence, morbidity, and mortality associated with COPD is increasing at an alarming rate, both in the United States and worldwide. There is a growing awareness that exacerbations of COPD are not only associated with a worsening of the patient's quality of life, but are directly responsible for patient hospitalization, increasing mortality, and increasing costs of care. The purpose of this project is to participate in the National, Heart, Lung, and Blood Institute (NHLBI) COPD Clinical Research Network (CRN) to investigate in a multidisciplinary fashion, disease management approaches in patients with moderate to severe COPD. We also propose to develop a Clinical Research Skills Development Core to assist new clinical investigators at Temple in developing clinical skills needed to develop clinical investigative programs. This program will also be used to further hone the skills of current investigators to progress to a more senior investigative status. Specific objectives of the COPD Clinical Research Network will be to: 1) strengthen the knowledge base for therapeutic decision-making by testing particular approaches in the management of moderate to severe COPD; 2) improve the management of co-morbid conditions associated with COPD; 3) develop methods for predicting individual patient responsiveness to treatments, and; 4) evaluate and correlate various outcome measures. The specific objectives of our 2 technical proposals are to address two important issues in COPD in a manner that satisfies the overall objectives of the COPD Clinical Research Network. We intend to: 1) determine the effect of chronic, nocturnal oxygen administration vs placebo in moderate to severe COPD patients whom exhibit nocturnal oxygen desaturation on sleep quality, functional performance, right heart function, quality of life, and COPD exacerbation frequency, and: 2) to determine the inciting factors, pattern of resolution, management of disease, and the genomics of COPD exacerbations requiring hospitalization in minority patients (African American) compared to Caucasians.