未来十年应对全球慢性阻塞性肺疾病（COPD）负担的研究重点。
Research priorities to address the global burden of chronic obstructive pulmonary disease (COPD) in the next decade.
机构信息
Usher Institute, University of Edinburgh, Edinburgh, UK.
Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
出版信息
J Glob Health. 2021 Oct 9;11:15003. doi: 10.7189/jogh.11.15003. eCollection 2021.
BACKGROUND
The global prevalence of chronic obstructive pulmonary disease (COPD) has increased markedly in recent decades. Given the scarcity of resources available to address global health challenges and respiratory medicine being relatively under-invested in, it is important to define research priorities for COPD globally. In this paper, we aim to identify a ranked set of COPD research priorities that need to be addressed in the next 10 years to substantially reduce the global impact of COPD.
METHODS
We adapted the Child Health and Nutrition Research Initiative (CHNRI) methodology to identify global COPD research priorities.
RESULTS
62 experts contributed 230 research ideas, which were scored by 34 researchers according to six pre-defined criteria: answerability, effectiveness, feasibility, deliverability, burden reduction, and equity. The top-ranked research priority was the need for new effective strategies to support smoking cessation. Of the top 20 overall research priorities, six were focused on feasible and cost-effective pulmonary rehabilitation delivery and access, particularly in primary/community care and low-resource settings. Three of the top 10 overall priorities called for research on improved screening and accurate diagnostic methods for COPD in low-resource primary care settings. Further ideas that drew support involved a better understanding of risk factors for COPD, development of effective training programmes for health workers and physicians in low resource settings, and evaluation of novel interventions to encourage physical activity.
CONCLUSIONS
The experts agreed that the most pressing feasible research questions to address in the next decade for COPD reduction were on prevention, diagnosis and rehabilitation of COPD, especially in low resource settings. The largest gains should be expected in low- and middle-income countries (LMIC) settings, as the large majority of COPD deaths occur in those settings. Research priorities identified by this systematic international process should inform and motivate policymakers, funders, and researchers to support and conduct research to reduce the global burden of COPD.
背景
在过去几十年中，全球慢性阻塞性肺疾病（COPD）的患病率显著增加。由于应对全球健康挑战的资源稀缺，以及呼吸医学相对投入不足，因此确定全球 COPD 的研究重点至关重要。在本文中，我们旨在确定需要在未来 10 年内解决的 COPD 研究重点，以大大降低 COPD 的全球影响。
方法
我们采用儿童健康与营养研究倡议（CHNRI）的方法来确定全球 COPD 研究重点。
结果
62 名专家提出了 230 项研究想法，由 34 名研究人员根据六个预先定义的标准（可回答性、有效性、可行性、可交付性、减轻负担和公平性）对这些想法进行了评分。排名最高的研究重点是需要新的有效策略来支持戒烟。在总体排名前 20 的研究重点中，有 6 项侧重于可行且具有成本效益的肺康复实施和获取，特别是在初级/社区护理和资源匮乏的环境中。前 10 项总体研究重点中的 3 项呼吁研究在资源匮乏的初级保健环境中，对 COPD 的更准确诊断方法和改善的筛选方法。得到支持的进一步想法涉及对 COPD 风险因素的更好理解，为资源匮乏环境中的卫生工作者和医生开发有效的培训计划，以及评估鼓励身体活动的新干预措施。
结论
专家们一致认为，在未来十年中，为降低 COPD 而需要解决的最紧迫的可行研究问题是预防、诊断和康复 COPD，特别是在资源匮乏的环境中。最大的收益应该在中低收入国家（LMIC）中实现，因为大多数 COPD 死亡发生在这些国家。通过这一系统的国际流程确定的研究重点应能为政策制定者、资助者和研究人员提供信息并激励他们支持和开展研究，以减轻全球 COPD 的负担。
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