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Below you can see details and summaries of NOVELTY publications and presentations to date.
This poster explored the physiological phenotypes of patients with asthma and/or COPD in the NOVELTY Advanced Diagnostic Profiling substudy using lung function and imaging methods to assess ventilation heterogeneity. More impaired lung function and 129Xe ventilation was observed in patients with asthma+COPD and COPD versus asthma alone, with no significant difference observed between patients with asthma+COPD or COPD for any metrics. In patients who had normal forced expiratory volume in 1 second, those with COPD had raised 129Xe ventilation defect percentage, heterogeneity index and lung clearance index compared with patients with asthma.
Smith L et al. Eur Respir J 2022;60(Suppl 66):2865.
This poster examined the relationship between health status in patients with physician-assigned COPD from NOVELTY, assessed using St George’s Respiratory Questionnaire total score at baseline, with exacerbation risk in the subsequent year. Results showed that exacerbation risk increased with poorer baseline COPD health status; patients with higher symptom burden should be considered for treatment optimisation to reduce future exacerbation risk.
Müllerová H et al. Eur Respir J 2022;60(Suppl 66):4417.
This poster evaluated the association between frequent productive cough (FPC) and subsequent exacerbations in patients with physician-assigned COPD in the NOVELTY study. Results showed that FPC was consistently associated with higher exacerbation risk in the first year of follow-up and should therefore be considered as a treatable trait associated with increased exacerbation risk, over at least 1 year.
Müllerová H et al. Eur Respir J 2022;60(Suppl 66):4418.
This presentation investigated whether patients from the NOVELTY ADPro substudy, with airways dysanapsis (low forced expiratory volume in 1 second [FEV1] / forced vital capacity, but normal FEV1), have a normal physiological variant of lung function or if this is an indicator of airways disease. Airways dysanapsis was associated with significantly worse ventilation abnormalities and increased acinar dimensions using 129Xe MRI versus patients with ‘normal’ spirometry suggesting that in these patients, airway dysanapsis is likely an indicator of significant airways disease.
Smith L et al. Eur Respir J 2022;60(Suppl 66):4486.
This presentation explored predictors for corticosteroid-treated/hospitalised and antibiotic only-treated asthma attacks in the NOVELTY cohort. Results showed that risk factors for asthma attacks differed depending on treatment decision. History of asthma attacks was a predictor for future events regardless of treatment with corticosteroids or antibiotics. Contrary to results from clinical trials, type-2 inflammation biomarkers did not predict asthma attacks in this observational study.
Couillard S et al. Eur Respir J 2022;60(Suppl 66):2125.
This article assessed a deep learning-based dual-channel approach using 129Xe MRI and proton MRI for lung cavity estimation (LCE), compared with single-channel deep learning-based methods. The dual-channel approach significantly outperformed single-channel approaches, and automatically generated ventilation defect percentages showed strong agreement with those generated manually.
Astley JR et al. J Magn Reson Imaging 2022; doi:10.1002/jmri.28519. Date accessed: 15 February 2023.
This oral presentation for the short conference proceedings paper explores a 3D multi-channel deep learning approach to synthesize hyperpolarised gas MRI ventilation scans from multi-inflation proton MRI and compares its quantitative performance with conventional synthetic proton MRI ventilation methods. The approach was validated in healthy participants and patients with numerous lung pathologies, including patients from the NOVELTY ADPro sub-study. The proposed deep-learning approach produced synthetic ventilation scans that mimicked hyperpolarised gas MRI, with significant improvements over proton MRI ventilation models.
Astley JR et al. MIDL 2022.
This oral presentation for the short conference proceedings paper explores a multi-channel deep learning-based approach to generate lung cavity estimations. The multi-channel approach, employing both hyperpolarised gas MRI and proton MRI, generated plausible lung cavity estimations and outperformed single-channel approaches across healthy participants and patients with numerous pulmonary pathologies, including patients from the NOVELTY ADPro sub-study.
Astley JR et al. MIDL 2022.
This article describes the prevalence of 30 treatable traits in patients with asthma and/or COPD in the NOVELTY study, and their association with physician-assigned diagnosis and physician-assessed disease severity. The presence/absence of treatable traits formed a pattern that is recognised by clinicians to determine diagnosis/severity. A few treatable traits were found to be associated with the diagnostic label of asthma or COPD, while many were independent of diagnostic label, and the prevalence of some treatable traits varied depending on disease severity. The results provide the largest characterisation of treatable traits in patients with asthma and/or COPD in a real-world setting to date. Treatments that target traits, regardless of diagnosis and severity, may lead to precision medicine for asthma and/or COPD, and may result in better patient outcomes.
Agustí A et al. Respirology 2022;27(11):929-940.
This article describes the prevalence of frequent productive cough, defined as cough with sputum most or several days a week for the past three months, in patients with asthma and/or COPD, and the relationships with baseline disease characteristics and exacerbations. Approximately one third of patients had frequent productive cough, which was more common with greater disease severity. Frequent productive cough was associated with lower lung function and a history of pollutant exposure at home/work in all diagnoses, as well as a higher risk of experiencing an exacerbation over the subsequent 12 months. These results show that frequent productive cough is an important indicator of adverse clinical outcomes in patients with obstructive lung disease.
Hughes R et al. Resp Med 2022;200:106921.
This presentation explored the physiological phenotypes of patients with asthma and/or COPD from NOVELTY using 129Xe MRI. 129Xe MRI metrics significantly differed between diagnoses, with patients with asthma showing lower ventilation heterogeneity, smaller acinar dimensions and greater gas exchange compared with patients with asthma+COPD and COPD. In this analysis, 129Xe MRI metrics could distinguish between diagnoses in patients with normal pulmonary function tests.
Marshall H et al. Am J Respir Crit Care Med 2022;205:A2175.
This poster explores the relationship between symptoms and lung function in patients with a physician-assigned diagnosis of asthma and/or COPD in NOVELTY. Lower forced expiratory volume in 1 second (FEV1), forced vital capacity and inspiratory capacity were associated with dyspnoea, wheeze, reliever medication use, and nocturnal awakening, with weaker associations reported with frequent productive cough and acute symptom worsening episodes. The association between lower FEV1 and physician-reported exacerbations was greater in patients with COPD than in patients with asthma.
Papi A et al. Am J Respir Crit Care Med 2022;205:A4013.
This poster describes the impact of the COVID-19 pandemic on physician-reported exacerbations and patient-reported worsenings in patients with asthma and/or COPD in NOVELTY. Large decreases in physician-reported exacerbation rates were observed during 2020 (during COVID-19) compared with 2019 (pre-COVID-19), with a similar trend, but with much smaller reductions, observed for patient-reported worsenings. This indicates that a more complete picture of disease activity during the COVID-19 pandemic may be provided by patient-reported data.
Müllerová H et al. Am J Respir Crit Care Med 2022;205:A5098.
This poster explores the performance of the prototype asthma attack risk scale (ORACLE), centred on peripheral blood eosinophil count and fractional exhaled oxide, in NOVELTY. Poor-to-modest agreement was observed between the prototype ORACLE’s predicted and observed asthma attack rates in NOVELTY. Real-world datasets may not reflect rates predicted using randomised clinical trial data, where conditions are more tightly controlled.
Couillard S et al. Am J Respir Crit Care Med 2022;205:A4866.
This poster explores the 129Xe MRI patterns of lung function (ventilation, acinar microstructure and gas exchange measurements) in patients with asthma and/or COPD from NOVELTY. Significant differences between patients with asthma, asthma+COPD and COPD in 129Xe MRI global and regional metrics were observed. Moreover, these metrics remained sensitive to the individual diagnoses when only patients with normal pulmonary function tests were considered.
Marshall H et al. ISMRM-ESMRMB 2022;1167.
This poster explores a 3D multi-channel deep learning approach to synthesise hyperpolarised gas MRI and assess its quantitative performance using several common image synthesis metrics. This was assessed across a large, diverse dataset of lung pathologies using 5-fold cross-validation.
Astley JR et al. ISMRM-ESMRMB 2022;1396.
This poster explores a multi-channel deep learning-based approach to generate accurate lung cavity estimations. This approach significantly outperformed single-channel approaches and generated plausible lung cavity estimations across a range of pulmonary pathologies. Furthermore, correlation and Bland-Altman analyses of lung volumes demonstrated strong correlation and minimal bias with expert lung cavity estimations.
Astley JR et al. ISMRM-ESMRMB 2022;1395.
This article described the clinical and healthcare resource utilisation burden of patients with physician-assessed mild asthma using baseline data from the NOVELTY study. In this analysis, almost one in three patients had symptoms that were either not well-controlled or poorly controlled in the past 4 weeks, and almost one in four patients had at least one exacerbation in the previous year. These results showed that many patients with physician-assessed mild asthma experience a substantial burden of disease and are being prescribed treatment normally used for more severe disease, indicating potential opportunities for improving patient outcomes.
Golam SM et al. Resp Med 2022;200:106863.
This presentation described the distribution of type 2 inflammatory markers (eosinophils, fractional exhaled nitric oxide [FeNO] and medical history of allergy) in patients with physician-assessed severe asthma, and a subset of these patients with severe uncontrolled asthma, in the NOVELTY study. The proportion of patients positive for type 2 inflammatory markers was similar between severe asthma and severe uncontrolled asthma, with overlap between the two patient groups. Approximately 86% of patients in both groups had at least one positive marker of Type 2 inflammation; most patients had one or two markers, with relatively few having no or all three markers.
Ding B et al. Eur Respir J 2021;58(Suppl 65):OA4214.
This presentation used network analysis to examine the distribution of 30 treatable traits (a variety of clinical, environmental, behavioural and biomarker features) within physician-assigned diagnostic groups and by physician-assessed severity, among patients with asthma and/or COPD in the NOVELTY study. Asthma and COPD were separately associated with the presence and absence of particular treatable traits, while asthma+COPD was associated with an accumulation of those associated with either diagnosis alone. In milder disease, the number and type of treatable traits differed between asthma and COPD, but with more severe disease, there was more commonality and overlap.
Faner R et al. Eur Respir J 2021;58(Suppl 65):OA1593.
This presentation described the prevalence, patterns and relationship with physician-assessed disease severity of 30 treatable traits in patients with asthma and/or COPD in the NOVELTY study. The presence of treatable traits varied greatly between asthma, asthma+COPD and COPD; some were more prevalent with a particular disease label, while many occurred independently of disease label. The number of treatable traits per patient was highest in asthma+COPD and lowest in asthma. The prevalence of some treatable traits changed with severe disease, suggesting that these may influence the physician’s clinical assessment of disease severity.
Agusti A et al. Eur Respir J 2021;58(Suppl 65):OA1289.
A type of magnetic resonance imaging (MRI) using an isotope of xenon, 129Xe, is highly sensitive to lung function abnormalities. This ePoster reported relationships between 129Xe MRI and pulmonary function testing in patients with asthma and/or COPD. Of the included patients, most had normal lung function measurements: over three quarters had a normal forced expiratory volume in one second (FEV1) z score and over half had a normal FEV1/forced vital capacity (FVC) z score. Preliminary 129Xe MRI analyses showed reduced ventilation, increased acinar airway dimensions and reduced gas transfer with increasing disease severity. This was consistent with airway obstruction, enlarged alveolar airspaces and damaged alveolar-capillary membrane, resulting in reduced gas transfer in these patients.
Marshall H et al. Eur Respir J 2021;58(Suppl 65):PA1872.
This ePoster described and characterised the NOVELTY patient population using the International Severe Asthma Registry eosinophilic grades for the NOVELTY population overall and according to exacerbation history. Grade 3 eosinophilic phenotype (i.e. the most likely to have an eosinophilic phenotype) was prevalent in nearly one third of the overall population and was lowest in patients with physician-assigned COPD. The proportion of patients with Grade 3 eosinophilic phenotype increased with higher physician-assessed severity in asthma alone and asthma+COPD, but not COPD alone. The number of exacerbations in the previous 12 months was highest in patients with Grade 3 eosinophilic phenotype for all physician-assigned diagnoses.
Price D et al. Eur Respir J 2021;58(Suppl 65):PA3705.
This ePoster presents the evaluation of the validity and consistency of a new health status patient-reported questionnaire called the Chronic Airways Assessment Test (CAAT). The CAAT is a version of the existing COPD Assessment Test that has been modified to assess the health status of patients with asthma and/or COPD. Baseline data from the NOVELTY study were used to test the CAAT. The CAAT was found to be consistent with other health status measures, and showed good validity. These results indicate that the CAAT is a suitable patient-reported outcome instrument for use across asthma and COPD. As the CAAT is relatively quick to complete, it may be particularly relevant for use in routine clinical practice.
Tomaszewski E et al. Am J Respir Crit Care Med 2021;203:A1661.
This article reported the baseline characteristics of patients participating in the NOVELTY study and revealed substantial heterogeneity within, and overlap between, physician-assigned diagnostic labels and physician-assessed severity categories in patients with asthma and/or COPD in terms of clinical, physiological and biomarker characteristics. Clinical characteristics associated with poor patient outcomes were higher with greater physician-assessed severity but were also present in patients with mild disease. These results suggest that current diagnostic and severity classifications poorly differentiate between clinically important phenotypes. Treatment strategies to improve outcomes for patients with asthma and/or COPD would be better targeted towards individual characteristics and disease traits than their diagnostic label.
Infographic and lead author video summary available here.
Reddel HK et al. Eur Respir J 2021;58(3):2003927.
This article described the development of the Respiratory Symptoms Questionnaire (RSQ) and assessed the psychometric validity of the RSQ in patients with physician-assigned diagnoses of asthma and/or COPD. The internal consistency, structural validity and psychometric performance of the RSQ were evaluated using baseline data from patients who had completed the RSQ in the NOVELTY study. Results of this analysis demonstrated that the RSQ is a valid, easy-to-administer patient-reported tool for assessing and monitoring respiratory symptoms in patients with asthma and/or COPD.
Karlsson N et al. ERJ Open Res 2021;7:00828-2020.
This ePoster aimed to describe the humanistic burden on patients with physician-assessed mild asthma. The results suggested that many patients with physician-assessed mild asthma had some degree of humanistic burden, with almost a third of patients reporting poor asthma symptom control. Disease-specific health-related quality of life was lower in patients with physician-assessed mild asthma compared with those who had no history of respiratory disease, with a subset of patients reporting poor overall health status.
Golam, S. et al. Value in Health 2020;23(Suppl 2):S730.
This ePoster aimed to compare spirometric markers of airflow obstruction and reversibility in asthma and/or COPD. Increasing physician-assessed severity was associated with decreased mean pre-bronchodilator forced expiratory volume in 1 second (FEV1), forced expiratory flow between 25% and 75% of forced vital capacity (FVC), peak expiratory flow rate and post-bronchodilator FEV1/FVC. Bronchodilator reversibility of these markers did not distinguish patients with a physician diagnosis of asthma from those with COPD. The authors concluded that while spirometry remains an important marker of disease severity, the use of bronchodilator reversibility to confirm the diagnosis of asthma in clinical trials should be challenged.
Hughes R et al. Eur Respir J 2020;56(Suppl 64):3759.
This ePoster aimed to evaluate the distribution of factors associated with blood eosinophil count in patients with physician-assigned asthma or COPD using baseline data from NOVELTY. The results revealed that 19% of patients with physician-assigned asthma and/or COPD had an elevated blood eosinophil count, which was numerically higher in patients with asthma than in patients with COPD. Increased blood eosinophil count was found to be associated with male sex, more frequent patient-reported episodes of symptomatic worsening, higher levels of fractional exhaled nitric oxide, greater forced expiratory volume in 1 second reversibility, frequent mucoid cough and obesity, irrespective of physician-assigned diagnosis.
Müllerová H et al. Eur Respir J 2020;56(Suppl 64):2990.
This ePoster aimed to identify the factors associated with physician-assigned severity of either asthma or COPD using baseline data from NOVELTY. Greater physician-assessed severity was associated with frequency of prior exacerbations, worse lung function, increasing bronchodilator responsiveness and modified Medical Research Council dyspnoea score for both diagnoses. Greater severity was associated with allergic and non-allergic rhinitis and emphysema in patients with asthma and COPD, respectively. The authors concluded that in the NOVELTY study, greater physician-assigned severity was associated with worse respiratory symptoms, lower lung function and exacerbation history in patients with asthma or COPD.
Papi A et al. Eur Respir J 2020;56(Suppl 64):2201.
This ePoster described the physician- and patient-reported burden of disease in patients with physician-assessed mild asthma, using baseline data from the NOVELTY study. The results demonstrated that many patients with physician-assessed mild asthma had a high disease burden, with nearly one-third of patients demonstrating poor symptom control and one in four patients having at least one exacerbation during the previous 12 months. Oral corticosteroids were used to treat half of the exacerbations and a quarter of the incidences of symptom worsening required corticosteroid treatment.
Golam SM et al. Eur Respir J 2020;56(Suppl 64):969.
This ePoster described the distribution of exacerbations and characterised patients with physician-assigned COPD (both with and without a concomitant diagnosis of asthma), stratified by exacerbation frequency. Frequent exacerbations were more common among patients with concomitant asthma versus those without concomitant asthma. Patients with COPD and a history of exacerbations had a higher disease burden, more work impairment and higher healthcare utilisation than those without exacerbations.
Müllerová H et al. Eur Respir J 2020;56(Suppl 64):2474.
This ePoster compared the baseline characteristics of patients with physician-assigned COPD with ‘normal’ spirometry or with Preserved Ratio but Impaired Spirometry (PRISm), compared with patients with Global Initiative for Obstructive Lung Disease (GOLD) 1 COPD. Patients in the normal spirometry and PRISm groups tended to be younger and female, and had higher body mass index, earlier onset of symptoms and lower smoking exposure, compared with patients in the GOLD 1 group. They also tended to have similar respiratory symptoms, exacerbations and were prescribed similar medications compared with patients in the GOLD 1 group. The authors concluded that patients were frequently diagnosed and treated for COPD based on a variety of background risk factors and clinical features, without meeting recommended spirometric criteria.
Agustí A et al. Eur Respir J 2020;56(Suppl 64):2195.
This review article examined the value of observational studies, alongside randomised controlled trials (RCTs), in the field of obstructive lung disease. The authors discussed the increasing importance of observational studies in broader patient populations due to the limitations of the strict inclusion criteria used in RCTs. They concluded that there is a need for large, inclusive observational studies such as NOVELTY to enhance our understanding of disease mechanisms and treatment.
Vestbo J et al. ERJ Open Res 2020;6:00044-2020.
This poster evaluated the reliability and validity of the Respiratory Symptoms Questionnaire (RSQ) as a general measure of respiratory symptoms in patients with asthma and/or COPD, using baseline data from NOVELTY. These results support the reliability and validity of the RSQ, indicating that it is a suitable patient-reported tool for assessing respiratory symptoms and their impact on patient’s activity without assuming a specific diagnostic label.
Müllerová H et al. Am J Respir Crit Care Med 2020;201:A7752.
This poster characterised the relationship between patient-reported cough and mucus production in patients with physician-assigned asthma and/or COPD. It also described the association between frequent mucoid cough and physician-assigned diagnosis and severity. The results suggested that patients often experienced both frequent cough and frequent mucus production, irrespective of diagnosis. Frequent mucoid cough occurred more often with greater physician-assigned severity and was most common in those with physician-assigned asthma+COPD or COPD compared with those with physician-assigned asthma.
Hughes R et al. Am J Respir Crit Care Med 2020;201:A5080.
This exploratory analysis of the genetics of obstructive lung disease in whole exome sequences (WES) did not identify any significant enrichment of deleterious rare variants among patients with physician-assigned asthma and/or COPD compared to controls. Further analyses of WES data are needed, to search for genetic variants associated with specific disease phenotypes of obstructive lung disease.
Lassi G et al. Am J Respir Crit Care Med 2020;201:A4001.
This review article examined the evolving clinical definitions of severe asthma and severe COPD and evaluated their influence on trial design. The authors concluded that a new approach to defining severe obstructive lung disease is needed for the biologic era. They recommended a phenotype- and endotype-focused approach to future research to identify novel biomarkers and potential therapeutic targets.
Martin RJ et al. Eur Respir J 2019;54:1900108.
This poster described baseline characteristics of NOVELTY patients by physician-assigned severity of asthma and/or COPD. The analysis showed that across physician-assigned diagnoses of asthma, asthma and COPD and COPD, more severe disease (as assigned by physician judgement) was associated with lower lung function, higher blood neutrophil counts and worse patient-reported outcomes, but that clinical features often overlapped across diagnosis and severity groups.
Vestbo J et al. Eur Respir J 2019;54:PA5029.
This oral presentation described the application of novel statistical approaches to account for missing data uncertainty in cluster predictions in complex real-world data. The random forest method combined with multiple imputation provided a flexible framework for the evaluation of cluster variability due to missing data. This approach could be used to improve the determination of discrete clinical clusters from complex data-sets, for example in the NOVELTY study.
This poster described baseline characteristics of NOVELTY patients and showed that clinical, physiological and inflammatory characteristics often overlapped across physician-assigned diagnoses of asthma and COPD. These results suggested that current diagnostic categories may generalise complex, heterogeneous obstructive lung diseases. Such overlaps may limit the potential for exploration of important underlying mechanisms of disease, eventually leading to personalised therapies.
Reddel HK et al. Am J Respir Crit Care Med 2019;199:A7394.
This poster described the NOVELTY study design and its anticipated outcomes. It summarised the data to be collected in NOVELTY at yearly visits and/or 3-month follow-ups, and how these data will be used to gain insights into the diagnosis, assessment and management of patients with asthma and COPD, with the ultimate aim of improving patient outcomes.
This abstract was an encore of the abstract from the methodology article published in ERJ Open Research.
This article described the NOVELTY study design and its anticipated outcomes. It summarised the data to be collected in NOVELTY (including clinical assessments, spirometry, biospecimens, patient-reported outcomes and healthcare utilisation [HCU]) at yearly visits and/or 3-month follow-ups, and how these data will be used to identify phenotypes and endotypes associated with different trajectories for symptom burden, clinical progression or remission and HCU. Results from the study may allow much more precise patient classification according to clinical outcomes and biomarker profiles over time and support the development of novel therapies and a personalised approach across obstructive lung disease.
Reddel HK et al. ERJ Open Res 2019;5:00036-2018.
A NOVEL observational longiTudinal studY in patients with asthma and/or COPD: NOVELTY protocol and rationale Oral presentation at the International Primary Care Respiratory Group (IPCRG) World Conference, 31 May–2 June 2018, Porto, Portugal This presentation described the rationale, research questions and study design of NOVELTY. The strengths of NOVELTY include its size and global nature (up to 12,000 patients across 19 countries), enrolment of patients across the spectrum of diagnoses and severities and from both primary care and specialist clinical practices, broad inclusion and minimal exclusion criteria, the wide range of data collected (including biospecimens), and the longitudinal follow-up over 3 years.
This presentation summarised the rationale for the NOVELTY study and described the objectives and methodology of the study. The heterogeneity among patients with asthma and/or COPD presents a need for a revised taxonomy of these diseases, but there are few prospective, observational studies across asthma, COPD and asthma–COPD overlap diagnoses. NOVELTY is a global, prospective, observational, longitudinal cohort study of patients with a diagnosis or suspected diagnosis of asthma and/or COPD that aims to describe patient characteristics, treatment patterns and burden of illness over time, and to identify phenotypes and endotypes associated with differential outcomes.
Gerhardsson de Verdier M et al. Respir Res 2018;19:REGABS18003.
This poster described the feasibility analysis conducted on electronic medical records (EMRs) from five different database sources in the USA. The databases analysed had high completeness for patient demographic and characteristics data, and partial completeness for respiratory-related variables. However, lung function data, and to a lesser extent treatment dosage information, were either not recorded during the 1-year assessment period, or were not recorded in a structured format; therefore, disease severity could not be classified using these data for many patients. EMRs are potential sources of patient data for observational studies such as NOVELTY, and can be useful in guiding study design. However, data availability and completeness issues currently limit their use.
Reddel HK et al. Am J Respir Crit Care Med 2017;195:A2032.
This analysis provided an estimation on the numbers of primary care patients in Sweden potentially eligible for NOVELTY, and algorithm-based disease severity distributions. While primary care electronic medical records (EMRs) are a potential source of patient data for observational studies like NOVELTY and can help guide study design, limited data availability and completeness limit their use. Data required for NOVELTY are not routinely collected in Swedish EMRs, so data will be collected using a custom-designed electronic case report form and patient-reported outcomes.
Despite the limitations of the electronic medical record (EMR) feasibility analysis (e.g. only a selected sample of EMRs and only 1-year follow up) in the NOVELTY study, EMRs will be used as a complementary data source for some countries. However, data for NOVELTY will primarily be collected from electronic case report forms completed by the treating healthcare professional, and from patient questionnaires completed every 3 months.
This abstract was an encore of the BTS 2016 abstract.
This analysis revealed the numbers of primary care patients potentially eligible for NOVELTY, and an algorithm-based estimation of disease severity distribution. The analysed electronic medical records (EMRs) appeared to be representative of the national asthma/COPD population, according to age and gender. COPD disease severity based on lung function could not be determined due to missing data, and a high proportion of patients classified from treatment level as having severe/very severe asthma or COPD reflects Australian prescribing patterns, which vary from clinical guidelines. This highlights a limitation of classifying severity based on prescriptions, which may be influenced by variations in prescribing patterns.
Reddel HK et al. Respirology 2017;22(S2):TP‐022.
This feasibility analysis of electronic medical records (EMRs) in 11 countries revealed the numbers of patients potentially eligible for the NOVELTY study, and the estimated severity distribution across clinical practices. Differences in the completeness of EMRs – in terms of variables included – provided insights into clinical practice around the world; a lack of lung function data suggests divergences in the diagnosis and management of asthma and COPD between clinical guidelines (which recommend lung function tests) and clinical practice, or that data are not recorded in readily accessible formats.
EMRs represent a potential data source for NOVELTY in some countries, and this analysis informed the study design.
Reddel HK et al. Thorax 2016;71(Suppl 3):P138.
This poster presented the findings from a feasibility analysis of electronic medical records (EMRs) from six European countries involved in NOVELTY: France, Germany, Italy, Spain, Sweden and the UK. The analysis provided a picture of current clinical practice for patients with asthma and/or COPD in these countries. Disease severity based on treatment use could not be classified for a high proportion of patients, implying that disease management practices differ between countries and clinical guidelines. Many of the selected EMRs also lacked data on variables such as prescriptions and lung function tests, indicating that these variables may not have been collected over the period studied, or were not recorded in an accessible format.
Wang X et al. Value in Health 2016;19(7):A367.
This poster described how electronic medical records (EMRs) from eight countries in Europe, North America and the Asia-Pacific region were generally representative of national data with regards to patient age and gender, and physician age, gender, specialty and geographical coverage. These findings suggest that EMRs may be generalisable to the national populations, and confirms the concept of performing an EMR-based feasibility assessment to guide the NOVELTY study design.
Wang X et al. Pharmacoepidemiol Drug Saf 2016;25(S3):1055.
This poster presented insights into current clinical practice in Australia, China and Japan for patients with asthma and/or COPD. Many variables of interest to NOVELTY were not routinely collected in electronic medical records (EMRs). The findings indicated that for many EMRs, treatment and disease monitoring differed from that used in international clinical guidelines, and highlighted that international clinical guidelines, national guidelines and standard clinical practice do not necessarily correlate. The analysis led to the decision to collect data for the NOVELTY study from Australia, China and Japan using electronic case reports rather than EMRs.
Wang X et al. Value in Health 2016;19(7):A852.
This poster described the feasibility analysis conducted on 11 country-specific electronic medical record (EMR) data sources (the USA, Canada, the UK, France, Germany, Italy, Spain, Sweden, Japan, China and Australia), to gain insights into the proportions of patients with different disease severities and to identify the variables routinely recorded on patients within current clinical care, in order to optimise NOVELTY study design.
Considerable differences in the type of information recorded between countries were observed, reflecting differences in clinical practice and EMR documentation. While patient demographics were routinely captured, disease- and treatment-related variables were not. The analysis provides insight into clinical practices, and highlights those variables not routinely collected and which will therefore require specific training in the NOVELTY study.
Wang X et al. Value in Health 2016;19(3):A81.
This invited presentation described a feasibility analysis performed on electronic medical records (EMRs) from 11 countries to assess EMR variable coverage and completeness in each country, and a survey of physicians in selected countries to identify routine clinical practices. EMRs identified a large patient population that would be eligible for the NOVELTY study. Some countries had EMRs that included considerable patient and disease information, such as laboratory test results, spirometer and healthcare utilisation, whereas EMRs from other countries did not. For a few countries (e.g. Sweden and the UK), EMRs had sufficient information to be used as supplementary data sources in the NOVELTY study.
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