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Predicting Exacerbations of Asthma in Real-World Patients with Low Medical Utilization (PEARL)

Award Number: R01HL163049
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/21/2023
PERIOD OF PERFORMANCE END DATE: 12/31/2027

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Predicting Exacerbations of Asthma in Real-World Patients with Low Medical Utilization (PEARL) - PROJECT SUMMARY Asthma is a chronic inflammatory condition that affects > 20 million Americans. The prevalence of asthma has been increasing since the early 1980s in all age, sex, and racial groups. There is no universal method for de- termining asthma severity. The terminology and the definition used in various asthma guidelines have evolved over time. Most commonly, asthma severity is determined by clinical parameters such as medica- tion use, presence and/or frequency of asthma symptoms, number of asthma exacerbations (which are acute or subacute episodes of progressively worsening shortness of breath, cough, wheezing, and chest tight- ness or some combination of these symptoms), and/or the results of lung function tests. Patients with persis- tent asthma are at elevated risk for exacerbations (attack) and often have decreased lung function. Yet the bur- den of intermittent asthma is also significant: It affects 50-75% of all asthma patients and represents 30-40% of total asthma exacerbations requiring emergency consultation. Risk factors for asthma exacerbations have been studied in patients with persistent asthma. However, little is known about risk factors in patients with in- termittent asthma, nor have risk prediction models been reported. A focused study on risk factor identification and future risk prediction will provide valuable insights into the etiology of asthma exacerbations in intermittent asthma patients and facilitate a personalized approach in the management of the disease. Without a clear un- derstanding of the risk of asthma exacerbation for each individual patient with intermittent asthma, we will not be able to optimally define the most appropriate intervention strategies to reduce the burden of the disease in this group of patients. To operationalize the clinical definition of intermittent asthma, we will focus on a pheno- typic group of low utilizers referred to in guidelines as intermittent asthma. We propose to identify potential risk factors for asthma exacerbation in low utilizers using high-dimensional and longitudinal KPSC EHR and exter- nal data sources (including air quality measures, social determinants of health and violent crime), subsequently develop and validate risk prediction models to stratify patients into low- and high-risk groups, and externally validate the risk prediction model using EHR data of another large health care organization. We also propose to establish a prospective cohort of low utilizers and collect patient-reported information (PRI) via a survey. The PRI will help characterize the patients of low utilizers in terms of asthma symptoms, activities, impairment and risk assessment, work productivity, beliefs about medicines and anxiety/depression scales. We will develop and internally validate a risk prediction model based on both EHR and PRI data. The proposed models will al- low physicians to provide personalized care (e.g., develop or adjust treatment plans, provide personal asthma action plans accordingly, and refer patients to asthma specialists when necessary) and thus improve the qual- ity of care and reduce asthma burden. Our proposal to examine heterogeneity across different racial/ethnic groups has the potential to inform practice for more accurate asthma risk assessment.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $707,253 )
2026	2026	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Lung Diseases Research	000	4	3/20/2026	NON-COMPETING CONTINUATION	$707,253
														Subtotal = $707,253

Issue Date FY: 2025 ( Subtotal = $740,839 )
2025	2025	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Lung Diseases Research	001	3	8/15/2025	NON-COMPETING CONTINUATION	$74,084
2025	2025	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Lung Diseases Research	000	3	2/27/2025	NON-COMPETING CONTINUATION	$666,755
														Subtotal = $740,839

Issue Date FY: 2024 ( Subtotal = $734,772 )
2024	2024	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Lung Diseases Research	001	2	7/18/2024	NON-COMPETING CONTINUATION	$59,980
2024	2024	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Lung Diseases Research	000	2	1/17/2024	NON-COMPETING CONTINUATION	$674,792
														Subtotal = $734,772

Issue Date FY: 2023 ( Subtotal = $773,756 )
2023	2023	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Lung Diseases Research	001	1	3/13/2023	NEW	$0
2023	2023	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Lung Diseases Research	000	1	2/21/2023	NEW	$773,756
														Subtotal = $773,756

Grand Total All Awards = $2,956,620

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Predicting Exacerbations of Asthma in Real-World Patients with Low Medical Utilization (PEARL)

Award Number: R01HL163049

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/21/2023

PERIOD OF PERFORMANCE END DATE: 12/31/2027

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