COPD by the numbers
- The leading cause of hospital admissions among all other chronic health conditions (2014-15)
- #1 cause of return visits to hospital emergency departments
- 4th highest cause of death in Canada in 2011, behind cancer, heart disease and stroke. It’s expected to reach #3 by 2020
- It’s estimated that 13% of the population over the age of 35 have some form of the disease; it’s estimated that will rise to 25% of the population over 35 who will develop it over their lifetime.
Sources: Statistics Canada, Canadian Institute for Health Information, Lung Association, Canadian Foundation for Healthcare Improvement
Chronic obstructive pulmonary disease (COPD) impacts an estimated 300- million people worldwide, but how it manifests in each case is not always the same, making blanket treatments often ineffective, costly, and frustrating.
Which is where Dr. Sin’s “crystal ball” comes in.
Dr. Don Sin, St. Paul’s respirologist, is thinking outside the box – or in this case, looking inside the crystal ball – to get ahead of COPD.
Using ongoing research with a cohort of nearly 6,000 COPD patients whose personal health profiles (the results of breathing tests and other analytics) were used to create computer algorithms, Dr. Sin and a team of international researchers, took this data to go the step further and develop a web-based tool that helps predict the progression of a patient’s COPD and, in turn, helping doctors calculate how progression could be delayed with tailored therapies.
And the fruits of this labour are already producing dramatic results.
Getting ahead of the disease
Vancouver resident Scott Finch, 62, is a patient of Dr. Sin’s and is one of the first to get specific therapy because of his respirologist’s online lung-function predictor. Diagnosed in his mid-40s, Scott now says that there are days when he can’t go up the stairs, let alone exercise.
So what can an online predictor tool do in a case like Scott’s?
In an appointment, Dr. Sin enters Scott’s latest clinical information into the site, including the results of a breathing test that shows Scott can exhale 1.37 litres of air in one second.
“For a normal person of his age, it would be 3.19 litres, so he’s at stage three of COPD,” explains Dr. Sin. Thanks to indicators built into the online tool, the correlation between Scott’s current health and the probability of his future need for supplemental oxygen is revealed..
“We know that if we don’t do anything today that, at the end of 10 years, his probability of ending up with oxygen is about 80 per cent,” says Dr. Sin. “Based on the information given by this tool, I would say we need to do something.”
With appropriate medication and ongoing monitoring, Dr. Sin and Scott know that the results are already increasing Scott’s breathing by 0.3 litres. And when Scott’s data is re-submitted into the online predictor, the previous indicators flagging the need for oxygen are receding.
Ultimately, Dr. Sin predicts that by taking the drug for a decade, Scott’s chances of needing an oxygen tank will be reduced by 20 to 30 per cent.
For Scott, the path forward signifies a halting of the COPD’s progression, giving him relief from “being reminded all the time that the disease I have is a progressive, incurable disease.”
And for Dr. Sin, his crystal ball affirms a need in today’s medicine.
This is the power of what we call precision medicine or individualized medicine and this is where we need to be at in 2016
“Similar websites that show doctors the probable progression of heart disease have existed for decades, and for a growing disease like COPD that currently affects up to three million Canadians, we require a similar tool,”says Dr. Sin.
In the next 20 years Dr. Sin predicts a 50-per-cent increase in the number of COPD cases due to an aging population and lungs becoming weaker with age, putting an even greater urgency on the importance of the work done by Dr. Sin, and the team at Providence’s Centre for Heart Lung Innovation (HLI).