Natural history of FEV1 loss and relationship between lung function and cause-specific mortality
Project Reference: NDPH/MT16/039
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, and the burden in low- and middle-income countries is expected to increase in the coming decades. However, understanding of the development and prognosis of COPD is still limited.
Accelerated lung function decline has long been considered as the hallmark of COPD. However, recent studies have challenged this classical view by suggesting lung function decline may not be progressive, with more rapid decline seen among patients with milder disease compared to those at more advanced stage. Some reports have suggested normal rate of lung function decline could also lead to COPD. The reasons for these conflicting observations have not been clear. More importantly, whether these different trajectories of lung function decline are associated with prognosis is not known.
To clarify the natural history and prognosis of lung function (as FEV1) decline, a large population-based cohort with detailed phenotypic information will be needed. The China Kadoorie Biobank (CKB), with 0.5M adults recruited from 10 diverse regions of China, is well poised for such research question. Around 15k participants have lung function measured at baseline (2005/08), first (2008) and second (2013/14) resurvey, thus allowing the tracking of changes in lung function over 10 years. In addition, >1.5 million ICD-10 coded disease events have been recorded, enabling the comparison of health outcomes in relation to different rates of lung function decline.
Research Experience, Research Methods and Training
This DPhil will encompass literature review, study design and planning, in-depth training in COPD epidemiology, quality assurance and interpretation of spirometry data, handling and analysis of large scale longitudinal data using state-of-the-art statistical methods.
Specifically the project aims (i) to investigate the natural history of lung function decline, in relation to smoking and other risk factors (e.g. early life passive smoking exposure), and (ii) to relate 10-year cause-specific mortality with baseline lung function and different decline trajectories.
Field Work, Secondments, Industry Placements and Training
The DPhil will be based at CTSU, with potential opportunities for field work in China. In-house training in spirometry will be provided. The candidate will be expected to present the work nationally and internationally and to publish 3-4 peer-reviewed papers.
The candidate should have a 2.1 or higher degree in medicine, biomedical science or a related discipline, and preferably with an MSc in epidemiology/statistics. Experience and interest in respiratory research will be advantageous.