Background: Individuals with chronic obstructive pulmonary disease (COPD) are often at risk for or have comorbid cardiovascular disease and are likely to die of cardiovascular-related causes. Objectives: To prioritize a list of research topics related to the diagnosis and management of patients with COPD and comorbid cardiovascular diseases (heart failure, atherosclerotic vascular disease, and atrial fibrillation) by summarizing existing evidence and using consensus-based methods. Methods: A literature search was performed. References were reviewed by committee co-chairs. An international, multidisciplinary committee, including a patient advocate, met virtually to review evidence and identify research topics. A modified Delphi approach was used to prioritize topics in real time on the basis of their potential for advancing the field. Results: Gaps spanned the translational science spectrum from basic science to implementation: 1) disease mechanisms; 2) epidemiology; 3) subphenotyping; 4) diagnosis and management; 5) clinical trials; 6) care delivery; 7) medication access, adherence, and side effects; 8) risk factor mitigation; 9) cardiac and pulmonary rehabilitation; and 10) health equity. Seventeen experts participated, and quorum was achieved for all votes (>80%). Of 17 topics, ≥70% agreement was achieved for 12 topics after two rounds of voting. The range of summative Likert scores was -15 to 25. The highest priority was "Conduct pragmatic clinical trials with patient-centered outcomes that collect both pulmonary and cardiac data elements." Health equity was identified as an important topic that should be embedded within all research. Conclusions: We propose a prioritized research agenda with the purpose of stimulating high-impact research that will hopefully improve outcomes among people with COPD and cardiovascular disease.

中文翻译：

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改善慢性阻塞性肺疾病和心血管疾病患者预后的研究议程：美国胸科学会官方研究声明。


背景：患有慢性阻塞性肺疾病（COPD）的个体通常有患心血管疾病的风险或患有心血管疾病，并且可能死于心血管相关原因。目的：通过总结现有证据并使用基于共识的方法，优先列出与 COPD 和合并心血管疾病（心力衰竭、动脉粥样硬化性血管疾病和心房颤动）患者的诊断和治疗相关的研究主题。方法：进行文献检索。委员会联合主席审查了参考文献。一个国际多学科委员会，包括一名患者倡导者，召开虚拟会议，审查证据并确定研究主题。改进的德尔菲方法用于根据主题推进该领域的潜力实时确定主题的优先级。结果：从基础科学到实施的转化科学领域存在差距：1）疾病机制； 2）流行病学； 3) 亚表型分析； 4）诊断和管理； 5）临床试验； 6) 护理服务； 7) 药物获取、依从性和副作用； 8）风险因素缓解； 9）心肺康复； 10) 健康公平。共有 17 名专家参与，所有投票均达到法定人数（>80%）。 17个议题中，经过两轮投票，有12个议题达成≥70%的一致意见。总结性 Likert 评分的范围为 -15 至 25。最高优先级是“开展务实的临床试验，以患者为中心，收集肺部和心脏数据元素。”健康公平被认为是应纳入所有研究的一个重要主题。 结论：我们提出了一个优先研究议程，旨在促进高影响力的研究，有望改善慢性阻塞性肺病和心血管疾病患者的治疗结果。