Lung disease, particularly COPD, is the third largest killer among diseases in the United States, and fourth in the world. Nonetheless, the early signs of the diseases are subtle and slow to advance, leading to late diagnosis. Once diagnosed, there is a great reluctance to the lifestyle changes necessary to slow the advancement of the disorder. Smoking addiction, the stigma of smoking history, reluctance to show weakness... more »

Disease progression should be characterized by COPD exacerbations or hospitalizations for respiratory insufficiency. It can also be characterized by changes in spirometry or chest radiographic (CT) evidence of progressive emphysema and/or airway inflammation. These characteristics should be correlated with smoking history, environmental exposures, pulmonary function, radiographic markers of disease, plasma protein biomarkers,... more »

Infants born at <28 weeks of gestation who survive can experience long-term impacts from subtle abnormalities in respiratory function to profound disability including asthma, early COPD, or long-term dependence on mechanical ventilation. It is unclear how maternal environmental exposures, geographic differences, social factors, or genetic predisposition in the pre-conceptional period or during pregnancy might contribute... more »

Both COPD and interstitial lung diseases (ILD)’s such as interstitial pulmonary fibrosis (IPF) are diseases of aging and more common in the elderly. For these reasons, lung function should be obtained in the elderly at every visit. Research Question: Does simple spirometry help us identify patients with lung disease early in the course of their disease.