Linking e-health records, patient-reported symptoms and environmental exposure data to characterise and model COPD exacerbations: protocol for the COPE study

BMJ Open. 2016 Jul 13;6(7):e011330. doi: 10.1136/bmjopen-2016-011330.


Introduction: Relationships between exacerbations of chronic obstructive pulmonary disease (COPD) and environmental factors such as temperature, humidity and air pollution are not well characterised, due in part to oversimplification in the assignment of exposure estimates to individuals and populations. New developments in miniature environmental sensors mean that patients can now carry a personal air quality monitor for long periods of time as they go about their daily lives. This creates the potential for capturing a direct link between individual activities, environmental exposures and the health of patients with COPD. Direct associations then have the potential to be scaled up to population levels and tested using advanced human exposure models linked to electronic health records.

Methods and analysis: This study has 5 stages: (1) development and deployment of personal air monitors; (2) recruitment and monitoring of a cohort of 160 patients with COPD for up to 6 months with recruitment of participants through the Clinical Practice Research Datalink (CPRD); (3) statistical associations between personal exposure with COPD-related health outcomes; (4) validation of a time-activity exposure model and (5) development of a COPD prediction model for London.

Ethics and dissemination: The Research Ethics Committee for Camden and Islington has provided ethical approval for the conduct of the study. Approval has also been granted by National Health Service (NHS) Research and Development and the Independent Scientific Advisory Committee. The results of the study will be disseminated through appropriate conference presentations and peer-reviewed journals.

Keywords: COPD; Exacerbation; Monitor; Pollution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Air Pollutants / adverse effects
  • Air Pollutants / analysis
  • Air Pollution / adverse effects*
  • Air Pollution / analysis
  • Cohort Studies
  • Data Collection / methods
  • Electronic Health Records
  • Environmental Exposure / adverse effects*
  • Environmental Exposure / analysis
  • Environmental Monitoring / methods
  • Female
  • Humans
  • London
  • Male
  • Middle Aged
  • Models, Biological*
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Research Design
  • Self Report
  • Severity of Illness Index*


  • Air Pollutants