title: Linking e-health records, patient-reported symptoms and environmental exposure data to characterise and model COPD exacerbations: protocol for the COPE study.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Medicine, Imperial College London, London, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Moore
authors.affiliation: Department of Chemistry, Centre for Atmospheric Science, University of Cambridge, Cambridge, UK.
authors.forename: Lia
authors.initials: L
authors.lastname: Chatzidiakou
authors.affiliation: Department of Chemistry, Centre for Atmospheric Science, University of Cambridge, Cambridge, UK.
authors.forename: Roderic L
authors.initials: RL
authors.lastname: Jones
authors.affiliation: Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Liam
authors.initials: L
authors.lastname: Smeeth
authors.affiliation: Analytical & Environmental Sciences Division, King's College London, London, UK.
authors.forename: Sean
authors.initials: S
authors.lastname: Beevers
authors.affiliation: NIHR Health Protection Research Unit in Health Impacts of Environmental Hazards, King's College London, London, UK.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Kelly
authors.affiliation: Department of Medicine, Imperial College London, London, UK.
authors.forename: Jennifer
authors.identifier: 0000-0003-0149-4869
authors.initials: J
authors.lastname: K Quint
authors.affiliation: Analytical & Environmental Sciences Division, King's College London, London, UK.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Barratt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D015331:Cohort Studies; D003625:Data Collection / Q000379:methods; D057286:Electronic Health Records; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D004784:Environmental Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012107:Research Design; D057566:Self Report; D012720:Severity of Illness Index
chemical_list: D000393:Air Pollutants
keywords: COPD; Exacerbation; Monitor; Pollution