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CHEST philanthropy: Moving into the future

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Fri, 10/13/2023 - 09:47

In an ideal world, change would be progressive, the direction would be clear, and adoption would be easy. We learned in these past few years that sometimes change cannot wait. The vulnerabilities of the health care system were laid bare by the pandemic, including vast disparities in treatment and the urgent need to grow our profession.

In the light of these truths, CHEST looked within and asked a difficult question: Are we doing everything we can? This question probably sounds very familiar – one you ask every day, one you know the importance of asking. It was time we asked it of ourselves.


Milestones are a good time to reevaluate


Philanthropy is not new to CHEST. We celebrated 25 years of the CHEST Foundation in Nashville during CHEST 2022. Stories about community and clinical research grants were circulated in website blogs, emails, and newsletters and on social media for years. Our committee member volunteers worked hard developing accurate and credible patient education content for the CHEST Foundation website. Because of our faithful donors, communities around the world had access to better medical care and healthier environments.

This is amazing work, but it was time to ask:

  • What can CHEST provide that others cannot?
  • Where are the gaps we can fill?
  • What is our community passionate about changing?

Working collectively, CHEST and CHEST Foundation leadership, along with staff, rigorously reviewed the success of our past fundraising efforts, areas of commitment our donors had specified, and the direction of interest our membership was leading us toward – like social accountability, growth and diversification of our profession, grassroots community impact, and partnerships to expand our reach. The process took nearly a year to complete – but, in the realm of big changes, that’s equal to the time needed for one good, deep breath.


Focusing on significant change means narrowing our scope


Meeting these goals would mean changing how we worked and letting go of areas better served elsewhere. CHEST needed to:

1. Align philanthropy with our mission to elevate the value placed on giving, making it a core priority and responsibility of CHEST as an organization.

2. Consolidate philanthropy under CHEST to reduce administrative costs and create efficiencies, allowing more funds to go directly to our philanthropic efforts.

3. Establish clear and transparent areas of giving that resonate with our members as a way to grow our impact and make real change.

With the full support of the CHEST Board of Regents, the CHEST Foundation Board of Advisors – under the guidance of Advisory Chair, Robert De Marco, MD, FCCP, and CHEST Foundation President, Ian Nathanson, MD, FCCP – approved a merger of the CHEST Foundation with CHEST.

In order to increase our impact and create greater awareness of CHEST philanthropic efforts, the Board of Advisors got to work defining a giving strategy that would meet the philanthropic goals and priorities of the CHEST membership. Four areas were defined and are referred to as our philanthropic pillars: clinical research, community impact, support of the profession, and dedication to education.

These pillars were approved by the Board of Regents at their spring leadership meeting.
 

 

 

Giving goals without support are just dreams

This transition puts the responsibility for funding the giving pillars in the hands of CHEST. The first step is ensuring the members see the impact of their donations.

“When you see your donation in action, you never doubt that you made a good decision,” said CHEST CEO, Robert A. Musacchio, PhD. “If we can show that to every member, the next 25 years of CHEST philanthropy are limitless.”

Helping connect donors to that experience is Meggie Cramer, the new Director of Philanthropy and Advancement , who has experience working directly with health care systems like Rush University Medical Center in Chicago and Hospital Sister Health System in Green Bay, Wisconsin.

“When you are giving to programs you are passionate about, you feel good about being a part of making a difference,” explained Cramer. “That’s my goal – to help our members find areas they care about and know their gift is part of creating real change.”

For frequently asked questions about the transition, please visit our website.

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In an ideal world, change would be progressive, the direction would be clear, and adoption would be easy. We learned in these past few years that sometimes change cannot wait. The vulnerabilities of the health care system were laid bare by the pandemic, including vast disparities in treatment and the urgent need to grow our profession.

In the light of these truths, CHEST looked within and asked a difficult question: Are we doing everything we can? This question probably sounds very familiar – one you ask every day, one you know the importance of asking. It was time we asked it of ourselves.


Milestones are a good time to reevaluate


Philanthropy is not new to CHEST. We celebrated 25 years of the CHEST Foundation in Nashville during CHEST 2022. Stories about community and clinical research grants were circulated in website blogs, emails, and newsletters and on social media for years. Our committee member volunteers worked hard developing accurate and credible patient education content for the CHEST Foundation website. Because of our faithful donors, communities around the world had access to better medical care and healthier environments.

This is amazing work, but it was time to ask:

  • What can CHEST provide that others cannot?
  • Where are the gaps we can fill?
  • What is our community passionate about changing?

Working collectively, CHEST and CHEST Foundation leadership, along with staff, rigorously reviewed the success of our past fundraising efforts, areas of commitment our donors had specified, and the direction of interest our membership was leading us toward – like social accountability, growth and diversification of our profession, grassroots community impact, and partnerships to expand our reach. The process took nearly a year to complete – but, in the realm of big changes, that’s equal to the time needed for one good, deep breath.


Focusing on significant change means narrowing our scope


Meeting these goals would mean changing how we worked and letting go of areas better served elsewhere. CHEST needed to:

1. Align philanthropy with our mission to elevate the value placed on giving, making it a core priority and responsibility of CHEST as an organization.

2. Consolidate philanthropy under CHEST to reduce administrative costs and create efficiencies, allowing more funds to go directly to our philanthropic efforts.

3. Establish clear and transparent areas of giving that resonate with our members as a way to grow our impact and make real change.

With the full support of the CHEST Board of Regents, the CHEST Foundation Board of Advisors – under the guidance of Advisory Chair, Robert De Marco, MD, FCCP, and CHEST Foundation President, Ian Nathanson, MD, FCCP – approved a merger of the CHEST Foundation with CHEST.

In order to increase our impact and create greater awareness of CHEST philanthropic efforts, the Board of Advisors got to work defining a giving strategy that would meet the philanthropic goals and priorities of the CHEST membership. Four areas were defined and are referred to as our philanthropic pillars: clinical research, community impact, support of the profession, and dedication to education.

These pillars were approved by the Board of Regents at their spring leadership meeting.
 

 

 

Giving goals without support are just dreams

This transition puts the responsibility for funding the giving pillars in the hands of CHEST. The first step is ensuring the members see the impact of their donations.

“When you see your donation in action, you never doubt that you made a good decision,” said CHEST CEO, Robert A. Musacchio, PhD. “If we can show that to every member, the next 25 years of CHEST philanthropy are limitless.”

Helping connect donors to that experience is Meggie Cramer, the new Director of Philanthropy and Advancement , who has experience working directly with health care systems like Rush University Medical Center in Chicago and Hospital Sister Health System in Green Bay, Wisconsin.

“When you are giving to programs you are passionate about, you feel good about being a part of making a difference,” explained Cramer. “That’s my goal – to help our members find areas they care about and know their gift is part of creating real change.”

For frequently asked questions about the transition, please visit our website.

In an ideal world, change would be progressive, the direction would be clear, and adoption would be easy. We learned in these past few years that sometimes change cannot wait. The vulnerabilities of the health care system were laid bare by the pandemic, including vast disparities in treatment and the urgent need to grow our profession.

In the light of these truths, CHEST looked within and asked a difficult question: Are we doing everything we can? This question probably sounds very familiar – one you ask every day, one you know the importance of asking. It was time we asked it of ourselves.


Milestones are a good time to reevaluate


Philanthropy is not new to CHEST. We celebrated 25 years of the CHEST Foundation in Nashville during CHEST 2022. Stories about community and clinical research grants were circulated in website blogs, emails, and newsletters and on social media for years. Our committee member volunteers worked hard developing accurate and credible patient education content for the CHEST Foundation website. Because of our faithful donors, communities around the world had access to better medical care and healthier environments.

This is amazing work, but it was time to ask:

  • What can CHEST provide that others cannot?
  • Where are the gaps we can fill?
  • What is our community passionate about changing?

Working collectively, CHEST and CHEST Foundation leadership, along with staff, rigorously reviewed the success of our past fundraising efforts, areas of commitment our donors had specified, and the direction of interest our membership was leading us toward – like social accountability, growth and diversification of our profession, grassroots community impact, and partnerships to expand our reach. The process took nearly a year to complete – but, in the realm of big changes, that’s equal to the time needed for one good, deep breath.


Focusing on significant change means narrowing our scope


Meeting these goals would mean changing how we worked and letting go of areas better served elsewhere. CHEST needed to:

1. Align philanthropy with our mission to elevate the value placed on giving, making it a core priority and responsibility of CHEST as an organization.

2. Consolidate philanthropy under CHEST to reduce administrative costs and create efficiencies, allowing more funds to go directly to our philanthropic efforts.

3. Establish clear and transparent areas of giving that resonate with our members as a way to grow our impact and make real change.

With the full support of the CHEST Board of Regents, the CHEST Foundation Board of Advisors – under the guidance of Advisory Chair, Robert De Marco, MD, FCCP, and CHEST Foundation President, Ian Nathanson, MD, FCCP – approved a merger of the CHEST Foundation with CHEST.

In order to increase our impact and create greater awareness of CHEST philanthropic efforts, the Board of Advisors got to work defining a giving strategy that would meet the philanthropic goals and priorities of the CHEST membership. Four areas were defined and are referred to as our philanthropic pillars: clinical research, community impact, support of the profession, and dedication to education.

These pillars were approved by the Board of Regents at their spring leadership meeting.
 

 

 

Giving goals without support are just dreams

This transition puts the responsibility for funding the giving pillars in the hands of CHEST. The first step is ensuring the members see the impact of their donations.

“When you see your donation in action, you never doubt that you made a good decision,” said CHEST CEO, Robert A. Musacchio, PhD. “If we can show that to every member, the next 25 years of CHEST philanthropy are limitless.”

Helping connect donors to that experience is Meggie Cramer, the new Director of Philanthropy and Advancement , who has experience working directly with health care systems like Rush University Medical Center in Chicago and Hospital Sister Health System in Green Bay, Wisconsin.

“When you are giving to programs you are passionate about, you feel good about being a part of making a difference,” explained Cramer. “That’s my goal – to help our members find areas they care about and know their gift is part of creating real change.”

For frequently asked questions about the transition, please visit our website.

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CHEST Advocates raises awareness against tobacco use

Article Type
Changed
Fri, 10/20/2023 - 14:02

“Ew, gross.”

“Um, no way.”

“Of course not.”

Earlier this summer, I partnered with Dr. Melissa Keene, the medical director of a federally qualified health center in southwest Virginia, to talk about tobacco with middle school students. A few minutes after our arrival, it was clear to us that cigarettes weren’t cool anymore.

We asked hundreds of kids if they or their friends smoked cigarettes. The above quoted responses were repeated over and over.

Tobacco health advocates have spent decades working on public health messaging surrounding cigarette use, which is clearly working in this Virginian middle school.

But our patients, friends, and family who are already dependent on tobacco products still face addiction, morbidity, and premature mortality. And the ever-changing forms of tobacco delivery pose new challenges for our collective cessation efforts.

The Summer 2023 issue of CHEST Advocates features parents, lawyers, doctors, and nonprofit leaders who all share their inspiring stories of action in the fight against tobacco use.

Learn from tobacco experts, Dr. Susan Walley and Dr. Evan Stepp, about evidence-based approaches to tobacco cessation in young people –including why we should start having conversations by age 11 about smoking or vaping and why it’s important to inform youth about big tobacco marketing strategies.

Read an interview with Dr. Anne Melzer, who shares lessons from her career in tobacco advocacy centered in a US veteran population. Dr. Melzer suggests free resources that are available to all clinicians who sometimes struggle to help patients find the best way to quit.

Watch a video of Dr. Iyaad Hasan and Dr. Roy St. John, who run The Breathing Association, a nonprofit in Ohio serving individuals who are underinsured or uninsured. This organization offers a mobile medical unit that provides a free, evidenced-based program to help with smoking cessation via education, counseling, and personalized quit plans.

Learn from Natasha Phelps, JD, the Director of Equity-Centered Policies at The Center for Black Health & Equity. For more than 2 decades, this organization has focused on building community capacity to give local constituents the tools needed for sustainable health improvements, including tobacco cessation.

Hear from Dr. Panagiotis Behrakis, who – after decades of advocacy against tobacco use—the World Health Organization recognized in May for his Smoke Free Greece program. He explains why his work focuses on a two-pronged approach that places equal emphasis on both cessation and prevention.

Listen to a podcast featuring an amazing organization called Parents Against Vaping e-cigarettes, which started in response to a predatory marketing strategy by a tobacco company in a school system.

See how CHEST is fighting the battle against smoking and vaping, as told by Dr. Frank Leone, Chair of the Tobacco/Vaping Work Group for the CHEST Health Policy and Advocacy Committee. And, lastly, interact with a timeline of CHEST’s advocacy work in tobacco cessation and regulation through the decades.

As Dr. Melzer so eloquently stated in her interview featured in this issue, “tobacco cessation is a process that belongs to everybody, and, therefore, sometimes to nobody.” We hope this issue will inspire you to advocate for your patients and partner with your communities in our shared mission to improve education, awareness, and action against tobacco use.

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“Ew, gross.”

“Um, no way.”

“Of course not.”

Earlier this summer, I partnered with Dr. Melissa Keene, the medical director of a federally qualified health center in southwest Virginia, to talk about tobacco with middle school students. A few minutes after our arrival, it was clear to us that cigarettes weren’t cool anymore.

We asked hundreds of kids if they or their friends smoked cigarettes. The above quoted responses were repeated over and over.

Tobacco health advocates have spent decades working on public health messaging surrounding cigarette use, which is clearly working in this Virginian middle school.

But our patients, friends, and family who are already dependent on tobacco products still face addiction, morbidity, and premature mortality. And the ever-changing forms of tobacco delivery pose new challenges for our collective cessation efforts.

The Summer 2023 issue of CHEST Advocates features parents, lawyers, doctors, and nonprofit leaders who all share their inspiring stories of action in the fight against tobacco use.

Learn from tobacco experts, Dr. Susan Walley and Dr. Evan Stepp, about evidence-based approaches to tobacco cessation in young people –including why we should start having conversations by age 11 about smoking or vaping and why it’s important to inform youth about big tobacco marketing strategies.

Read an interview with Dr. Anne Melzer, who shares lessons from her career in tobacco advocacy centered in a US veteran population. Dr. Melzer suggests free resources that are available to all clinicians who sometimes struggle to help patients find the best way to quit.

Watch a video of Dr. Iyaad Hasan and Dr. Roy St. John, who run The Breathing Association, a nonprofit in Ohio serving individuals who are underinsured or uninsured. This organization offers a mobile medical unit that provides a free, evidenced-based program to help with smoking cessation via education, counseling, and personalized quit plans.

Learn from Natasha Phelps, JD, the Director of Equity-Centered Policies at The Center for Black Health & Equity. For more than 2 decades, this organization has focused on building community capacity to give local constituents the tools needed for sustainable health improvements, including tobacco cessation.

Hear from Dr. Panagiotis Behrakis, who – after decades of advocacy against tobacco use—the World Health Organization recognized in May for his Smoke Free Greece program. He explains why his work focuses on a two-pronged approach that places equal emphasis on both cessation and prevention.

Listen to a podcast featuring an amazing organization called Parents Against Vaping e-cigarettes, which started in response to a predatory marketing strategy by a tobacco company in a school system.

See how CHEST is fighting the battle against smoking and vaping, as told by Dr. Frank Leone, Chair of the Tobacco/Vaping Work Group for the CHEST Health Policy and Advocacy Committee. And, lastly, interact with a timeline of CHEST’s advocacy work in tobacco cessation and regulation through the decades.

As Dr. Melzer so eloquently stated in her interview featured in this issue, “tobacco cessation is a process that belongs to everybody, and, therefore, sometimes to nobody.” We hope this issue will inspire you to advocate for your patients and partner with your communities in our shared mission to improve education, awareness, and action against tobacco use.

“Ew, gross.”

“Um, no way.”

“Of course not.”

Earlier this summer, I partnered with Dr. Melissa Keene, the medical director of a federally qualified health center in southwest Virginia, to talk about tobacco with middle school students. A few minutes after our arrival, it was clear to us that cigarettes weren’t cool anymore.

We asked hundreds of kids if they or their friends smoked cigarettes. The above quoted responses were repeated over and over.

Tobacco health advocates have spent decades working on public health messaging surrounding cigarette use, which is clearly working in this Virginian middle school.

But our patients, friends, and family who are already dependent on tobacco products still face addiction, morbidity, and premature mortality. And the ever-changing forms of tobacco delivery pose new challenges for our collective cessation efforts.

The Summer 2023 issue of CHEST Advocates features parents, lawyers, doctors, and nonprofit leaders who all share their inspiring stories of action in the fight against tobacco use.

Learn from tobacco experts, Dr. Susan Walley and Dr. Evan Stepp, about evidence-based approaches to tobacco cessation in young people –including why we should start having conversations by age 11 about smoking or vaping and why it’s important to inform youth about big tobacco marketing strategies.

Read an interview with Dr. Anne Melzer, who shares lessons from her career in tobacco advocacy centered in a US veteran population. Dr. Melzer suggests free resources that are available to all clinicians who sometimes struggle to help patients find the best way to quit.

Watch a video of Dr. Iyaad Hasan and Dr. Roy St. John, who run The Breathing Association, a nonprofit in Ohio serving individuals who are underinsured or uninsured. This organization offers a mobile medical unit that provides a free, evidenced-based program to help with smoking cessation via education, counseling, and personalized quit plans.

Learn from Natasha Phelps, JD, the Director of Equity-Centered Policies at The Center for Black Health & Equity. For more than 2 decades, this organization has focused on building community capacity to give local constituents the tools needed for sustainable health improvements, including tobacco cessation.

Hear from Dr. Panagiotis Behrakis, who – after decades of advocacy against tobacco use—the World Health Organization recognized in May for his Smoke Free Greece program. He explains why his work focuses on a two-pronged approach that places equal emphasis on both cessation and prevention.

Listen to a podcast featuring an amazing organization called Parents Against Vaping e-cigarettes, which started in response to a predatory marketing strategy by a tobacco company in a school system.

See how CHEST is fighting the battle against smoking and vaping, as told by Dr. Frank Leone, Chair of the Tobacco/Vaping Work Group for the CHEST Health Policy and Advocacy Committee. And, lastly, interact with a timeline of CHEST’s advocacy work in tobacco cessation and regulation through the decades.

As Dr. Melzer so eloquently stated in her interview featured in this issue, “tobacco cessation is a process that belongs to everybody, and, therefore, sometimes to nobody.” We hope this issue will inspire you to advocate for your patients and partner with your communities in our shared mission to improve education, awareness, and action against tobacco use.

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CHEST SEEK releases key points feature and new print edition

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Mon, 09/11/2023 - 12:52

Two exciting updates have come to the CHEST SEEK portfolio this summer.

The latest book, CHEST SEEK Pulmonary Medicine: 33rd Edition, was released in August. And in this newest book and certain CHEST SEEK Library collections, a feature called key points is included in the recently published 150 pulmonary medicine questions.

Key points are concise summaries of the most important takeaways of SEEK questions. Knowing the key point can help learners focus their studies.

“SEEK questions can be quite robust and intentionally detailed in their response as to why the answer options are correct or incorrect. But because of the level of detail, it can be difficult at times for the learner to correctly hone in on the author’s teaching point,” said CHEST Director, Product Strategy and Evaluation, Martha Zaborowski Pascale, CPM.

“Key points concisely summarize each question’s most important details, potentially saving the learner study time.”

CHEST SEEK Pulmonary Medicine: 33rd Edition was developed from the pulmonary medicine board subspecialty examination content blueprints. It tests recall, interpretation, and problem-solving skills.

Rationales provide thorough explanations and reasoning for the correct and incorrect answers. Key points are easy to find at the bottom of the pages and in a tab within SEEK Library questions.

For 3 decades, SEEK has been a trusted resource for chest medicine clinicians. From a printed booklet to the classic book and subscription-based library, learners have engaged with case-based questions in multiple ways. As SEEK has transformed through the years, it’s continued to be a timeless, reliable study partner.

“SEEK has evolved in many ways over its 30-year history. As technologic involvement has permitted greater advances in imaging and data presentation, SEEK has sought to make such advances from the bedside as part of the SEEK experience,” said Pascale.

“The strength of peer-reviewed, expert-written content has remained the same, but modalities such as digital flash cards and behind-the-scenes peer review discussions have enhanced this enduring product in ways that help it stand the test of time.”

Based on CHEST evaluation data, more than 90% of SEEK learners said their practice will change based on content found in the library. Plus, more than 95% of SEEK learners agreed that SEEK question authors are effective instructors.

“The success of SEEK in the past and the ability of this tool to be adapted to the changing needs of learners makes one excited about the editions to come,” said Jesse B. Hall, MD, FCCP, SEEK Editor-in-Chief and Chair of CHEST SEEK Pulmonary Medicine: 33rd Edition.

Looking toward the future, SEEK will continue to develop and serve the needs of chest medicine clinicians.

“One of the joys of our professional lives is the constant new discoveries and trials that change the way we practice,” said SEEK Pulmonary Medicine Vice-Chair and Deputy Editor, Jess Mandel, MD.

“However, with this comes the challenge of keeping up and staying current as the field evolves. SEEK is a terrific resource for keeping up with changes in practice and the underlying data that justify them.”

Subscribe to the SEEK Library and find CHEST SEEK Pulmonary Medicine: 33rd Edition at chestnet.org/Learning-and-Events/Learning/Seek-App.

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Two exciting updates have come to the CHEST SEEK portfolio this summer.

The latest book, CHEST SEEK Pulmonary Medicine: 33rd Edition, was released in August. And in this newest book and certain CHEST SEEK Library collections, a feature called key points is included in the recently published 150 pulmonary medicine questions.

Key points are concise summaries of the most important takeaways of SEEK questions. Knowing the key point can help learners focus their studies.

“SEEK questions can be quite robust and intentionally detailed in their response as to why the answer options are correct or incorrect. But because of the level of detail, it can be difficult at times for the learner to correctly hone in on the author’s teaching point,” said CHEST Director, Product Strategy and Evaluation, Martha Zaborowski Pascale, CPM.

“Key points concisely summarize each question’s most important details, potentially saving the learner study time.”

CHEST SEEK Pulmonary Medicine: 33rd Edition was developed from the pulmonary medicine board subspecialty examination content blueprints. It tests recall, interpretation, and problem-solving skills.

Rationales provide thorough explanations and reasoning for the correct and incorrect answers. Key points are easy to find at the bottom of the pages and in a tab within SEEK Library questions.

For 3 decades, SEEK has been a trusted resource for chest medicine clinicians. From a printed booklet to the classic book and subscription-based library, learners have engaged with case-based questions in multiple ways. As SEEK has transformed through the years, it’s continued to be a timeless, reliable study partner.

“SEEK has evolved in many ways over its 30-year history. As technologic involvement has permitted greater advances in imaging and data presentation, SEEK has sought to make such advances from the bedside as part of the SEEK experience,” said Pascale.

“The strength of peer-reviewed, expert-written content has remained the same, but modalities such as digital flash cards and behind-the-scenes peer review discussions have enhanced this enduring product in ways that help it stand the test of time.”

Based on CHEST evaluation data, more than 90% of SEEK learners said their practice will change based on content found in the library. Plus, more than 95% of SEEK learners agreed that SEEK question authors are effective instructors.

“The success of SEEK in the past and the ability of this tool to be adapted to the changing needs of learners makes one excited about the editions to come,” said Jesse B. Hall, MD, FCCP, SEEK Editor-in-Chief and Chair of CHEST SEEK Pulmonary Medicine: 33rd Edition.

Looking toward the future, SEEK will continue to develop and serve the needs of chest medicine clinicians.

“One of the joys of our professional lives is the constant new discoveries and trials that change the way we practice,” said SEEK Pulmonary Medicine Vice-Chair and Deputy Editor, Jess Mandel, MD.

“However, with this comes the challenge of keeping up and staying current as the field evolves. SEEK is a terrific resource for keeping up with changes in practice and the underlying data that justify them.”

Subscribe to the SEEK Library and find CHEST SEEK Pulmonary Medicine: 33rd Edition at chestnet.org/Learning-and-Events/Learning/Seek-App.

Two exciting updates have come to the CHEST SEEK portfolio this summer.

The latest book, CHEST SEEK Pulmonary Medicine: 33rd Edition, was released in August. And in this newest book and certain CHEST SEEK Library collections, a feature called key points is included in the recently published 150 pulmonary medicine questions.

Key points are concise summaries of the most important takeaways of SEEK questions. Knowing the key point can help learners focus their studies.

“SEEK questions can be quite robust and intentionally detailed in their response as to why the answer options are correct or incorrect. But because of the level of detail, it can be difficult at times for the learner to correctly hone in on the author’s teaching point,” said CHEST Director, Product Strategy and Evaluation, Martha Zaborowski Pascale, CPM.

“Key points concisely summarize each question’s most important details, potentially saving the learner study time.”

CHEST SEEK Pulmonary Medicine: 33rd Edition was developed from the pulmonary medicine board subspecialty examination content blueprints. It tests recall, interpretation, and problem-solving skills.

Rationales provide thorough explanations and reasoning for the correct and incorrect answers. Key points are easy to find at the bottom of the pages and in a tab within SEEK Library questions.

For 3 decades, SEEK has been a trusted resource for chest medicine clinicians. From a printed booklet to the classic book and subscription-based library, learners have engaged with case-based questions in multiple ways. As SEEK has transformed through the years, it’s continued to be a timeless, reliable study partner.

“SEEK has evolved in many ways over its 30-year history. As technologic involvement has permitted greater advances in imaging and data presentation, SEEK has sought to make such advances from the bedside as part of the SEEK experience,” said Pascale.

“The strength of peer-reviewed, expert-written content has remained the same, but modalities such as digital flash cards and behind-the-scenes peer review discussions have enhanced this enduring product in ways that help it stand the test of time.”

Based on CHEST evaluation data, more than 90% of SEEK learners said their practice will change based on content found in the library. Plus, more than 95% of SEEK learners agreed that SEEK question authors are effective instructors.

“The success of SEEK in the past and the ability of this tool to be adapted to the changing needs of learners makes one excited about the editions to come,” said Jesse B. Hall, MD, FCCP, SEEK Editor-in-Chief and Chair of CHEST SEEK Pulmonary Medicine: 33rd Edition.

Looking toward the future, SEEK will continue to develop and serve the needs of chest medicine clinicians.

“One of the joys of our professional lives is the constant new discoveries and trials that change the way we practice,” said SEEK Pulmonary Medicine Vice-Chair and Deputy Editor, Jess Mandel, MD.

“However, with this comes the challenge of keeping up and staying current as the field evolves. SEEK is a terrific resource for keeping up with changes in practice and the underlying data that justify them.”

Subscribe to the SEEK Library and find CHEST SEEK Pulmonary Medicine: 33rd Edition at chestnet.org/Learning-and-Events/Learning/Seek-App.

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Are you ready for CHEST 2023 in Hawai’i?

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Mon, 09/11/2023 - 12:46

Just a few weeks ahead of CHEST 2023, we’re sharing the can’t-miss opportunities available on site at the meeting.

With double the abstract submissions of previous meetings, CHEST 2023 – taking place October 8 to 11 in Honolulu – will offer the highest caliber of educational content covering pulmonary, critical care, and sleep medicine. Beyond the top-tier education, CHEST 2023 has a lot to offer attendees in the way of networking, development, and unique experiences that will all make for a memorable meeting.

We’re sharing a preview of the many opportunities that will be available over the 4 days of the meeting. For more specifics on these events, including locations, visit the CHEST 2023 website. You can also download the CHEST 2023 mobile app, which will be available in mid-September.

 

Networking and development

• For those who want to get more involved with the CHEST community, the Networks Mixer (Monday, October 9, 4 PM HST) is open to all who’d like to learn more about the seven CHEST Networks and the 21 clinically-focused Sections within them.

• The annual Women in Chest Medicine Luncheon (Monday, October 9, 12:45 PM HST) will feature a panel of three women speaking about their experiences, their advice, how to support other women in the field, and more. This event is free, but preregistration is required. Scan the QR code to sign up.

• The first-ever Ohana Mixer (Tuesday, October 10, 6 PM HST) is an opportunity for CHEST attendees to celebrate the spirit of community that unites us across our differences. Attendees can network with each other, meet the members of our newly formed Interest Groups – including the leaders of our Women in Chest Medicine Interest Group and Respiratory Care Interest Group – and socialize with presenters from our three local CHEST Community Connections organizations.

• The Trainee Lounge will feature activities like speed mentoring, a lunch and learn with the Keynote Speaker, Dr. Cedric “Jamie” Rutland, financial wellness presentations, and more.
 

CHEST experiences

• The Opening Session (Sunday, October 8, 3:15 PM HST) will showcase traditional Hawaiian performances and the Keynote Address from Dr. Rutland. Immediately following, the CHEST Welcome Reception will feature live music and a traditional Hawaiian luau.

• For the second year, CHEST After Hours (Monday, October 9, 3 PM HST) will feature clinicians sharing stories of their personal triumphs, tribulations, and more experiences within medicine.

• Each year, the CHEST Challenge Championship (Tuesday, October 10, 7 PM HST) gives pulmonary and critical care medicine fellows-in-training an opportunity to compete in a live Jeopardy-style game – with bragging rights and cash prizes on the line.

• The Wellness Zone has a packed schedule of events, including beachy workouts, food demonstrations, meditation, and more.
 

Exhibit hall activities

• Opportunities to network with and hear presentations from local Hawaiian organizations, such as the Waianae Coast Comprehensive Health Center

• Hands-on, experiential education escape rooms

• Live educational games, including Hocus POCUS Diagnosis, PulmMemory, Peer Pressure, and more

• Simulation experiences, including Aspirated and Need for Speed – Airway Bleed



Mark your calendars now to participate in all that CHEST 2023 has to offer. We’ll see you in Hawai’i!

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Just a few weeks ahead of CHEST 2023, we’re sharing the can’t-miss opportunities available on site at the meeting.

With double the abstract submissions of previous meetings, CHEST 2023 – taking place October 8 to 11 in Honolulu – will offer the highest caliber of educational content covering pulmonary, critical care, and sleep medicine. Beyond the top-tier education, CHEST 2023 has a lot to offer attendees in the way of networking, development, and unique experiences that will all make for a memorable meeting.

We’re sharing a preview of the many opportunities that will be available over the 4 days of the meeting. For more specifics on these events, including locations, visit the CHEST 2023 website. You can also download the CHEST 2023 mobile app, which will be available in mid-September.

 

Networking and development

• For those who want to get more involved with the CHEST community, the Networks Mixer (Monday, October 9, 4 PM HST) is open to all who’d like to learn more about the seven CHEST Networks and the 21 clinically-focused Sections within them.

• The annual Women in Chest Medicine Luncheon (Monday, October 9, 12:45 PM HST) will feature a panel of three women speaking about their experiences, their advice, how to support other women in the field, and more. This event is free, but preregistration is required. Scan the QR code to sign up.

• The first-ever Ohana Mixer (Tuesday, October 10, 6 PM HST) is an opportunity for CHEST attendees to celebrate the spirit of community that unites us across our differences. Attendees can network with each other, meet the members of our newly formed Interest Groups – including the leaders of our Women in Chest Medicine Interest Group and Respiratory Care Interest Group – and socialize with presenters from our three local CHEST Community Connections organizations.

• The Trainee Lounge will feature activities like speed mentoring, a lunch and learn with the Keynote Speaker, Dr. Cedric “Jamie” Rutland, financial wellness presentations, and more.
 

CHEST experiences

• The Opening Session (Sunday, October 8, 3:15 PM HST) will showcase traditional Hawaiian performances and the Keynote Address from Dr. Rutland. Immediately following, the CHEST Welcome Reception will feature live music and a traditional Hawaiian luau.

• For the second year, CHEST After Hours (Monday, October 9, 3 PM HST) will feature clinicians sharing stories of their personal triumphs, tribulations, and more experiences within medicine.

• Each year, the CHEST Challenge Championship (Tuesday, October 10, 7 PM HST) gives pulmonary and critical care medicine fellows-in-training an opportunity to compete in a live Jeopardy-style game – with bragging rights and cash prizes on the line.

• The Wellness Zone has a packed schedule of events, including beachy workouts, food demonstrations, meditation, and more.
 

Exhibit hall activities

• Opportunities to network with and hear presentations from local Hawaiian organizations, such as the Waianae Coast Comprehensive Health Center

• Hands-on, experiential education escape rooms

• Live educational games, including Hocus POCUS Diagnosis, PulmMemory, Peer Pressure, and more

• Simulation experiences, including Aspirated and Need for Speed – Airway Bleed



Mark your calendars now to participate in all that CHEST 2023 has to offer. We’ll see you in Hawai’i!

Just a few weeks ahead of CHEST 2023, we’re sharing the can’t-miss opportunities available on site at the meeting.

With double the abstract submissions of previous meetings, CHEST 2023 – taking place October 8 to 11 in Honolulu – will offer the highest caliber of educational content covering pulmonary, critical care, and sleep medicine. Beyond the top-tier education, CHEST 2023 has a lot to offer attendees in the way of networking, development, and unique experiences that will all make for a memorable meeting.

We’re sharing a preview of the many opportunities that will be available over the 4 days of the meeting. For more specifics on these events, including locations, visit the CHEST 2023 website. You can also download the CHEST 2023 mobile app, which will be available in mid-September.

 

Networking and development

• For those who want to get more involved with the CHEST community, the Networks Mixer (Monday, October 9, 4 PM HST) is open to all who’d like to learn more about the seven CHEST Networks and the 21 clinically-focused Sections within them.

• The annual Women in Chest Medicine Luncheon (Monday, October 9, 12:45 PM HST) will feature a panel of three women speaking about their experiences, their advice, how to support other women in the field, and more. This event is free, but preregistration is required. Scan the QR code to sign up.

• The first-ever Ohana Mixer (Tuesday, October 10, 6 PM HST) is an opportunity for CHEST attendees to celebrate the spirit of community that unites us across our differences. Attendees can network with each other, meet the members of our newly formed Interest Groups – including the leaders of our Women in Chest Medicine Interest Group and Respiratory Care Interest Group – and socialize with presenters from our three local CHEST Community Connections organizations.

• The Trainee Lounge will feature activities like speed mentoring, a lunch and learn with the Keynote Speaker, Dr. Cedric “Jamie” Rutland, financial wellness presentations, and more.
 

CHEST experiences

• The Opening Session (Sunday, October 8, 3:15 PM HST) will showcase traditional Hawaiian performances and the Keynote Address from Dr. Rutland. Immediately following, the CHEST Welcome Reception will feature live music and a traditional Hawaiian luau.

• For the second year, CHEST After Hours (Monday, October 9, 3 PM HST) will feature clinicians sharing stories of their personal triumphs, tribulations, and more experiences within medicine.

• Each year, the CHEST Challenge Championship (Tuesday, October 10, 7 PM HST) gives pulmonary and critical care medicine fellows-in-training an opportunity to compete in a live Jeopardy-style game – with bragging rights and cash prizes on the line.

• The Wellness Zone has a packed schedule of events, including beachy workouts, food demonstrations, meditation, and more.
 

Exhibit hall activities

• Opportunities to network with and hear presentations from local Hawaiian organizations, such as the Waianae Coast Comprehensive Health Center

• Hands-on, experiential education escape rooms

• Live educational games, including Hocus POCUS Diagnosis, PulmMemory, Peer Pressure, and more

• Simulation experiences, including Aspirated and Need for Speed – Airway Bleed



Mark your calendars now to participate in all that CHEST 2023 has to offer. We’ll see you in Hawai’i!

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Upper airway ultrasound: Easy to learn, facile to use!

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Changed
Thu, 08/10/2023 - 16:49

 

Thoracic Oncology & Chest Procedures Network

Ultrasound & Chest Imaging Section

Point-of-care ultrasound (POCUS) is integral to the delivery of high-quality patient care. The benefits of POCUS for timely diagnosis and procedural assistance are well documented. With continued innovation, its novel benefits can extend to the upper airway evaluation in both inpatient and outpatient settings.

Adi et al notes that POCUS can serve as an adjunct to traditional airway checklists and help intensivists/anesthesiologists identify potentially difficult laryngoscopies, choose the correct endotracheal tube size to reduce the risk of subglottic stenosis, and help confirm appropriate endotracheal tube placement (Adi, et al. J Emerg Crit Care Med. 2019;3:31).

The prediction of a difficult airway is a potentially lifesaving use for this technology. The authors note that smaller studies demonstrate promising results in four techniques: the inability to visualize the hyoid bone using the sublingual approach, a shorter hyomental distance in morbidly obese patients, anterior neck thickness at different anatomical levels (vocal cords, hyoid bone, and thyroid membrane), and a tongue thickness of more than 6.1 cm from the submental approach were all capable of predicting difficult tracheal intubation with varying degrees of sensitivity and specificity.

In the outpatient setting, an understanding of the upper airway anatomy can help with sleep apnea screenings. Korotun, et al. demonstrated in a small sample that ultrasound evaluation of hyoid bone excursion during hypoglossal nerve stimulation may be a useful tool to predict response to therapy and guide hypoglossal nerve stimulator settings (Korotun, et al. Sleep. 2020;43[Suppl_1]:A247-A248).Upper airway ultrasound is easy to learn. The anatomical landmarks are similar in most patients. This convenient tool can be added to your patient care repertoire in a variety of clinical settings.

Sameer Khanijo, MD, FCCP
Section Member-at-Large

Navitha Ramesh, MD, FCCP
Section Vice-Chair

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Thoracic Oncology & Chest Procedures Network

Ultrasound & Chest Imaging Section

Point-of-care ultrasound (POCUS) is integral to the delivery of high-quality patient care. The benefits of POCUS for timely diagnosis and procedural assistance are well documented. With continued innovation, its novel benefits can extend to the upper airway evaluation in both inpatient and outpatient settings.

Adi et al notes that POCUS can serve as an adjunct to traditional airway checklists and help intensivists/anesthesiologists identify potentially difficult laryngoscopies, choose the correct endotracheal tube size to reduce the risk of subglottic stenosis, and help confirm appropriate endotracheal tube placement (Adi, et al. J Emerg Crit Care Med. 2019;3:31).

The prediction of a difficult airway is a potentially lifesaving use for this technology. The authors note that smaller studies demonstrate promising results in four techniques: the inability to visualize the hyoid bone using the sublingual approach, a shorter hyomental distance in morbidly obese patients, anterior neck thickness at different anatomical levels (vocal cords, hyoid bone, and thyroid membrane), and a tongue thickness of more than 6.1 cm from the submental approach were all capable of predicting difficult tracheal intubation with varying degrees of sensitivity and specificity.

In the outpatient setting, an understanding of the upper airway anatomy can help with sleep apnea screenings. Korotun, et al. demonstrated in a small sample that ultrasound evaluation of hyoid bone excursion during hypoglossal nerve stimulation may be a useful tool to predict response to therapy and guide hypoglossal nerve stimulator settings (Korotun, et al. Sleep. 2020;43[Suppl_1]:A247-A248).Upper airway ultrasound is easy to learn. The anatomical landmarks are similar in most patients. This convenient tool can be added to your patient care repertoire in a variety of clinical settings.

Sameer Khanijo, MD, FCCP
Section Member-at-Large

Navitha Ramesh, MD, FCCP
Section Vice-Chair

 

Thoracic Oncology & Chest Procedures Network

Ultrasound & Chest Imaging Section

Point-of-care ultrasound (POCUS) is integral to the delivery of high-quality patient care. The benefits of POCUS for timely diagnosis and procedural assistance are well documented. With continued innovation, its novel benefits can extend to the upper airway evaluation in both inpatient and outpatient settings.

Adi et al notes that POCUS can serve as an adjunct to traditional airway checklists and help intensivists/anesthesiologists identify potentially difficult laryngoscopies, choose the correct endotracheal tube size to reduce the risk of subglottic stenosis, and help confirm appropriate endotracheal tube placement (Adi, et al. J Emerg Crit Care Med. 2019;3:31).

The prediction of a difficult airway is a potentially lifesaving use for this technology. The authors note that smaller studies demonstrate promising results in four techniques: the inability to visualize the hyoid bone using the sublingual approach, a shorter hyomental distance in morbidly obese patients, anterior neck thickness at different anatomical levels (vocal cords, hyoid bone, and thyroid membrane), and a tongue thickness of more than 6.1 cm from the submental approach were all capable of predicting difficult tracheal intubation with varying degrees of sensitivity and specificity.

In the outpatient setting, an understanding of the upper airway anatomy can help with sleep apnea screenings. Korotun, et al. demonstrated in a small sample that ultrasound evaluation of hyoid bone excursion during hypoglossal nerve stimulation may be a useful tool to predict response to therapy and guide hypoglossal nerve stimulator settings (Korotun, et al. Sleep. 2020;43[Suppl_1]:A247-A248).Upper airway ultrasound is easy to learn. The anatomical landmarks are similar in most patients. This convenient tool can be added to your patient care repertoire in a variety of clinical settings.

Sameer Khanijo, MD, FCCP
Section Member-at-Large

Navitha Ramesh, MD, FCCP
Section Vice-Chair

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Addressing disparities in goals-of-care conversations

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Changed
Tue, 09/19/2023 - 15:06

 

Critical Care Network

Nonrespiratory Critical Care Section

Goals-of-care discussions are essential to management of the intensive care unit (ICU) patient. Racial inequities in end-of-life decision making have been documented for many years, with literature demonstrating that marginalized populations are less likely to have EHR-documented goals-of-care discussions and more likely to have concerns regarding clinician communication.

A recently published randomized control trial in JAMA highlights an intervention that offers promise in addressing disparities in goals-of-care conversations. Curtis, et al. studied whether priming physicians with a communication guide advising on discussion prompts and language for goals-of-care could improve the rate of documented goals-of-care discussions among hospitalized older adults with serious illness. The study found that for patients in the intervention arm, there was a significant increase in proportion of goals-of-care discussions within 30 days. Notably, the difference in documented goals-of-care discussions between arms was greater in the subgroup of patients from underserved groups (Curtis JR, et al. JAMA. 2023;329[23]:2028-37).

Nevertheless, while interventions may help increase the rate of goals-of-care discussions, it is also important to address the content of discussions themselves. You and colleagues recently published a mixed-methods study assessing the impact of race on shared decision-making behaviors during family/caregiver meetings. The authors found that while ICU physicians approached shared decision making with White and Black families similarly, Black families felt their physicians provided less validation of the family role in decision making than White families did (You H, et al. Ann Am Thorac Soc. 2023 May;20[5]:759-62). These findings highlight the importance of ongoing work that focuses not only on quantity but also on quality of communication regarding goals-of-care for patients from diverse backgrounds.

Divya Shankar MD
Section Fellow-in-Training

Muhammad Hayat-Syed MD
Section Vice Chair

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Critical Care Network

Nonrespiratory Critical Care Section

Goals-of-care discussions are essential to management of the intensive care unit (ICU) patient. Racial inequities in end-of-life decision making have been documented for many years, with literature demonstrating that marginalized populations are less likely to have EHR-documented goals-of-care discussions and more likely to have concerns regarding clinician communication.

A recently published randomized control trial in JAMA highlights an intervention that offers promise in addressing disparities in goals-of-care conversations. Curtis, et al. studied whether priming physicians with a communication guide advising on discussion prompts and language for goals-of-care could improve the rate of documented goals-of-care discussions among hospitalized older adults with serious illness. The study found that for patients in the intervention arm, there was a significant increase in proportion of goals-of-care discussions within 30 days. Notably, the difference in documented goals-of-care discussions between arms was greater in the subgroup of patients from underserved groups (Curtis JR, et al. JAMA. 2023;329[23]:2028-37).

Nevertheless, while interventions may help increase the rate of goals-of-care discussions, it is also important to address the content of discussions themselves. You and colleagues recently published a mixed-methods study assessing the impact of race on shared decision-making behaviors during family/caregiver meetings. The authors found that while ICU physicians approached shared decision making with White and Black families similarly, Black families felt their physicians provided less validation of the family role in decision making than White families did (You H, et al. Ann Am Thorac Soc. 2023 May;20[5]:759-62). These findings highlight the importance of ongoing work that focuses not only on quantity but also on quality of communication regarding goals-of-care for patients from diverse backgrounds.

Divya Shankar MD
Section Fellow-in-Training

Muhammad Hayat-Syed MD
Section Vice Chair

 

Critical Care Network

Nonrespiratory Critical Care Section

Goals-of-care discussions are essential to management of the intensive care unit (ICU) patient. Racial inequities in end-of-life decision making have been documented for many years, with literature demonstrating that marginalized populations are less likely to have EHR-documented goals-of-care discussions and more likely to have concerns regarding clinician communication.

A recently published randomized control trial in JAMA highlights an intervention that offers promise in addressing disparities in goals-of-care conversations. Curtis, et al. studied whether priming physicians with a communication guide advising on discussion prompts and language for goals-of-care could improve the rate of documented goals-of-care discussions among hospitalized older adults with serious illness. The study found that for patients in the intervention arm, there was a significant increase in proportion of goals-of-care discussions within 30 days. Notably, the difference in documented goals-of-care discussions between arms was greater in the subgroup of patients from underserved groups (Curtis JR, et al. JAMA. 2023;329[23]:2028-37).

Nevertheless, while interventions may help increase the rate of goals-of-care discussions, it is also important to address the content of discussions themselves. You and colleagues recently published a mixed-methods study assessing the impact of race on shared decision-making behaviors during family/caregiver meetings. The authors found that while ICU physicians approached shared decision making with White and Black families similarly, Black families felt their physicians provided less validation of the family role in decision making than White families did (You H, et al. Ann Am Thorac Soc. 2023 May;20[5]:759-62). These findings highlight the importance of ongoing work that focuses not only on quantity but also on quality of communication regarding goals-of-care for patients from diverse backgrounds.

Divya Shankar MD
Section Fellow-in-Training

Muhammad Hayat-Syed MD
Section Vice Chair

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Use of frailty assessment in lung transplant evaluation

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Thu, 08/10/2023 - 16:46

 

Diffuse Lung Disease & Transplant Network

Lung Transplant Section

Frailty, a concept that originated in the geriatric population, is a state of vulnerability resulting from a decline in reserve and function across physiological systems. While it is more commonly observed in older adults, some aging-associated syndromes, such as sarcopenia, impaired cognition, inflammation, and malnutrition, may be present in younger patients with end-stage organ disease. These syndromes can be associated with biological age, as opposed to chronological age, which explains why younger patients with end-stage organ disease can develop frailty (Schaenman JM, et al. Am J Transplant. 2021 Jun;21[6]:2018-24). Frailty in the lung transplant population is associated with increased morbidity and mortality while on the waitlist and post-transplant (Montgomery E, et al. J Transplant. 2020 Aug 7:3239495). In 2021, the International Society of Heart and Lung Transplantation recommended including a frailty assessment to complete a patient’s transplant evaluation. The committee cautioned using current assessment tools, as they are not yet accepted as the standard of care (Leard, et al. J Heart Lung Transplant. 2021 Nov;40[11]:1349-79). Existing tools being used evolved from studies of community-dwelling older adults with no predilection for distinct organ disease, which include the Fried Physical Frailty Phenotype (FPFP) and the Short Physical Performance Battery (SPPB). Along with physical limitations, frail patients tend to have abnormal biomarkers including higher inflammatory cytokines, such as plasma IL-6 and tumor necrosis factor receptor 1, and lower insulin-like growth factor I and leptin (Singer JP, et al. Am J Respir Crit Care Med. 2015;192[11]1325-34). The concept of a lung-focused approach to frailty, which considers biomarkers and body composition, is currently being researched (Singer JP, et al. J Heart Lung Transplant. 2023;S1053-S2498[23]00049-9). This disease-specific frailty scale would identify lung transplant candidates who may benefit from targeted interventions, and such frailty would also be expected to improve after transplant.

Erin Meier, MD
Section Fellow-in-Training

Anupam Kumar, MD, FCCP
Section Member-at-Large

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Diffuse Lung Disease & Transplant Network

Lung Transplant Section

Frailty, a concept that originated in the geriatric population, is a state of vulnerability resulting from a decline in reserve and function across physiological systems. While it is more commonly observed in older adults, some aging-associated syndromes, such as sarcopenia, impaired cognition, inflammation, and malnutrition, may be present in younger patients with end-stage organ disease. These syndromes can be associated with biological age, as opposed to chronological age, which explains why younger patients with end-stage organ disease can develop frailty (Schaenman JM, et al. Am J Transplant. 2021 Jun;21[6]:2018-24). Frailty in the lung transplant population is associated with increased morbidity and mortality while on the waitlist and post-transplant (Montgomery E, et al. J Transplant. 2020 Aug 7:3239495). In 2021, the International Society of Heart and Lung Transplantation recommended including a frailty assessment to complete a patient’s transplant evaluation. The committee cautioned using current assessment tools, as they are not yet accepted as the standard of care (Leard, et al. J Heart Lung Transplant. 2021 Nov;40[11]:1349-79). Existing tools being used evolved from studies of community-dwelling older adults with no predilection for distinct organ disease, which include the Fried Physical Frailty Phenotype (FPFP) and the Short Physical Performance Battery (SPPB). Along with physical limitations, frail patients tend to have abnormal biomarkers including higher inflammatory cytokines, such as plasma IL-6 and tumor necrosis factor receptor 1, and lower insulin-like growth factor I and leptin (Singer JP, et al. Am J Respir Crit Care Med. 2015;192[11]1325-34). The concept of a lung-focused approach to frailty, which considers biomarkers and body composition, is currently being researched (Singer JP, et al. J Heart Lung Transplant. 2023;S1053-S2498[23]00049-9). This disease-specific frailty scale would identify lung transplant candidates who may benefit from targeted interventions, and such frailty would also be expected to improve after transplant.

Erin Meier, MD
Section Fellow-in-Training

Anupam Kumar, MD, FCCP
Section Member-at-Large

 

Diffuse Lung Disease & Transplant Network

Lung Transplant Section

Frailty, a concept that originated in the geriatric population, is a state of vulnerability resulting from a decline in reserve and function across physiological systems. While it is more commonly observed in older adults, some aging-associated syndromes, such as sarcopenia, impaired cognition, inflammation, and malnutrition, may be present in younger patients with end-stage organ disease. These syndromes can be associated with biological age, as opposed to chronological age, which explains why younger patients with end-stage organ disease can develop frailty (Schaenman JM, et al. Am J Transplant. 2021 Jun;21[6]:2018-24). Frailty in the lung transplant population is associated with increased morbidity and mortality while on the waitlist and post-transplant (Montgomery E, et al. J Transplant. 2020 Aug 7:3239495). In 2021, the International Society of Heart and Lung Transplantation recommended including a frailty assessment to complete a patient’s transplant evaluation. The committee cautioned using current assessment tools, as they are not yet accepted as the standard of care (Leard, et al. J Heart Lung Transplant. 2021 Nov;40[11]:1349-79). Existing tools being used evolved from studies of community-dwelling older adults with no predilection for distinct organ disease, which include the Fried Physical Frailty Phenotype (FPFP) and the Short Physical Performance Battery (SPPB). Along with physical limitations, frail patients tend to have abnormal biomarkers including higher inflammatory cytokines, such as plasma IL-6 and tumor necrosis factor receptor 1, and lower insulin-like growth factor I and leptin (Singer JP, et al. Am J Respir Crit Care Med. 2015;192[11]1325-34). The concept of a lung-focused approach to frailty, which considers biomarkers and body composition, is currently being researched (Singer JP, et al. J Heart Lung Transplant. 2023;S1053-S2498[23]00049-9). This disease-specific frailty scale would identify lung transplant candidates who may benefit from targeted interventions, and such frailty would also be expected to improve after transplant.

Erin Meier, MD
Section Fellow-in-Training

Anupam Kumar, MD, FCCP
Section Member-at-Large

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DPP1 a promising target for bronchiectasis

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Thu, 08/10/2023 - 16:45

Airway Disorders Network

Bronchiectasis Section

Bronchiectasis is a chronic inflammatory lung disease characterized by the progressive destruction of the airways and persistent inflammation. In bronchiectasis, excessive neutrophil accumulation in the airways leads to release of neutrophil serine proteases (NSPs), which contributes to tissue damage and perpetuates the inflammatory process in the lungs. The three main NSPs include neutrophil elastase (NE), proteinase3, and cathepsin G. Elevations in NE activity in sputum in NCFBE are associated with increased exacerbations and declines in lung function. Dipeptidyl peptidase 1 (DPP1), an enzyme primarily found in neutrophils, is responsible for activating NSPs during neutrophil maturation. In bronchiectasis, increased DPP1 activity results in an augmented production of active NSPs, exacerbating lung damage and inflammation.

Dr. Shyamsunder Subramanian

Brensocatib, an oral, reversible inhibitor of DPP1 is currently being developed as a novel approach to managing bronchiectasis. Brensocatib was evaluated in a phase 2 clinical trial (WILLOW), a randomized, double-blind, placebo-controlled trial involving adults with non–cystic fibrosis bronchiectasis (NCFBE). Treatment with brensocatib for 24 weeks significantly prolonged the time to the first exacerbation at both the 10 mg and 25 mg doses and lowered the risk of exacerbation by 40% relative to placebo. The treatment was well tolerated, with no significant safety concerns. Results of a recent post hoc analysis from the WILLOW study show that brensocatib effectively reduces exacerbations and slows lung function decline across different severities of bronchiectasis. These findings suggest that brensocatib holds potential as the 1st new therapeutic option for patients with NCFBE, with currently no FDA-approved drugs. Results of a larger-scale phase 3 trial are awaited later this year, which will hopefully confirm these results and ascertain the long-term safety.

Shyamsunder Subramanian, MD, MBBS, FCCP
Section Chair

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Airway Disorders Network

Bronchiectasis Section

Bronchiectasis is a chronic inflammatory lung disease characterized by the progressive destruction of the airways and persistent inflammation. In bronchiectasis, excessive neutrophil accumulation in the airways leads to release of neutrophil serine proteases (NSPs), which contributes to tissue damage and perpetuates the inflammatory process in the lungs. The three main NSPs include neutrophil elastase (NE), proteinase3, and cathepsin G. Elevations in NE activity in sputum in NCFBE are associated with increased exacerbations and declines in lung function. Dipeptidyl peptidase 1 (DPP1), an enzyme primarily found in neutrophils, is responsible for activating NSPs during neutrophil maturation. In bronchiectasis, increased DPP1 activity results in an augmented production of active NSPs, exacerbating lung damage and inflammation.

Dr. Shyamsunder Subramanian

Brensocatib, an oral, reversible inhibitor of DPP1 is currently being developed as a novel approach to managing bronchiectasis. Brensocatib was evaluated in a phase 2 clinical trial (WILLOW), a randomized, double-blind, placebo-controlled trial involving adults with non–cystic fibrosis bronchiectasis (NCFBE). Treatment with brensocatib for 24 weeks significantly prolonged the time to the first exacerbation at both the 10 mg and 25 mg doses and lowered the risk of exacerbation by 40% relative to placebo. The treatment was well tolerated, with no significant safety concerns. Results of a recent post hoc analysis from the WILLOW study show that brensocatib effectively reduces exacerbations and slows lung function decline across different severities of bronchiectasis. These findings suggest that brensocatib holds potential as the 1st new therapeutic option for patients with NCFBE, with currently no FDA-approved drugs. Results of a larger-scale phase 3 trial are awaited later this year, which will hopefully confirm these results and ascertain the long-term safety.

Shyamsunder Subramanian, MD, MBBS, FCCP
Section Chair

Airway Disorders Network

Bronchiectasis Section

Bronchiectasis is a chronic inflammatory lung disease characterized by the progressive destruction of the airways and persistent inflammation. In bronchiectasis, excessive neutrophil accumulation in the airways leads to release of neutrophil serine proteases (NSPs), which contributes to tissue damage and perpetuates the inflammatory process in the lungs. The three main NSPs include neutrophil elastase (NE), proteinase3, and cathepsin G. Elevations in NE activity in sputum in NCFBE are associated with increased exacerbations and declines in lung function. Dipeptidyl peptidase 1 (DPP1), an enzyme primarily found in neutrophils, is responsible for activating NSPs during neutrophil maturation. In bronchiectasis, increased DPP1 activity results in an augmented production of active NSPs, exacerbating lung damage and inflammation.

Dr. Shyamsunder Subramanian

Brensocatib, an oral, reversible inhibitor of DPP1 is currently being developed as a novel approach to managing bronchiectasis. Brensocatib was evaluated in a phase 2 clinical trial (WILLOW), a randomized, double-blind, placebo-controlled trial involving adults with non–cystic fibrosis bronchiectasis (NCFBE). Treatment with brensocatib for 24 weeks significantly prolonged the time to the first exacerbation at both the 10 mg and 25 mg doses and lowered the risk of exacerbation by 40% relative to placebo. The treatment was well tolerated, with no significant safety concerns. Results of a recent post hoc analysis from the WILLOW study show that brensocatib effectively reduces exacerbations and slows lung function decline across different severities of bronchiectasis. These findings suggest that brensocatib holds potential as the 1st new therapeutic option for patients with NCFBE, with currently no FDA-approved drugs. Results of a larger-scale phase 3 trial are awaited later this year, which will hopefully confirm these results and ascertain the long-term safety.

Shyamsunder Subramanian, MD, MBBS, FCCP
Section Chair

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Add hands-on and interactive learning opportunities to your CHEST 2023 schedule

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Changed
Thu, 08/10/2023 - 09:39

As part of the 300+ educational sessions attendees will find at CHEST 2023 in Hawai’i, ticketed sessions are available for learners looking to attend smaller group sessions or experience hands-on learning.

CHEST

Explore the many ticketed sessions, and sign up early in case they sell out.
 

Simulation sessions

If you’re looking to gain hands-on exposure to equipment and tools that may not be available at your home institution, look no further than these simulation sessions. Choose from 25 different sessions offering firsthand experience with procedures relevant to your clinical practice.

“It’s a great opportunity to teach higher stakes procedures in a very low stakes environment where everybody’s comfortable and everybody’s learning from each other,” said Live Learning Subcommittee Chair, Nicholas Pastis, MD, FCCP.

CHEST 2023 simulation sessions will address clinical topics, including endobronchial ultrasound, cardiopulmonary exercise testing (CPET), intubation and cricothyrotomy, bronchoscopy management, and more. These sessions are taught by experts who use these real-world strategies in their daily practice.

CHEST 2022 attendee, Weston Bowker, MD, found value in the simulation courses he was able to attend in Nashville.

“It’s fantastic just to work with some of the leading experts in the field, especially from an interventional pulmonology standpoint. And, you truly get a different experience than maybe what your home institution offers,” he said.
 

Problem-based learning sessions

Exercise your critical thinking skills by working to resolve real-world clinical problems during these small group sessions. Refine your expertise on topics like lung cancer screening and staging, biologics in asthma, pneumonia, and more.

“Problem-based learning courses take a clinical problem or case study that is somewhat controversial to create a learning environment where the problem itself drives the learning with participants,” said CHEST 2023 Scientific Program Committee Chair, Aneesa Das, MD, FCCP. “These are small group sessions where learners can actively participate and collaborate to discuss various perspectives on the issue and work toward potential solutions.”

This year’s problem-based learning courses were chosen based on common controversies in chest medicine and current hot topics in medicine.

Dr. Das is excited for the Using CPET to Solve Your Difficult Cases course. “Cardiopulmonary exercise tests can sometimes be difficult even for seasoned physicians. This is always an amazing problem-based learning topic,” she added.
 

Meet the Professor sessions

Connect with leading chest medicine experts during these limited-capacity discussions capped at 24 registrants per session. Meet the Professor attendees will have the opportunity to engage in stimulating conversations on bronchiectasis, central airway obstructions, obesity hypoventilation, and sublobar resection.

“Meet the Professor sessions are a unique opportunity to interact and learn from a leader in the field in a very small group setting on a high-yield topic,” said Dr. Das. “These sessions allow for a learning environment that is personalized and intimate.”

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As part of the 300+ educational sessions attendees will find at CHEST 2023 in Hawai’i, ticketed sessions are available for learners looking to attend smaller group sessions or experience hands-on learning.

CHEST

Explore the many ticketed sessions, and sign up early in case they sell out.
 

Simulation sessions

If you’re looking to gain hands-on exposure to equipment and tools that may not be available at your home institution, look no further than these simulation sessions. Choose from 25 different sessions offering firsthand experience with procedures relevant to your clinical practice.

“It’s a great opportunity to teach higher stakes procedures in a very low stakes environment where everybody’s comfortable and everybody’s learning from each other,” said Live Learning Subcommittee Chair, Nicholas Pastis, MD, FCCP.

CHEST 2023 simulation sessions will address clinical topics, including endobronchial ultrasound, cardiopulmonary exercise testing (CPET), intubation and cricothyrotomy, bronchoscopy management, and more. These sessions are taught by experts who use these real-world strategies in their daily practice.

CHEST 2022 attendee, Weston Bowker, MD, found value in the simulation courses he was able to attend in Nashville.

“It’s fantastic just to work with some of the leading experts in the field, especially from an interventional pulmonology standpoint. And, you truly get a different experience than maybe what your home institution offers,” he said.
 

Problem-based learning sessions

Exercise your critical thinking skills by working to resolve real-world clinical problems during these small group sessions. Refine your expertise on topics like lung cancer screening and staging, biologics in asthma, pneumonia, and more.

“Problem-based learning courses take a clinical problem or case study that is somewhat controversial to create a learning environment where the problem itself drives the learning with participants,” said CHEST 2023 Scientific Program Committee Chair, Aneesa Das, MD, FCCP. “These are small group sessions where learners can actively participate and collaborate to discuss various perspectives on the issue and work toward potential solutions.”

This year’s problem-based learning courses were chosen based on common controversies in chest medicine and current hot topics in medicine.

Dr. Das is excited for the Using CPET to Solve Your Difficult Cases course. “Cardiopulmonary exercise tests can sometimes be difficult even for seasoned physicians. This is always an amazing problem-based learning topic,” she added.
 

Meet the Professor sessions

Connect with leading chest medicine experts during these limited-capacity discussions capped at 24 registrants per session. Meet the Professor attendees will have the opportunity to engage in stimulating conversations on bronchiectasis, central airway obstructions, obesity hypoventilation, and sublobar resection.

“Meet the Professor sessions are a unique opportunity to interact and learn from a leader in the field in a very small group setting on a high-yield topic,” said Dr. Das. “These sessions allow for a learning environment that is personalized and intimate.”

As part of the 300+ educational sessions attendees will find at CHEST 2023 in Hawai’i, ticketed sessions are available for learners looking to attend smaller group sessions or experience hands-on learning.

CHEST

Explore the many ticketed sessions, and sign up early in case they sell out.
 

Simulation sessions

If you’re looking to gain hands-on exposure to equipment and tools that may not be available at your home institution, look no further than these simulation sessions. Choose from 25 different sessions offering firsthand experience with procedures relevant to your clinical practice.

“It’s a great opportunity to teach higher stakes procedures in a very low stakes environment where everybody’s comfortable and everybody’s learning from each other,” said Live Learning Subcommittee Chair, Nicholas Pastis, MD, FCCP.

CHEST 2023 simulation sessions will address clinical topics, including endobronchial ultrasound, cardiopulmonary exercise testing (CPET), intubation and cricothyrotomy, bronchoscopy management, and more. These sessions are taught by experts who use these real-world strategies in their daily practice.

CHEST 2022 attendee, Weston Bowker, MD, found value in the simulation courses he was able to attend in Nashville.

“It’s fantastic just to work with some of the leading experts in the field, especially from an interventional pulmonology standpoint. And, you truly get a different experience than maybe what your home institution offers,” he said.
 

Problem-based learning sessions

Exercise your critical thinking skills by working to resolve real-world clinical problems during these small group sessions. Refine your expertise on topics like lung cancer screening and staging, biologics in asthma, pneumonia, and more.

“Problem-based learning courses take a clinical problem or case study that is somewhat controversial to create a learning environment where the problem itself drives the learning with participants,” said CHEST 2023 Scientific Program Committee Chair, Aneesa Das, MD, FCCP. “These are small group sessions where learners can actively participate and collaborate to discuss various perspectives on the issue and work toward potential solutions.”

This year’s problem-based learning courses were chosen based on common controversies in chest medicine and current hot topics in medicine.

Dr. Das is excited for the Using CPET to Solve Your Difficult Cases course. “Cardiopulmonary exercise tests can sometimes be difficult even for seasoned physicians. This is always an amazing problem-based learning topic,” she added.
 

Meet the Professor sessions

Connect with leading chest medicine experts during these limited-capacity discussions capped at 24 registrants per session. Meet the Professor attendees will have the opportunity to engage in stimulating conversations on bronchiectasis, central airway obstructions, obesity hypoventilation, and sublobar resection.

“Meet the Professor sessions are a unique opportunity to interact and learn from a leader in the field in a very small group setting on a high-yield topic,” said Dr. Das. “These sessions allow for a learning environment that is personalized and intimate.”

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RAPID updates in pleural infection

Article Type
Changed
Wed, 08/09/2023 - 09:13

 

Thoracic Oncology & Chest Imaging Network

Interventional Procedures Section

The MIST-2 trial (Rahman, et al. N Engl J Med. 2011;365:518), the first randomized trial to show the benefit of intrapleural enzyme therapy (IET) with tissue plasminogen activator and deoxyribonuclease for the treatment of complicated pleural infection (cPI) is the foundational study for the use of IET. It was from this cohort that the first prospectively validated mortality prediction score for cPI was developed – the RAPID score (Rahman, et al. Chest. 2014;145[4]:848).

The RAPID score, comprised of Renal, Age, Purulence, Infection source, and Dietary factors (albumin) divides patients with cPI into three 3-month mortality groups: low (1.5%), medium (17.8%), and high (47.8%). The score was externally validated in the PILOT trial (Corcoran, et al. Eur Respir J. 2020;56[5]:2000130). Mortality outcomes were separately assessed in 1-, 3-, and 5-year follow-up by White, et al (Ann Am Thorac Soc. 2015;12[9]:1310) and found to bear out with an increased OR for mortality of 14.3 and 53.3 in the medium and high risk groups, respectively. Of note, there was a surgical referral rate of only 4% to16% in the study cohort, and the original study did not distinguish between IET use or surgery.

To look at RAPID in a purely surgical cohort, Stüben, et al (Sci Rep. 2023;13[1]:3206) applied the RAPID score to a cohort of patients with empyema all treated with initial surgical drainage. They found the RAPID score to be an accurate predictor of 90-day mortality and improved with the addition of diabetes and renal replacement therapy. Liou, et al (J Thorac Dis. 2023;15[3]:985) showed that patients with a low RAPID score who were taken to surgery early had improved length of stay and organ failure and mortality rates compared with those taken later.

Can the RAPID score differentiate between those who need IET alone, early surgery, or late surgery? Not yet, but several prospective studies are underway to help improve outcomes in this ancient disease. Until then, the RAPID score remains a useful risk-stratification tool for an increasingly broad population of patients with pleural infection.

Max Diddams, MD
Section Fellow-in-Training

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Thoracic Oncology & Chest Imaging Network

Interventional Procedures Section

The MIST-2 trial (Rahman, et al. N Engl J Med. 2011;365:518), the first randomized trial to show the benefit of intrapleural enzyme therapy (IET) with tissue plasminogen activator and deoxyribonuclease for the treatment of complicated pleural infection (cPI) is the foundational study for the use of IET. It was from this cohort that the first prospectively validated mortality prediction score for cPI was developed – the RAPID score (Rahman, et al. Chest. 2014;145[4]:848).

The RAPID score, comprised of Renal, Age, Purulence, Infection source, and Dietary factors (albumin) divides patients with cPI into three 3-month mortality groups: low (1.5%), medium (17.8%), and high (47.8%). The score was externally validated in the PILOT trial (Corcoran, et al. Eur Respir J. 2020;56[5]:2000130). Mortality outcomes were separately assessed in 1-, 3-, and 5-year follow-up by White, et al (Ann Am Thorac Soc. 2015;12[9]:1310) and found to bear out with an increased OR for mortality of 14.3 and 53.3 in the medium and high risk groups, respectively. Of note, there was a surgical referral rate of only 4% to16% in the study cohort, and the original study did not distinguish between IET use or surgery.

To look at RAPID in a purely surgical cohort, Stüben, et al (Sci Rep. 2023;13[1]:3206) applied the RAPID score to a cohort of patients with empyema all treated with initial surgical drainage. They found the RAPID score to be an accurate predictor of 90-day mortality and improved with the addition of diabetes and renal replacement therapy. Liou, et al (J Thorac Dis. 2023;15[3]:985) showed that patients with a low RAPID score who were taken to surgery early had improved length of stay and organ failure and mortality rates compared with those taken later.

Can the RAPID score differentiate between those who need IET alone, early surgery, or late surgery? Not yet, but several prospective studies are underway to help improve outcomes in this ancient disease. Until then, the RAPID score remains a useful risk-stratification tool for an increasingly broad population of patients with pleural infection.

Max Diddams, MD
Section Fellow-in-Training

 

Thoracic Oncology & Chest Imaging Network

Interventional Procedures Section

The MIST-2 trial (Rahman, et al. N Engl J Med. 2011;365:518), the first randomized trial to show the benefit of intrapleural enzyme therapy (IET) with tissue plasminogen activator and deoxyribonuclease for the treatment of complicated pleural infection (cPI) is the foundational study for the use of IET. It was from this cohort that the first prospectively validated mortality prediction score for cPI was developed – the RAPID score (Rahman, et al. Chest. 2014;145[4]:848).

The RAPID score, comprised of Renal, Age, Purulence, Infection source, and Dietary factors (albumin) divides patients with cPI into three 3-month mortality groups: low (1.5%), medium (17.8%), and high (47.8%). The score was externally validated in the PILOT trial (Corcoran, et al. Eur Respir J. 2020;56[5]:2000130). Mortality outcomes were separately assessed in 1-, 3-, and 5-year follow-up by White, et al (Ann Am Thorac Soc. 2015;12[9]:1310) and found to bear out with an increased OR for mortality of 14.3 and 53.3 in the medium and high risk groups, respectively. Of note, there was a surgical referral rate of only 4% to16% in the study cohort, and the original study did not distinguish between IET use or surgery.

To look at RAPID in a purely surgical cohort, Stüben, et al (Sci Rep. 2023;13[1]:3206) applied the RAPID score to a cohort of patients with empyema all treated with initial surgical drainage. They found the RAPID score to be an accurate predictor of 90-day mortality and improved with the addition of diabetes and renal replacement therapy. Liou, et al (J Thorac Dis. 2023;15[3]:985) showed that patients with a low RAPID score who were taken to surgery early had improved length of stay and organ failure and mortality rates compared with those taken later.

Can the RAPID score differentiate between those who need IET alone, early surgery, or late surgery? Not yet, but several prospective studies are underway to help improve outcomes in this ancient disease. Until then, the RAPID score remains a useful risk-stratification tool for an increasingly broad population of patients with pleural infection.

Max Diddams, MD
Section Fellow-in-Training

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