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And, they’re off! Belmont Stakes Dinner and Auction fundraises for patient education

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For a night of fun and philanthropy, CHEST leadership and supporters of the CHEST Foundation came together in New York City to watch the Belmont Stakes race and raise money to support patient education.

What started 8 years ago as a brunch in the living room of Doreen Addrizzo-Harris, MD, FCCP, the 2022 Belmont Stakes Dinner and Auction has grown into an event that welcomed 250 guests to the Manhattan waterfront and raised over $290,000 to support the initiatives of the CHEST Foundation.

Courtesy CHEST
CHEST member Bravein Amalakuhan, MD, FCCP, and his wife, Megan Cool Amalakuhan, show off their winning raffle number.

Spearheaded by Dr. Addrizzo- Harris, President-Elect of the American College of Chest Physicians, this year’s event was focused entirely on patient education and advocacy. The attendees heard the moving stories of Betsy Glaeser and Fred Schick who are both patients living with lung disease and advocates for others living with like afflictions. Betsy is living with nontuberculous mycobacteria (NTM) disease and Fred with idiopathic pulmonary fibrosis (IPF). Betsy and Fred have used their experiences to serve as support for others in similar positions.

Betsy Glaeser, a longtime patient of Dr. Addrizzo-Harris, shared a story about the struggle of being one of the first cases of NTM bronchiectasis and helping to define the course of action. She shared that her original doctors gave her 5 years to live. The room erupted in applause when she shared that with the exceptional treatment she’s received, over 20 years later, she is standing in front of the supporters of the CHEST Foundation to share her story.

Because of the rarity of her disease, she was hospitalized multiple times with pneumonia before finally reaching her diagnosis of NTM disease. She channeled the accompanying frustrations into helping others who were recently diagnosed with the NTM disorder by sharing her experiences. “I would give them guidance on treatment options because in my years of living with the disease, I’d been there and tried almost everything,” said Betsy. “I would get calls from my doctor all of the time to speak with someone who just received an NTM disease diagnosis. I was happy to do so – at the time, the Internet didn’t exist, and firsthand experiences were all we had. Since forming our physical support group, the most memorable experience I can recall is when a woman, newly diagnosed with NTM, walked into the room and immediately burst into tears. She shared that she expected to see all of us on oxygen and wheelchair-bound, but that wasn’t the case at all. That day, we were able to give her hope. That’s why I do what I do, and I’m proud to do it.”

Fred Schick shared with the attendees his story of struggling to find his IPF diagnosis and how incredibly frustrating it was to be so short of breath that he needed to be rescued from the water while on vacation. With a history of cardiac complications, Fred’s doctors were looking at his heart.

For Fred to get to his IPF diagnosis, it took the careful ear of a primary care doctor Fred started to see when his previous doctor retired.

“It was almost like she was listening with different ears and was hearing what others didn’t. Once she recommended speaking with a pulmonologist, everything fell into place,” said Fred. “From my experience, IPF is best treated by a lot of pieces coming together and working together. It takes the dedication of a care team in the hospital, proper diet and exercise and, just as importantly, it takes a support group to guide you through the process. I’m grateful to my care team, but I’m equally thankful for the work I get to do as an advocate for others living with IPF.”

When she spoke to the attendees, Lisa Moores, MD, FCCP, reflected on what the patients shared. “We saw great examples of why we’re here tonight,” said Dr. Moores. “One of the things CHEST and the Foundation are focusing on is earlier diagnosis for interstitial lung diseases like pulmonary fibrosis and, with voices like Fred Schick, we’ll get there. The patients remind us why we’re here. We’re here for our patients; we’re here for Fred; and we’re here for Betsy.”

Laurence Feldman, Vice President of the Feldman Family Foundation that partners with the CHEST Foundation for their annual casino fundraiser benefiting pulmonary fibrosis, was able to participate in the dinner and theauction.

He shared, “Tonight, I was so impressed with the generosity of the attendees and the organization of this event. It reminded me that if you ask your supporters to give, they’ll be there for you. Almost like the ‘Field of Dreams’ quote of ‘if you build it, they will come.’ Being at the Belmont Stakes Dinner and Auction makes me that much more excited for our upcoming Irv Feldman Casino Night and Texas Hold ‘Em Tournament coming up in late August. Thanks to our corporate partners and the support of the CHEST Foundation, we’re able to produce an excellent event like the Belmont Stakes fundraiser that helps bring in donations that can make a difference in the lives of patients.”

At the end of the day, medicine is all about the patients and, by dedicating the night to patient education and patient advocates, the Belmont Stakes event brought the focus to where it should always be – improving care and helping patients.

To learn more and to support the various initiatives of the CHEST Foundation, visit foundation.chestnet.org/donate.

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For a night of fun and philanthropy, CHEST leadership and supporters of the CHEST Foundation came together in New York City to watch the Belmont Stakes race and raise money to support patient education.

What started 8 years ago as a brunch in the living room of Doreen Addrizzo-Harris, MD, FCCP, the 2022 Belmont Stakes Dinner and Auction has grown into an event that welcomed 250 guests to the Manhattan waterfront and raised over $290,000 to support the initiatives of the CHEST Foundation.

Courtesy CHEST
CHEST member Bravein Amalakuhan, MD, FCCP, and his wife, Megan Cool Amalakuhan, show off their winning raffle number.

Spearheaded by Dr. Addrizzo- Harris, President-Elect of the American College of Chest Physicians, this year’s event was focused entirely on patient education and advocacy. The attendees heard the moving stories of Betsy Glaeser and Fred Schick who are both patients living with lung disease and advocates for others living with like afflictions. Betsy is living with nontuberculous mycobacteria (NTM) disease and Fred with idiopathic pulmonary fibrosis (IPF). Betsy and Fred have used their experiences to serve as support for others in similar positions.

Betsy Glaeser, a longtime patient of Dr. Addrizzo-Harris, shared a story about the struggle of being one of the first cases of NTM bronchiectasis and helping to define the course of action. She shared that her original doctors gave her 5 years to live. The room erupted in applause when she shared that with the exceptional treatment she’s received, over 20 years later, she is standing in front of the supporters of the CHEST Foundation to share her story.

Because of the rarity of her disease, she was hospitalized multiple times with pneumonia before finally reaching her diagnosis of NTM disease. She channeled the accompanying frustrations into helping others who were recently diagnosed with the NTM disorder by sharing her experiences. “I would give them guidance on treatment options because in my years of living with the disease, I’d been there and tried almost everything,” said Betsy. “I would get calls from my doctor all of the time to speak with someone who just received an NTM disease diagnosis. I was happy to do so – at the time, the Internet didn’t exist, and firsthand experiences were all we had. Since forming our physical support group, the most memorable experience I can recall is when a woman, newly diagnosed with NTM, walked into the room and immediately burst into tears. She shared that she expected to see all of us on oxygen and wheelchair-bound, but that wasn’t the case at all. That day, we were able to give her hope. That’s why I do what I do, and I’m proud to do it.”

Fred Schick shared with the attendees his story of struggling to find his IPF diagnosis and how incredibly frustrating it was to be so short of breath that he needed to be rescued from the water while on vacation. With a history of cardiac complications, Fred’s doctors were looking at his heart.

For Fred to get to his IPF diagnosis, it took the careful ear of a primary care doctor Fred started to see when his previous doctor retired.

“It was almost like she was listening with different ears and was hearing what others didn’t. Once she recommended speaking with a pulmonologist, everything fell into place,” said Fred. “From my experience, IPF is best treated by a lot of pieces coming together and working together. It takes the dedication of a care team in the hospital, proper diet and exercise and, just as importantly, it takes a support group to guide you through the process. I’m grateful to my care team, but I’m equally thankful for the work I get to do as an advocate for others living with IPF.”

When she spoke to the attendees, Lisa Moores, MD, FCCP, reflected on what the patients shared. “We saw great examples of why we’re here tonight,” said Dr. Moores. “One of the things CHEST and the Foundation are focusing on is earlier diagnosis for interstitial lung diseases like pulmonary fibrosis and, with voices like Fred Schick, we’ll get there. The patients remind us why we’re here. We’re here for our patients; we’re here for Fred; and we’re here for Betsy.”

Laurence Feldman, Vice President of the Feldman Family Foundation that partners with the CHEST Foundation for their annual casino fundraiser benefiting pulmonary fibrosis, was able to participate in the dinner and theauction.

He shared, “Tonight, I was so impressed with the generosity of the attendees and the organization of this event. It reminded me that if you ask your supporters to give, they’ll be there for you. Almost like the ‘Field of Dreams’ quote of ‘if you build it, they will come.’ Being at the Belmont Stakes Dinner and Auction makes me that much more excited for our upcoming Irv Feldman Casino Night and Texas Hold ‘Em Tournament coming up in late August. Thanks to our corporate partners and the support of the CHEST Foundation, we’re able to produce an excellent event like the Belmont Stakes fundraiser that helps bring in donations that can make a difference in the lives of patients.”

At the end of the day, medicine is all about the patients and, by dedicating the night to patient education and patient advocates, the Belmont Stakes event brought the focus to where it should always be – improving care and helping patients.

To learn more and to support the various initiatives of the CHEST Foundation, visit foundation.chestnet.org/donate.

For a night of fun and philanthropy, CHEST leadership and supporters of the CHEST Foundation came together in New York City to watch the Belmont Stakes race and raise money to support patient education.

What started 8 years ago as a brunch in the living room of Doreen Addrizzo-Harris, MD, FCCP, the 2022 Belmont Stakes Dinner and Auction has grown into an event that welcomed 250 guests to the Manhattan waterfront and raised over $290,000 to support the initiatives of the CHEST Foundation.

Courtesy CHEST
CHEST member Bravein Amalakuhan, MD, FCCP, and his wife, Megan Cool Amalakuhan, show off their winning raffle number.

Spearheaded by Dr. Addrizzo- Harris, President-Elect of the American College of Chest Physicians, this year’s event was focused entirely on patient education and advocacy. The attendees heard the moving stories of Betsy Glaeser and Fred Schick who are both patients living with lung disease and advocates for others living with like afflictions. Betsy is living with nontuberculous mycobacteria (NTM) disease and Fred with idiopathic pulmonary fibrosis (IPF). Betsy and Fred have used their experiences to serve as support for others in similar positions.

Betsy Glaeser, a longtime patient of Dr. Addrizzo-Harris, shared a story about the struggle of being one of the first cases of NTM bronchiectasis and helping to define the course of action. She shared that her original doctors gave her 5 years to live. The room erupted in applause when she shared that with the exceptional treatment she’s received, over 20 years later, she is standing in front of the supporters of the CHEST Foundation to share her story.

Because of the rarity of her disease, she was hospitalized multiple times with pneumonia before finally reaching her diagnosis of NTM disease. She channeled the accompanying frustrations into helping others who were recently diagnosed with the NTM disorder by sharing her experiences. “I would give them guidance on treatment options because in my years of living with the disease, I’d been there and tried almost everything,” said Betsy. “I would get calls from my doctor all of the time to speak with someone who just received an NTM disease diagnosis. I was happy to do so – at the time, the Internet didn’t exist, and firsthand experiences were all we had. Since forming our physical support group, the most memorable experience I can recall is when a woman, newly diagnosed with NTM, walked into the room and immediately burst into tears. She shared that she expected to see all of us on oxygen and wheelchair-bound, but that wasn’t the case at all. That day, we were able to give her hope. That’s why I do what I do, and I’m proud to do it.”

Fred Schick shared with the attendees his story of struggling to find his IPF diagnosis and how incredibly frustrating it was to be so short of breath that he needed to be rescued from the water while on vacation. With a history of cardiac complications, Fred’s doctors were looking at his heart.

For Fred to get to his IPF diagnosis, it took the careful ear of a primary care doctor Fred started to see when his previous doctor retired.

“It was almost like she was listening with different ears and was hearing what others didn’t. Once she recommended speaking with a pulmonologist, everything fell into place,” said Fred. “From my experience, IPF is best treated by a lot of pieces coming together and working together. It takes the dedication of a care team in the hospital, proper diet and exercise and, just as importantly, it takes a support group to guide you through the process. I’m grateful to my care team, but I’m equally thankful for the work I get to do as an advocate for others living with IPF.”

When she spoke to the attendees, Lisa Moores, MD, FCCP, reflected on what the patients shared. “We saw great examples of why we’re here tonight,” said Dr. Moores. “One of the things CHEST and the Foundation are focusing on is earlier diagnosis for interstitial lung diseases like pulmonary fibrosis and, with voices like Fred Schick, we’ll get there. The patients remind us why we’re here. We’re here for our patients; we’re here for Fred; and we’re here for Betsy.”

Laurence Feldman, Vice President of the Feldman Family Foundation that partners with the CHEST Foundation for their annual casino fundraiser benefiting pulmonary fibrosis, was able to participate in the dinner and theauction.

He shared, “Tonight, I was so impressed with the generosity of the attendees and the organization of this event. It reminded me that if you ask your supporters to give, they’ll be there for you. Almost like the ‘Field of Dreams’ quote of ‘if you build it, they will come.’ Being at the Belmont Stakes Dinner and Auction makes me that much more excited for our upcoming Irv Feldman Casino Night and Texas Hold ‘Em Tournament coming up in late August. Thanks to our corporate partners and the support of the CHEST Foundation, we’re able to produce an excellent event like the Belmont Stakes fundraiser that helps bring in donations that can make a difference in the lives of patients.”

At the end of the day, medicine is all about the patients and, by dedicating the night to patient education and patient advocates, the Belmont Stakes event brought the focus to where it should always be – improving care and helping patients.

To learn more and to support the various initiatives of the CHEST Foundation, visit foundation.chestnet.org/donate.

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Pulmonary Physiology & Rehabilitation Section

Interpretive strategies for routine lung function tests

In December 2021, the European Respiratory Journal published the, ERS/ATS technical standard on interpretive strategies for routine lung function tests (Stanojevic S, et al. Eur Respir J. 2021 Dec 23;2101499). Briefly, a few of the updated recommendations are discussed here.

First, the task force recommends the use of Global Lung Initiative (GLI) reference values for spirometry, lung volumes, and diffusing capacity of carbon monoxide. GLI equations were derived from the largest sample of healthy individuals to date and provide an internal consistency across all ages.

Dr. Tom DeCato

Second, it is now recommended that z-scores are used as opposed to percent predicted in grading severity of impairment. Z-scores, which refer to the number of standard deviations a measurement is positioned from the predicted value, centered at zero, account better for age, sex, and height biases compared with percent predicted, and is simplified into mild (z-score -1.65 to -2.5), moderate (-2.51 to -4), and severe (< -4) categories.

Finally, there are new and possibly controversial recommendations in defining a bronchodilator response and interpretation of change over time. A bronchodilator response is now defined as a > 10% change from the predicted value in FEV1 or FVC while the concept of a conditional change score in children and FEV1Q in adults has been introduced to describe lung function change.

The recommendations reflect and reiterate a shift in reporting a range of values, rather than using absolute threshold values, with an emphasis on the classification of physiologic impairments. The uncertainty present as lung function approaches the lower limit of normal is acknowledged, emphasizing the importance of pretest probability in making a clinical diagnosis and/or clinical decision. We encourage all pulmonary clinicians to review this important paper for more detailed information on these changes.

Tom DeCato, MD, Vice-Chair

Gina Lee, MD, Member-at-Large

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Pulmonary Physiology & Rehabilitation Section

Interpretive strategies for routine lung function tests

In December 2021, the European Respiratory Journal published the, ERS/ATS technical standard on interpretive strategies for routine lung function tests (Stanojevic S, et al. Eur Respir J. 2021 Dec 23;2101499). Briefly, a few of the updated recommendations are discussed here.

First, the task force recommends the use of Global Lung Initiative (GLI) reference values for spirometry, lung volumes, and diffusing capacity of carbon monoxide. GLI equations were derived from the largest sample of healthy individuals to date and provide an internal consistency across all ages.

Dr. Tom DeCato

Second, it is now recommended that z-scores are used as opposed to percent predicted in grading severity of impairment. Z-scores, which refer to the number of standard deviations a measurement is positioned from the predicted value, centered at zero, account better for age, sex, and height biases compared with percent predicted, and is simplified into mild (z-score -1.65 to -2.5), moderate (-2.51 to -4), and severe (< -4) categories.

Finally, there are new and possibly controversial recommendations in defining a bronchodilator response and interpretation of change over time. A bronchodilator response is now defined as a > 10% change from the predicted value in FEV1 or FVC while the concept of a conditional change score in children and FEV1Q in adults has been introduced to describe lung function change.

The recommendations reflect and reiterate a shift in reporting a range of values, rather than using absolute threshold values, with an emphasis on the classification of physiologic impairments. The uncertainty present as lung function approaches the lower limit of normal is acknowledged, emphasizing the importance of pretest probability in making a clinical diagnosis and/or clinical decision. We encourage all pulmonary clinicians to review this important paper for more detailed information on these changes.

Tom DeCato, MD, Vice-Chair

Gina Lee, MD, Member-at-Large

Pulmonary Physiology & Rehabilitation Section

Interpretive strategies for routine lung function tests

In December 2021, the European Respiratory Journal published the, ERS/ATS technical standard on interpretive strategies for routine lung function tests (Stanojevic S, et al. Eur Respir J. 2021 Dec 23;2101499). Briefly, a few of the updated recommendations are discussed here.

First, the task force recommends the use of Global Lung Initiative (GLI) reference values for spirometry, lung volumes, and diffusing capacity of carbon monoxide. GLI equations were derived from the largest sample of healthy individuals to date and provide an internal consistency across all ages.

Dr. Tom DeCato

Second, it is now recommended that z-scores are used as opposed to percent predicted in grading severity of impairment. Z-scores, which refer to the number of standard deviations a measurement is positioned from the predicted value, centered at zero, account better for age, sex, and height biases compared with percent predicted, and is simplified into mild (z-score -1.65 to -2.5), moderate (-2.51 to -4), and severe (< -4) categories.

Finally, there are new and possibly controversial recommendations in defining a bronchodilator response and interpretation of change over time. A bronchodilator response is now defined as a > 10% change from the predicted value in FEV1 or FVC while the concept of a conditional change score in children and FEV1Q in adults has been introduced to describe lung function change.

The recommendations reflect and reiterate a shift in reporting a range of values, rather than using absolute threshold values, with an emphasis on the classification of physiologic impairments. The uncertainty present as lung function approaches the lower limit of normal is acknowledged, emphasizing the importance of pretest probability in making a clinical diagnosis and/or clinical decision. We encourage all pulmonary clinicians to review this important paper for more detailed information on these changes.

Tom DeCato, MD, Vice-Chair

Gina Lee, MD, Member-at-Large

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Pediatric Chest Medicine Section

Hope is on the horizon—new RSV protection for all infants

There is a dire unmet need for RSV protection in healthy term infants as available preventive therapies are limited and currently reserved for former preterm infants and those with certain underlying medical conditions (Brady MT, et al. Pediatrics. 2014;134[2]:415). Globally, RSV is a significant cause of lower respiratory tract infection impacting all age groups, yet, in infants and young children, the first infection may cause severe bronchiolitis that can be fatal (Li Y, et al. Lancet. 2022;399:2047).

Dr. Anne C. Coates

There are currently three approaches for protection at various stages of clinical development. The first is direct administration of antibodies to the infant. Two potent, longer-lasting, single-dose monoclonal antibody products, including nirsevimab which is a monoclonal antibody to the RSV fusion protein that has an extended half-life, for the general infant population are in phase 3 trials (Hammitt LL, et al. N Engl J Med. 2022;386:837; Griffin PM, et al. N Engl J Med. 2020;383:415).

Dr. Mary Cataletto


Passive antibody acquired from maternal vaccination in pregnancy is a second approach. Notably, a recent phase 3 trial that evaluated maternal vaccination did not show significance with respect to the primary end point of medically significant RSV-associated lower respiratory tract infection in infants up to 90 days of life (Madhi SA. N Engl J Med. 2020;383:426).

The third type of protection is active vaccination. Increased understanding of the biology of RSV and related technological advances have resulted in the entry of multiple vaccines into clinical development for pediatrics and adults, some of which may receive regulatory approval in the near future (Munoz FM, et al. Vaccine. 2021;39[22]:3053).

The burden of RSV is tremendous, yet the future of RSV protection looks promising.

Anne C. Coates, MD, FCCP, Member-at-Large
Mary Cataletto, MD, FCCP, Member-at-Large

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Pediatric Chest Medicine Section

Hope is on the horizon—new RSV protection for all infants

There is a dire unmet need for RSV protection in healthy term infants as available preventive therapies are limited and currently reserved for former preterm infants and those with certain underlying medical conditions (Brady MT, et al. Pediatrics. 2014;134[2]:415). Globally, RSV is a significant cause of lower respiratory tract infection impacting all age groups, yet, in infants and young children, the first infection may cause severe bronchiolitis that can be fatal (Li Y, et al. Lancet. 2022;399:2047).

Dr. Anne C. Coates

There are currently three approaches for protection at various stages of clinical development. The first is direct administration of antibodies to the infant. Two potent, longer-lasting, single-dose monoclonal antibody products, including nirsevimab which is a monoclonal antibody to the RSV fusion protein that has an extended half-life, for the general infant population are in phase 3 trials (Hammitt LL, et al. N Engl J Med. 2022;386:837; Griffin PM, et al. N Engl J Med. 2020;383:415).

Dr. Mary Cataletto


Passive antibody acquired from maternal vaccination in pregnancy is a second approach. Notably, a recent phase 3 trial that evaluated maternal vaccination did not show significance with respect to the primary end point of medically significant RSV-associated lower respiratory tract infection in infants up to 90 days of life (Madhi SA. N Engl J Med. 2020;383:426).

The third type of protection is active vaccination. Increased understanding of the biology of RSV and related technological advances have resulted in the entry of multiple vaccines into clinical development for pediatrics and adults, some of which may receive regulatory approval in the near future (Munoz FM, et al. Vaccine. 2021;39[22]:3053).

The burden of RSV is tremendous, yet the future of RSV protection looks promising.

Anne C. Coates, MD, FCCP, Member-at-Large
Mary Cataletto, MD, FCCP, Member-at-Large

 

Pediatric Chest Medicine Section

Hope is on the horizon—new RSV protection for all infants

There is a dire unmet need for RSV protection in healthy term infants as available preventive therapies are limited and currently reserved for former preterm infants and those with certain underlying medical conditions (Brady MT, et al. Pediatrics. 2014;134[2]:415). Globally, RSV is a significant cause of lower respiratory tract infection impacting all age groups, yet, in infants and young children, the first infection may cause severe bronchiolitis that can be fatal (Li Y, et al. Lancet. 2022;399:2047).

Dr. Anne C. Coates

There are currently three approaches for protection at various stages of clinical development. The first is direct administration of antibodies to the infant. Two potent, longer-lasting, single-dose monoclonal antibody products, including nirsevimab which is a monoclonal antibody to the RSV fusion protein that has an extended half-life, for the general infant population are in phase 3 trials (Hammitt LL, et al. N Engl J Med. 2022;386:837; Griffin PM, et al. N Engl J Med. 2020;383:415).

Dr. Mary Cataletto


Passive antibody acquired from maternal vaccination in pregnancy is a second approach. Notably, a recent phase 3 trial that evaluated maternal vaccination did not show significance with respect to the primary end point of medically significant RSV-associated lower respiratory tract infection in infants up to 90 days of life (Madhi SA. N Engl J Med. 2020;383:426).

The third type of protection is active vaccination. Increased understanding of the biology of RSV and related technological advances have resulted in the entry of multiple vaccines into clinical development for pediatrics and adults, some of which may receive regulatory approval in the near future (Munoz FM, et al. Vaccine. 2021;39[22]:3053).

The burden of RSV is tremendous, yet the future of RSV protection looks promising.

Anne C. Coates, MD, FCCP, Member-at-Large
Mary Cataletto, MD, FCCP, Member-at-Large

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Critical Care Network

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Sepsis and Shock Section

SEP-1 measure saves lives, let’s not debate!

On December 21, 2021, the National Quality Form (NQF) re-endorsed Measure 0500 Severe Sepsis and Septic Shock: Management Bundle, which CMS adopts as the SEP-1 core measure. The decision was initially met by a request for appeal. On April 29, 2022, the appeals board met to adjudicate the appeal and voted unanimously to uphold the Standards Approval Committee (CSAC) decision to endorse the measure once again (https://tinyurl.com/yc4tjxbz).

The appeals board voted 5-0 on whether procedural errors reasonably affected the outcome of the original endorsement and whether there was new information or evidence unavailable at the time of the CSAC endorsement decision that would reasonably affect the outcome of the original endorsement decision.

The implementation of NQF 0500 and SEP-1 continues to spark controversy in the medical community even though the results of this bundled approach support an opportunity to save lives. SEP-1 compliance is associated with a lower 30-day mortality, and rendering this care saves lives.

In the Townsend, et al cohort study (Chest. 2022 Feb;161[2]:392) examining patient level Medicare data from October 2015 – March 2017, there was an absolute risk reduction of 5.67% in a standard propensity matched comparison of SEP-1 compliant vs noncompliant care. With a more stringent match, the absolute risk reduction was 4.06%. That’s an outcome that our patients likely appreciate the most…lives saved.

As former CHEST President, Dr. Steven Simpson highlighted in his April 2022 commentary (CHEST Physician. 2022 April;17[4]:15), “Success is not dependent only on what we do but on when we do it.” Let’s not debate any further.

Namita Jayaprakash, MBBCh
Member-at-Large

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Sepsis and Shock Section

SEP-1 measure saves lives, let’s not debate!

On December 21, 2021, the National Quality Form (NQF) re-endorsed Measure 0500 Severe Sepsis and Septic Shock: Management Bundle, which CMS adopts as the SEP-1 core measure. The decision was initially met by a request for appeal. On April 29, 2022, the appeals board met to adjudicate the appeal and voted unanimously to uphold the Standards Approval Committee (CSAC) decision to endorse the measure once again (https://tinyurl.com/yc4tjxbz).

The appeals board voted 5-0 on whether procedural errors reasonably affected the outcome of the original endorsement and whether there was new information or evidence unavailable at the time of the CSAC endorsement decision that would reasonably affect the outcome of the original endorsement decision.

The implementation of NQF 0500 and SEP-1 continues to spark controversy in the medical community even though the results of this bundled approach support an opportunity to save lives. SEP-1 compliance is associated with a lower 30-day mortality, and rendering this care saves lives.

In the Townsend, et al cohort study (Chest. 2022 Feb;161[2]:392) examining patient level Medicare data from October 2015 – March 2017, there was an absolute risk reduction of 5.67% in a standard propensity matched comparison of SEP-1 compliant vs noncompliant care. With a more stringent match, the absolute risk reduction was 4.06%. That’s an outcome that our patients likely appreciate the most…lives saved.

As former CHEST President, Dr. Steven Simpson highlighted in his April 2022 commentary (CHEST Physician. 2022 April;17[4]:15), “Success is not dependent only on what we do but on when we do it.” Let’s not debate any further.

Namita Jayaprakash, MBBCh
Member-at-Large

 

Sepsis and Shock Section

SEP-1 measure saves lives, let’s not debate!

On December 21, 2021, the National Quality Form (NQF) re-endorsed Measure 0500 Severe Sepsis and Septic Shock: Management Bundle, which CMS adopts as the SEP-1 core measure. The decision was initially met by a request for appeal. On April 29, 2022, the appeals board met to adjudicate the appeal and voted unanimously to uphold the Standards Approval Committee (CSAC) decision to endorse the measure once again (https://tinyurl.com/yc4tjxbz).

The appeals board voted 5-0 on whether procedural errors reasonably affected the outcome of the original endorsement and whether there was new information or evidence unavailable at the time of the CSAC endorsement decision that would reasonably affect the outcome of the original endorsement decision.

The implementation of NQF 0500 and SEP-1 continues to spark controversy in the medical community even though the results of this bundled approach support an opportunity to save lives. SEP-1 compliance is associated with a lower 30-day mortality, and rendering this care saves lives.

In the Townsend, et al cohort study (Chest. 2022 Feb;161[2]:392) examining patient level Medicare data from October 2015 – March 2017, there was an absolute risk reduction of 5.67% in a standard propensity matched comparison of SEP-1 compliant vs noncompliant care. With a more stringent match, the absolute risk reduction was 4.06%. That’s an outcome that our patients likely appreciate the most…lives saved.

As former CHEST President, Dr. Steven Simpson highlighted in his April 2022 commentary (CHEST Physician. 2022 April;17[4]:15), “Success is not dependent only on what we do but on when we do it.” Let’s not debate any further.

Namita Jayaprakash, MBBCh
Member-at-Large

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Sleep Medicine Network

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Respiratory-Related Sleep Disorders Section

Reducing racial disparities in sleep apnea

Health inequity pervades many aspects of medicine, including the care of patients with obstructive sleep apnea. For example, a growing body of research has shown that black race is associated with underdiagnosis of OSA, greater disease severity at time of diagnosis and reduced PAP adherence (Hsu N, et al. J Clin Sleep Med. 2020;16[8]:1249; Thornton JD, et al. Ann Am Thorac Soc. 2022;19[2]:272).

Dr. Swetha Gogineni

A recent article (Billings ME, et al. Chest. 2021;159[3]:1232) offered potential strategies to mitigate racial disparities in sleep apnea management. To expand access to care, they advocate embracing telemedicine for those who may have difficulty coming to clinic – due to transportation issues, arranging sufficient time off work, or residing in remote locations. On the other hand, an over-reliance on telemedicine has the potential to worsen disparities in populations whose access to technology is limited.

Dr. Lauren Tobias


The authors also recommend inpatient screening of high-risk patient populations to detect disease earlier and to help facilitate referrals to a sleep center. They propose the idea of “peer buddies” of similar racial and socioeconomic backgrounds to provide support and counseling, while cautioning against overburden these populations. Finally, they propose broadening the sleep provider workforce by training primary care providers to manage OSA.

The higher proportion of nonwhite providers in these groups as compared with sleep specialists may improve care, since concordant race provision has been associated with better communication. Underlying these interventions is the need to diversify representation within the medical field at large.

Swetha Gogineni, MD, Vice-Chair
Lauren Tobias, MD, Member-at-Large

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Respiratory-Related Sleep Disorders Section

Reducing racial disparities in sleep apnea

Health inequity pervades many aspects of medicine, including the care of patients with obstructive sleep apnea. For example, a growing body of research has shown that black race is associated with underdiagnosis of OSA, greater disease severity at time of diagnosis and reduced PAP adherence (Hsu N, et al. J Clin Sleep Med. 2020;16[8]:1249; Thornton JD, et al. Ann Am Thorac Soc. 2022;19[2]:272).

Dr. Swetha Gogineni

A recent article (Billings ME, et al. Chest. 2021;159[3]:1232) offered potential strategies to mitigate racial disparities in sleep apnea management. To expand access to care, they advocate embracing telemedicine for those who may have difficulty coming to clinic – due to transportation issues, arranging sufficient time off work, or residing in remote locations. On the other hand, an over-reliance on telemedicine has the potential to worsen disparities in populations whose access to technology is limited.

Dr. Lauren Tobias


The authors also recommend inpatient screening of high-risk patient populations to detect disease earlier and to help facilitate referrals to a sleep center. They propose the idea of “peer buddies” of similar racial and socioeconomic backgrounds to provide support and counseling, while cautioning against overburden these populations. Finally, they propose broadening the sleep provider workforce by training primary care providers to manage OSA.

The higher proportion of nonwhite providers in these groups as compared with sleep specialists may improve care, since concordant race provision has been associated with better communication. Underlying these interventions is the need to diversify representation within the medical field at large.

Swetha Gogineni, MD, Vice-Chair
Lauren Tobias, MD, Member-at-Large

 

Respiratory-Related Sleep Disorders Section

Reducing racial disparities in sleep apnea

Health inequity pervades many aspects of medicine, including the care of patients with obstructive sleep apnea. For example, a growing body of research has shown that black race is associated with underdiagnosis of OSA, greater disease severity at time of diagnosis and reduced PAP adherence (Hsu N, et al. J Clin Sleep Med. 2020;16[8]:1249; Thornton JD, et al. Ann Am Thorac Soc. 2022;19[2]:272).

Dr. Swetha Gogineni

A recent article (Billings ME, et al. Chest. 2021;159[3]:1232) offered potential strategies to mitigate racial disparities in sleep apnea management. To expand access to care, they advocate embracing telemedicine for those who may have difficulty coming to clinic – due to transportation issues, arranging sufficient time off work, or residing in remote locations. On the other hand, an over-reliance on telemedicine has the potential to worsen disparities in populations whose access to technology is limited.

Dr. Lauren Tobias


The authors also recommend inpatient screening of high-risk patient populations to detect disease earlier and to help facilitate referrals to a sleep center. They propose the idea of “peer buddies” of similar racial and socioeconomic backgrounds to provide support and counseling, while cautioning against overburden these populations. Finally, they propose broadening the sleep provider workforce by training primary care providers to manage OSA.

The higher proportion of nonwhite providers in these groups as compared with sleep specialists may improve care, since concordant race provision has been associated with better communication. Underlying these interventions is the need to diversify representation within the medical field at large.

Swetha Gogineni, MD, Vice-Chair
Lauren Tobias, MD, Member-at-Large

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Pulmonary Vascular & Cardiovascular Network

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Pulmonary Vascular Disease Section

Restoration of RV function in PAH: Is it the holy grail to improve mortality and long-term outcomes?

Pulmonary arterial hypertension (PAH) remains an incurable disease, and clinical progression is inevitable. Despite several therapeutic advances, PAH continues to be associated with high mortality. Even mild increases in mean pulmonary arterial pressure (mPAP) have been shown to directly impact outcomes (Maron BA, et al. Circulation. 2016 Mar 29;133[13]:1240), leading to a change in the hemodynamic definition of PAH (mPAP > 20 mm Hg) at the 2018 World Symposium on Pulmonary Hypertension (WSPH) (Galiè N, et al. Eur Respir J. 2019;53[1]:1801889). The WSPH also recommended a more aggressive and proactive approach to move patients to “low-risk” status.

Dr. Vijay Balasubramanian

Elevated mPAP results in increased RV afterload with subsequent RV dysfunction and consequent abnormal remodeling, which is associated with poor outcomes. Reversal of RV remodeling has been demonstrated in patients after PEA for CTEPH and/or lung transplantation for PAH (D’Armini AM, et al. J Thorac Cardiovasc Surg. 2007;133:162).

Dr. Jean M. Elwing


Aggressive mPAP reduction facilitates RV recovery, which may alter the course of PAH in the form of improved survival. RV dysfunction is mainly attributed to afterload mismatch and uncoupling of the RV. Although oral therapies have shown significant improvements in symptoms, functional class, and delaying clinical worsening, normalization of RV size and function is often not achieved. More aggressive reduction of mPAP with a combination of parenteral and oral therapies has been shown to be more effective in restoring RV function (Vizza CD, et al. Am J Respir Crit Care Med. 2022;205) with the ultimate goal of improving quality and quantity of life in those affected by PAH.

Vijay Balasubramanian, MD, FCCP, Chair
Jean M. Elwing, MD, FCCP, Ex-Officio

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Pulmonary Vascular Disease Section

Restoration of RV function in PAH: Is it the holy grail to improve mortality and long-term outcomes?

Pulmonary arterial hypertension (PAH) remains an incurable disease, and clinical progression is inevitable. Despite several therapeutic advances, PAH continues to be associated with high mortality. Even mild increases in mean pulmonary arterial pressure (mPAP) have been shown to directly impact outcomes (Maron BA, et al. Circulation. 2016 Mar 29;133[13]:1240), leading to a change in the hemodynamic definition of PAH (mPAP > 20 mm Hg) at the 2018 World Symposium on Pulmonary Hypertension (WSPH) (Galiè N, et al. Eur Respir J. 2019;53[1]:1801889). The WSPH also recommended a more aggressive and proactive approach to move patients to “low-risk” status.

Dr. Vijay Balasubramanian

Elevated mPAP results in increased RV afterload with subsequent RV dysfunction and consequent abnormal remodeling, which is associated with poor outcomes. Reversal of RV remodeling has been demonstrated in patients after PEA for CTEPH and/or lung transplantation for PAH (D’Armini AM, et al. J Thorac Cardiovasc Surg. 2007;133:162).

Dr. Jean M. Elwing


Aggressive mPAP reduction facilitates RV recovery, which may alter the course of PAH in the form of improved survival. RV dysfunction is mainly attributed to afterload mismatch and uncoupling of the RV. Although oral therapies have shown significant improvements in symptoms, functional class, and delaying clinical worsening, normalization of RV size and function is often not achieved. More aggressive reduction of mPAP with a combination of parenteral and oral therapies has been shown to be more effective in restoring RV function (Vizza CD, et al. Am J Respir Crit Care Med. 2022;205) with the ultimate goal of improving quality and quantity of life in those affected by PAH.

Vijay Balasubramanian, MD, FCCP, Chair
Jean M. Elwing, MD, FCCP, Ex-Officio

 

Pulmonary Vascular Disease Section

Restoration of RV function in PAH: Is it the holy grail to improve mortality and long-term outcomes?

Pulmonary arterial hypertension (PAH) remains an incurable disease, and clinical progression is inevitable. Despite several therapeutic advances, PAH continues to be associated with high mortality. Even mild increases in mean pulmonary arterial pressure (mPAP) have been shown to directly impact outcomes (Maron BA, et al. Circulation. 2016 Mar 29;133[13]:1240), leading to a change in the hemodynamic definition of PAH (mPAP > 20 mm Hg) at the 2018 World Symposium on Pulmonary Hypertension (WSPH) (Galiè N, et al. Eur Respir J. 2019;53[1]:1801889). The WSPH also recommended a more aggressive and proactive approach to move patients to “low-risk” status.

Dr. Vijay Balasubramanian

Elevated mPAP results in increased RV afterload with subsequent RV dysfunction and consequent abnormal remodeling, which is associated with poor outcomes. Reversal of RV remodeling has been demonstrated in patients after PEA for CTEPH and/or lung transplantation for PAH (D’Armini AM, et al. J Thorac Cardiovasc Surg. 2007;133:162).

Dr. Jean M. Elwing


Aggressive mPAP reduction facilitates RV recovery, which may alter the course of PAH in the form of improved survival. RV dysfunction is mainly attributed to afterload mismatch and uncoupling of the RV. Although oral therapies have shown significant improvements in symptoms, functional class, and delaying clinical worsening, normalization of RV size and function is often not achieved. More aggressive reduction of mPAP with a combination of parenteral and oral therapies has been shown to be more effective in restoring RV function (Vizza CD, et al. Am J Respir Crit Care Med. 2022;205) with the ultimate goal of improving quality and quantity of life in those affected by PAH.

Vijay Balasubramanian, MD, FCCP, Chair
Jean M. Elwing, MD, FCCP, Ex-Officio

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Thoracic Oncology & Chest Procedures Network

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Interventional Procedures Section

Role of EBUS for staging and prognostication in patients with lung cancer

Lung cancer is the leading cause of cancer-related deaths worldwide and forms of a large burden of cancer-related mortality in the United States. With the rapid advent of new disease-directed therapy, including molecular and targeted therapies, the outlook for management of lung cancer has changed dramatically over the last decade. The choice of therapy, as well as prognosis, is dependent on the stage at diagnosis. It is thus imperative that we accurately differentiate between stages I, II, and III disease by assessment of hilar and mediastinal lymph nodes.

Dr. Abhinav Agrawal

Traditionally, CT and PET/CT scans have been the mainstay to assess stage, with patients with abnormal lymph nodes or high risk of nodal metastasis (≥ T2 disease or “central” location) undergoing invasive mediastinal evaluation (Silvestri, et al. Chest. 2013 May;143(5 Suppl):e211S). The decision to perform invasive mediastinal staging for T1 tumors remains a matter of discussion. DuComb and colleagues, in their study demonstrated a high rate of N2 metastasis (8.1%) even amongst those with T1 tumors, which was independent of tumor location (DuComb, et al. Chest. 2020 Nov;158[5]:2192). This rate is consistent with previous reported rates ranging from 6.9% to 13% of N2 disease in patients with no radiographic evidence of lymph node metastasis (Gonzalez-Stawinski, et al. J Thorac Cardiovasc Surg. 2003 Dec;126[6]:1900; Bao, et al. J Thorac Dis. 2014;6[12]:1697; Shin, et al. Eur Respir J. 2019;53[3]:1801508). The above indicates a possible role of invasive mediastinal staging using EBUS-TBNA in patients with T1 disease to accurately stage the disease prior to curative intent treatment.

Dr. Ellen Volker


While the role of EBUS-TBNA in diagnosis and staging has been a role of ongoing research, data are limited on prognostic implications of EBUS-guided staging in patients with NSCLC. In a recently published paper in Chest, Hwangbo and colleagues assessed the prognostic impact of staging via EBUS in these patients (Hwangbo et al. Chest 2022 May;161[5]:1382). In the 1,089 patients who underwent EBUS-TBNA, they observed a significant difference in survival based on the staging established via EBUS-TBNA, highlighting the importance of EBUS-TBNA in staging for NSCLC. Also of note, patients with false-negative EBUS results had favorable survival that was similar to patients with pathologic N1 disease. While the exact reason for this is unclear and may be related to disease burden, the authors postulated that this may provide a rationale to performing surgery after negative EBUS-TBNA results.

Abhinav Agrawal, MD, FCCP, Member-at-Large
Ellen Volker, MD, MSPH, FCCP, Member-at-Large

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Interventional Procedures Section

Role of EBUS for staging and prognostication in patients with lung cancer

Lung cancer is the leading cause of cancer-related deaths worldwide and forms of a large burden of cancer-related mortality in the United States. With the rapid advent of new disease-directed therapy, including molecular and targeted therapies, the outlook for management of lung cancer has changed dramatically over the last decade. The choice of therapy, as well as prognosis, is dependent on the stage at diagnosis. It is thus imperative that we accurately differentiate between stages I, II, and III disease by assessment of hilar and mediastinal lymph nodes.

Dr. Abhinav Agrawal

Traditionally, CT and PET/CT scans have been the mainstay to assess stage, with patients with abnormal lymph nodes or high risk of nodal metastasis (≥ T2 disease or “central” location) undergoing invasive mediastinal evaluation (Silvestri, et al. Chest. 2013 May;143(5 Suppl):e211S). The decision to perform invasive mediastinal staging for T1 tumors remains a matter of discussion. DuComb and colleagues, in their study demonstrated a high rate of N2 metastasis (8.1%) even amongst those with T1 tumors, which was independent of tumor location (DuComb, et al. Chest. 2020 Nov;158[5]:2192). This rate is consistent with previous reported rates ranging from 6.9% to 13% of N2 disease in patients with no radiographic evidence of lymph node metastasis (Gonzalez-Stawinski, et al. J Thorac Cardiovasc Surg. 2003 Dec;126[6]:1900; Bao, et al. J Thorac Dis. 2014;6[12]:1697; Shin, et al. Eur Respir J. 2019;53[3]:1801508). The above indicates a possible role of invasive mediastinal staging using EBUS-TBNA in patients with T1 disease to accurately stage the disease prior to curative intent treatment.

Dr. Ellen Volker


While the role of EBUS-TBNA in diagnosis and staging has been a role of ongoing research, data are limited on prognostic implications of EBUS-guided staging in patients with NSCLC. In a recently published paper in Chest, Hwangbo and colleagues assessed the prognostic impact of staging via EBUS in these patients (Hwangbo et al. Chest 2022 May;161[5]:1382). In the 1,089 patients who underwent EBUS-TBNA, they observed a significant difference in survival based on the staging established via EBUS-TBNA, highlighting the importance of EBUS-TBNA in staging for NSCLC. Also of note, patients with false-negative EBUS results had favorable survival that was similar to patients with pathologic N1 disease. While the exact reason for this is unclear and may be related to disease burden, the authors postulated that this may provide a rationale to performing surgery after negative EBUS-TBNA results.

Abhinav Agrawal, MD, FCCP, Member-at-Large
Ellen Volker, MD, MSPH, FCCP, Member-at-Large

 

Interventional Procedures Section

Role of EBUS for staging and prognostication in patients with lung cancer

Lung cancer is the leading cause of cancer-related deaths worldwide and forms of a large burden of cancer-related mortality in the United States. With the rapid advent of new disease-directed therapy, including molecular and targeted therapies, the outlook for management of lung cancer has changed dramatically over the last decade. The choice of therapy, as well as prognosis, is dependent on the stage at diagnosis. It is thus imperative that we accurately differentiate between stages I, II, and III disease by assessment of hilar and mediastinal lymph nodes.

Dr. Abhinav Agrawal

Traditionally, CT and PET/CT scans have been the mainstay to assess stage, with patients with abnormal lymph nodes or high risk of nodal metastasis (≥ T2 disease or “central” location) undergoing invasive mediastinal evaluation (Silvestri, et al. Chest. 2013 May;143(5 Suppl):e211S). The decision to perform invasive mediastinal staging for T1 tumors remains a matter of discussion. DuComb and colleagues, in their study demonstrated a high rate of N2 metastasis (8.1%) even amongst those with T1 tumors, which was independent of tumor location (DuComb, et al. Chest. 2020 Nov;158[5]:2192). This rate is consistent with previous reported rates ranging from 6.9% to 13% of N2 disease in patients with no radiographic evidence of lymph node metastasis (Gonzalez-Stawinski, et al. J Thorac Cardiovasc Surg. 2003 Dec;126[6]:1900; Bao, et al. J Thorac Dis. 2014;6[12]:1697; Shin, et al. Eur Respir J. 2019;53[3]:1801508). The above indicates a possible role of invasive mediastinal staging using EBUS-TBNA in patients with T1 disease to accurately stage the disease prior to curative intent treatment.

Dr. Ellen Volker


While the role of EBUS-TBNA in diagnosis and staging has been a role of ongoing research, data are limited on prognostic implications of EBUS-guided staging in patients with NSCLC. In a recently published paper in Chest, Hwangbo and colleagues assessed the prognostic impact of staging via EBUS in these patients (Hwangbo et al. Chest 2022 May;161[5]:1382). In the 1,089 patients who underwent EBUS-TBNA, they observed a significant difference in survival based on the staging established via EBUS-TBNA, highlighting the importance of EBUS-TBNA in staging for NSCLC. Also of note, patients with false-negative EBUS results had favorable survival that was similar to patients with pathologic N1 disease. While the exact reason for this is unclear and may be related to disease burden, the authors postulated that this may provide a rationale to performing surgery after negative EBUS-TBNA results.

Abhinav Agrawal, MD, FCCP, Member-at-Large
Ellen Volker, MD, MSPH, FCCP, Member-at-Large

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Chest Infections & Disaster Response Network

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Disaster Response and Global Health Section

Physician response to Ukraine and beyond

Displaced persons, international refugee crises, gun violence, and other disasters remain prevalent in current news. Recent events highlight the need for continued civilian physician leadership and response to disasters.

Before the Ukraine crisis, the United Nations Refugee Agency estimated displaced persons more than doubled to greater than 82 million persons over the last decade (unhcr.org). Since that analysis, there have been over 6.5 million externally displaced persons, 7.5 million internally displaced persons, and significant numbers of injured patients from the Ukraine crisis alone. The Ukraine Ministry of Health has shown preparedness in its ability to handle significant patient surges with minimal assistance.

Dr. Christopher Miller

However, organizations like the Ukraine Medical Association of North America, Razom for Ukraine, Doctors Without Borders (MSF), MedGlobal, Samaritan’s Purse, Global Response Management, and many more have deployed to assist in Ukraine. These NGOs continue to help with medical care, fulfill critical supply needs, and provide training in cutting-edge medicine (POCUS, trauma updates).

Challenges posed by unstable environments, from wars to active shooter situations, further underscore the need for continued education, advances in technology, and preparedness. Providers responding to these events often treat vulnerable populations suffering from physical and mental violence, requiring physicians to step out of their comfort zone.

Opportunities remain plentiful to affect many lives as physicians respond through well-established and coordinated efforts with NGOs across the world. Physicians should continue to be leaders in the care of vulnerable displaced persons.

Christopher Miller, DO, MPH
Fellow-in-Training Member

Thomas Marston, MD
Member-at-Large

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Disaster Response and Global Health Section

Physician response to Ukraine and beyond

Displaced persons, international refugee crises, gun violence, and other disasters remain prevalent in current news. Recent events highlight the need for continued civilian physician leadership and response to disasters.

Before the Ukraine crisis, the United Nations Refugee Agency estimated displaced persons more than doubled to greater than 82 million persons over the last decade (unhcr.org). Since that analysis, there have been over 6.5 million externally displaced persons, 7.5 million internally displaced persons, and significant numbers of injured patients from the Ukraine crisis alone. The Ukraine Ministry of Health has shown preparedness in its ability to handle significant patient surges with minimal assistance.

Dr. Christopher Miller

However, organizations like the Ukraine Medical Association of North America, Razom for Ukraine, Doctors Without Borders (MSF), MedGlobal, Samaritan’s Purse, Global Response Management, and many more have deployed to assist in Ukraine. These NGOs continue to help with medical care, fulfill critical supply needs, and provide training in cutting-edge medicine (POCUS, trauma updates).

Challenges posed by unstable environments, from wars to active shooter situations, further underscore the need for continued education, advances in technology, and preparedness. Providers responding to these events often treat vulnerable populations suffering from physical and mental violence, requiring physicians to step out of their comfort zone.

Opportunities remain plentiful to affect many lives as physicians respond through well-established and coordinated efforts with NGOs across the world. Physicians should continue to be leaders in the care of vulnerable displaced persons.

Christopher Miller, DO, MPH
Fellow-in-Training Member

Thomas Marston, MD
Member-at-Large

Disaster Response and Global Health Section

Physician response to Ukraine and beyond

Displaced persons, international refugee crises, gun violence, and other disasters remain prevalent in current news. Recent events highlight the need for continued civilian physician leadership and response to disasters.

Before the Ukraine crisis, the United Nations Refugee Agency estimated displaced persons more than doubled to greater than 82 million persons over the last decade (unhcr.org). Since that analysis, there have been over 6.5 million externally displaced persons, 7.5 million internally displaced persons, and significant numbers of injured patients from the Ukraine crisis alone. The Ukraine Ministry of Health has shown preparedness in its ability to handle significant patient surges with minimal assistance.

Dr. Christopher Miller

However, organizations like the Ukraine Medical Association of North America, Razom for Ukraine, Doctors Without Borders (MSF), MedGlobal, Samaritan’s Purse, Global Response Management, and many more have deployed to assist in Ukraine. These NGOs continue to help with medical care, fulfill critical supply needs, and provide training in cutting-edge medicine (POCUS, trauma updates).

Challenges posed by unstable environments, from wars to active shooter situations, further underscore the need for continued education, advances in technology, and preparedness. Providers responding to these events often treat vulnerable populations suffering from physical and mental violence, requiring physicians to step out of their comfort zone.

Opportunities remain plentiful to affect many lives as physicians respond through well-established and coordinated efforts with NGOs across the world. Physicians should continue to be leaders in the care of vulnerable displaced persons.

Christopher Miller, DO, MPH
Fellow-in-Training Member

Thomas Marston, MD
Member-at-Large

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‘The Rock’ assumes the presidency of AGA

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We’re honored to announce that John M. Carethers, MD, AGAF, affectionately nicknamed ‘The Rock,’ will begin his term as the 117th president of the AGA Institute on June 1, 2022.

He currently serves as John G. Searle professor of internal medicine and chair of the department of internal medicine at the University of Michigan Health System, a position he has held since 2009.

Dr. Carethers’ research programs focus on familial colon cancer and polyposis syndromes. His research encompasses Lynch syndrome, juvenile polyposis, hyperplastic polyposis, and colorectal cancer. He has published more than 182 articles.

A native of Detroit, Dr. Carethers earned his undergraduate degree in molecular biology and biophysics at Wayne State University. He remained there for medical school, where he graduated at the top of his class. His ability to stay focused on his work earned him the moniker ‘The Rock’. It’s a strength that’s made him an outstanding role model and exemplary leader.

An active member of AGA for more than 20 years, Dr. Carethers received the AGA Gastrointestinal Oncology Section Research Mentor Award as well as the AGA Distinguished Mentor Award in 2017. He has served on several AGA committees, including the AGA Nominating Committee, AGA Underrepresented Minorities Committee, AGA Research Policy Committee, AGA Institute Council and the AGA Trainee & Young GI Committee. He has also served as senior associate editor of Gastroenterology.

His academic career began at the University of California, San Diego, preceded by a gastroenterology fellowship at University of Michigan in Ann Arbor and residency at Massachusetts General Hospital in Boston. From the beginning, he has inspired others with his strong work ethic and intense dedication.

Dr. Carethers joined the AGA Governing Board in June 2020 as vice president and served as president-elect prior to assuming the top leadership role.

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We’re honored to announce that John M. Carethers, MD, AGAF, affectionately nicknamed ‘The Rock,’ will begin his term as the 117th president of the AGA Institute on June 1, 2022.

He currently serves as John G. Searle professor of internal medicine and chair of the department of internal medicine at the University of Michigan Health System, a position he has held since 2009.

Dr. Carethers’ research programs focus on familial colon cancer and polyposis syndromes. His research encompasses Lynch syndrome, juvenile polyposis, hyperplastic polyposis, and colorectal cancer. He has published more than 182 articles.

A native of Detroit, Dr. Carethers earned his undergraduate degree in molecular biology and biophysics at Wayne State University. He remained there for medical school, where he graduated at the top of his class. His ability to stay focused on his work earned him the moniker ‘The Rock’. It’s a strength that’s made him an outstanding role model and exemplary leader.

An active member of AGA for more than 20 years, Dr. Carethers received the AGA Gastrointestinal Oncology Section Research Mentor Award as well as the AGA Distinguished Mentor Award in 2017. He has served on several AGA committees, including the AGA Nominating Committee, AGA Underrepresented Minorities Committee, AGA Research Policy Committee, AGA Institute Council and the AGA Trainee & Young GI Committee. He has also served as senior associate editor of Gastroenterology.

His academic career began at the University of California, San Diego, preceded by a gastroenterology fellowship at University of Michigan in Ann Arbor and residency at Massachusetts General Hospital in Boston. From the beginning, he has inspired others with his strong work ethic and intense dedication.

Dr. Carethers joined the AGA Governing Board in June 2020 as vice president and served as president-elect prior to assuming the top leadership role.

We’re honored to announce that John M. Carethers, MD, AGAF, affectionately nicknamed ‘The Rock,’ will begin his term as the 117th president of the AGA Institute on June 1, 2022.

He currently serves as John G. Searle professor of internal medicine and chair of the department of internal medicine at the University of Michigan Health System, a position he has held since 2009.

Dr. Carethers’ research programs focus on familial colon cancer and polyposis syndromes. His research encompasses Lynch syndrome, juvenile polyposis, hyperplastic polyposis, and colorectal cancer. He has published more than 182 articles.

A native of Detroit, Dr. Carethers earned his undergraduate degree in molecular biology and biophysics at Wayne State University. He remained there for medical school, where he graduated at the top of his class. His ability to stay focused on his work earned him the moniker ‘The Rock’. It’s a strength that’s made him an outstanding role model and exemplary leader.

An active member of AGA for more than 20 years, Dr. Carethers received the AGA Gastrointestinal Oncology Section Research Mentor Award as well as the AGA Distinguished Mentor Award in 2017. He has served on several AGA committees, including the AGA Nominating Committee, AGA Underrepresented Minorities Committee, AGA Research Policy Committee, AGA Institute Council and the AGA Trainee & Young GI Committee. He has also served as senior associate editor of Gastroenterology.

His academic career began at the University of California, San Diego, preceded by a gastroenterology fellowship at University of Michigan in Ann Arbor and residency at Massachusetts General Hospital in Boston. From the beginning, he has inspired others with his strong work ethic and intense dedication.

Dr. Carethers joined the AGA Governing Board in June 2020 as vice president and served as president-elect prior to assuming the top leadership role.

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New AGA Research Foundation Executive Board members

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We’re pleased to share that Michael Camilleri, MD, AGAF, will be taking over the AGA Research Foundation chair role beginning this month. He has recruited five members to be part of the 2022-2024 AGA Research Foundation Executive Board.

Meet the new Foundation Executive Board members

  • Michael Camilleri, MD, AGAF, Mayo Clinic, Rochester, MN.
  • Aline Charabaty, MD, AGAF, Johns Hopkins School of Medicine, Washington, D.C.
  • Eric Esrailian, MD, MPH, AGAF, David Geffen School of Medicine at UCLA, Los Angeles, CA
  • Robert A. Ganz, MD, MASGE, MNGI Digestive Health, Minnetonka, MN
  • Aja S. McCutchen, MD, Atlanta Gastroenterology Associates, Hoschton, GA
  • Michael L. Kochman, MD, AGAF, University of Pennsylvania, Philadelphia, PA
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We’re pleased to share that Michael Camilleri, MD, AGAF, will be taking over the AGA Research Foundation chair role beginning this month. He has recruited five members to be part of the 2022-2024 AGA Research Foundation Executive Board.

Meet the new Foundation Executive Board members

  • Michael Camilleri, MD, AGAF, Mayo Clinic, Rochester, MN.
  • Aline Charabaty, MD, AGAF, Johns Hopkins School of Medicine, Washington, D.C.
  • Eric Esrailian, MD, MPH, AGAF, David Geffen School of Medicine at UCLA, Los Angeles, CA
  • Robert A. Ganz, MD, MASGE, MNGI Digestive Health, Minnetonka, MN
  • Aja S. McCutchen, MD, Atlanta Gastroenterology Associates, Hoschton, GA
  • Michael L. Kochman, MD, AGAF, University of Pennsylvania, Philadelphia, PA

We’re pleased to share that Michael Camilleri, MD, AGAF, will be taking over the AGA Research Foundation chair role beginning this month. He has recruited five members to be part of the 2022-2024 AGA Research Foundation Executive Board.

Meet the new Foundation Executive Board members

  • Michael Camilleri, MD, AGAF, Mayo Clinic, Rochester, MN.
  • Aline Charabaty, MD, AGAF, Johns Hopkins School of Medicine, Washington, D.C.
  • Eric Esrailian, MD, MPH, AGAF, David Geffen School of Medicine at UCLA, Los Angeles, CA
  • Robert A. Ganz, MD, MASGE, MNGI Digestive Health, Minnetonka, MN
  • Aja S. McCutchen, MD, Atlanta Gastroenterology Associates, Hoschton, GA
  • Michael L. Kochman, MD, AGAF, University of Pennsylvania, Philadelphia, PA
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