80 PICTURE – Lung function testing in chronic lung allograft dysfunction

• Published in: BMJ paediatrics open 2023-12, Vol.7 (Suppl 2), p.A12-A12
• Main Authors: Sheldon, Ewart J, Booth, John, Pissaridou, Eleni, Key, Daniel, Bowyer, Stuart A, Sebire, Neil J, Brugha, Rossa
• Format: Article
• Language: English
• Subjects: Electronic health records; Lung transplants; Pediatrics; Poster Presentations; Spirometry; Trends
• ISSN: 2399-9772
• DOI: 10.1136/bmjpo-2023-GOSH.25

IntroductionChronic lung allograft dysfunction (CLAD) is driven by chronic rejection post lung transplantation and is the main cause of mortality in those more than one year post lung transplantation. It’s defined by change in lung function (spirometry) results. We hypothesised that analysis of trends in lung function could identify early changes in spirometry (forced expiratory volume in 1 second; FEV1) trends. We built an analysis web application (PICTURE) that analyses electronic health record (EHR) data and presents it interactively or as PDF reports. We used PICTURE to compare FEV1 in transplant patients alongside additional lung function outcomes (lung clearance index; LCI), demographics, and laboratory data from the EHR.MethodsData for Paediatric lung transplant patients cared for at GOSH between 01/05/2019 and 31/03/2023 were extracted and divided by outcome (presence or absence of CLAD) within PICTURE. LCI and FEV1 results were obtained and compared with the Kruskal–Wallis test.ResultsThere were 8 CLAD positive and 27 CLAD negative lung transplant patients. FEV1 scores were lower in patients with CLAD diagnoses. LCI didn’t significantly differ between groups.ConclusionsPICTURE allows rapid extraction and analysis of datasets for children with rare diseases whose data is held at GOSH. The finding of lower FEV1 in the CLAD group validates the use of PICTURE for audit type analyses. LCI is reported to be more sensitive than spirometry in CLAD, a finding that was not reproduced in this study. As PICTURE used existing functions this report demonstrates its potential to answer queries which previously required manually transferring data between systems.This project has been completed by Great Ormond Street Hospital NHS Foundation Trust and Roche Products Ltd as part of a collaborative working agreement. Roche Products Ltd had no influence on the results or decision to publish regarding this work. M-GB-00013791 | September 2023Acknowledgements for funding or supportThis work is supported by the NIHR GOSH BRC. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.