• Thursday, April 8th
  • Friday, April 9th
  • Saturday, April 10th
  • Co-Developed Symposia
1130 - 1300
1300 - 1315

Welcome and Opening Remarks

Opening remarks by Dr. Dina Brooks and Dr. Paul Hernandez – CTS Board of Directors

1315 - 1400

Plenary Session

Learnings from the Pandemic: Experiences and Best Practices

Public Health Perspective

Dr. Horacio Arruda, National Director of Public Health and Assistant Deputy Minister at the Ministry of Health and Social Services, Quebec, QC

In the context of an emerging disease, multiples unknows are frequent in the first weeks or months to really have a precise risk analysis. Very important aspects of the specific epidemiology are missing but decisions have to be taken in the context of uncertainty.  In the recent years the detection, surveillance and scientific knowledge have improved dramatically specifically in sequencing the virus and the production of vaccines.

As the same time public health decisions have to take into account the context of specific cultural and health care systems that differs over the world. The rapidity of the information in the media and social media have positives impacts but may also introduce some confusion in the diverses approachs of communication

The presentation will illustrate some of these aspects of science in the context of uncertainty and the fragile equilibrium to the decision process which need to take multiples aspects and determinants of health.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • List a series of factors to take into account in the process of decision in a context of uncertainty;
  • Recognize the principles of a good strategy of risk communication; and
  • Identify the benefit and also negative impact of differents populational measures

CanMEDs Competencies Addressed
Communicator, Leader

Dr. Horacio Arruda

Dr. Horacio Arruda is a medical specialist in public health and preventive medicine. For many years, he focused in the fields of Interventional Epidemiology and the prevention and control of infectious diseases.

From 2000 to 2012, he served as the Director of Public Health at the Québec Department of Health and Social Services. He was a leader in the fields of infectious and communicable diseases, nosocomial infections, occupational and environmental health and emergency measures.

In 2012 he was named National Director of Public Health and Assistant Deputy Minister at the Québec Department of Health and Social Services. It was under his leadership that the first Gouvernment Health Prevention Policy was launched for the 2015-2025 period. From this, Dr. Arruda drafted the first ever Interdepartmental Action Plan for 2017-2021. This policy and the accompanied action plan are one of the first of their kind in North America in the field of preventative medicine.

Research Perspectives – the Good, the Bad and the Ugly

Dr. Jeremy Grimshaw, The Ottawa Hospital Research Institute, Ottawa, ON

During the COVID-19 pandemic, there has been an unprecedented demand for robust evidence to support policy, practice and personal decisions. The research community has rapidly responded to this need. So far over $3.5B of COVID research funding has been released. This has led to rapid discoveries relating to vaccines and therapeutics. However there has undoubtedly been waste in the research response with duplication of effort, variable quality of the science, and failure to address key areas (such as research on behavioural, environmental, social and systems interventions to reduce transmission). This presentation will focus on the Good, the Bad and the Ugly of COVID research and consider what we can learn for future global challenges.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Recognise the evidentiary needs of societies when dealing with global challenges such as the COVID-19 pandemic;
  • Identify examples of good research practices that have led to rapid scientific advances; and
  • Discuss opportunities to improve the research response during future global challenges.

 

Dr. Jeremy Grimshaw

Dr. Jeremy Grimshaw received a MBChB (MD equivalent) from the University of Edinburgh, UK. He trained as a family physician prior to undertaking a PhD in health services research at the University of Aberdeen. He moved to Canada in 2002. His research focuses on the evaluation of interventions to disseminate and implement evidence-based practice. Dr. Grimshaw is a Senior Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute, a Full Professor in the Department of Medicine, University of Ottawa and a Tier 1 Canada Research Chair in Health Knowledge Transfer and Uptake. He is a Fellow of the Canadian Academy of Health Sciences and a Corresponding Fellow of the Royal College of Edinburgh. He has been awarded the CIHR Knowledge Translation award twice and the 2018 CIHR Barer-Flood career achievement award for Health Services and Policy Research. He has over 630 peer-reviewed publications. During the COVID pandemic he has been involved in the establishment of and co-leads COVID-END and the Coalition for Behavioral and Social Preparedness for Pandemics.

1400 - 1415
1415 - 1500

Plenary Session

Big Data for the Lung Specialist

Dr. Andrea Gershon, Sunnybrook Health Sciences Centre, University of Toronto, ICES, Toronto, ON
Dr. Jesse Lu, Adult Respirology Program, Postgraduate Medical Education, University of Toronto, Toronto, ON

Artificial intelligence (AI) has the potential to change the delivery of healthcare. It builds on technology such as decision support and machine learning. This presentation will review what these terms mean, discuss the promise of AI, point out its limitations, and present what new innovative work is happening with big data in lung health today.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Discuss what artificial intelligence and machine learning are;
  • Understand the potential of AI in healthcare; and
  • Understand the limitations of machine learning and big data in respirology.

CanMEDS Competencies addressed:
Scholar

Dr. Andrea Gershon

Dr. Andrea Gershon is an Associate Professor at the University of Toronto, Scientist and Respirologist at the Sunnybrook Health Sciences Centre and a Canadian Institutes for Health Research Investigator. Her award-winning research investigates health outcomes, health services, and drug safety and effectiveness in individuals with respiratory disease. Her research and knowledge translation program uses ‘Big Data’ to learn from the real-world experiences of people with lung disease, with a focus on vulnerable groups. She has published over 160 peer-reviewed articles and her findings inform clinical care, government and non-profit organizations.

Dr. Jesse Lu
Dr. Jesse Lu

Dr. Jesse Lu is currently a PGY-5 Respirology resident at the University of Toronto. She is also a computer scientist interested in clinical applications of machine learning algorithms and knowledge representation of healthcare big data.

1500 - 1530
1530 - 1700

Concurrent Sessions

CTS Guidelines: Year in Review

1530 – 1615

2021 Asthma Guideline Update: What’s New in the Management of “Very Mild” and “Mild” Asthma

Dr. Connie Yang, BC Children’s Hospital, Vancouver, BC

This presentation will review the latest CTS Guideline on the Management of Very Mild and Mild Asthma in Children and Adults. It will discuss the recommendations involving ICS-formoterol as needed, ICS-short acting beta agonist as needed and short courses of inhaled corticosteroids. It will compare the CTS recommendations to other recent guidelines and strategies.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the evidence for ICS-formoterol PRN versus SABA in very mild asthma;
  • Understand the evidence for ICS-formoterol PRN versus daily inhaled corticosteroids in mild asthma; and
  • Understand the rationale for recommendations involving ICS-short acting beta agonist and short courses of inhaled corticosteroids.

CanMEDs Competencies addressed:
Collaborator, Health Advocate, Medical Expert, Scholar

Dr. Connie Yang

Dr. Connie Yang is a pediatric respirologist at BC Children’s Hospital in Vancouver where she is the director of the Pediatric Asthma Program. She is currently the co-chair of the Asthma Assembly and led the development of the latest CTS Asthma Guideline on the Management of Very Mild and Mild Asthma. She is also the president of the Respiratory Health section of the Canadian Pediatric Society where she helps disseminate unified information on pediatric respiratory health topics.

1615 – 1700

Long-Term Non-invasive Ventilation in Patients with COPD

Dr. Marta Kaminska, McGill University Health Centre, Montréal, QC
Dr. François Maltais, Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval, Québec, QC

During this presentation, we will first discuss the current (2011) Canadian recommendation regarding the use of home mechanical ventilation in patients with stable COPD. We will then review the recent literature concerning the use of home mechanical ventilation in patients with stable COPD and present the new Canadian recommendations for the use of home mechanical ventilation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the expected benefits of home mechanical ventilation in stable COPD;
  • Describe the 2021 Canadian recommendations for the use of home mechanical ventilation in stable COPD; and
  • Describe how to prescribe and adjust home mechanical ventilation in stable COPD.

CanMEDs Competencies Addressed:
Health Advocate, Medical Expert, Scholar

Dr. Marta Kaminska

Dr. Marta Kaminska is an Associate Professor and a sleep-trained pulmonologist in the Respiratory Division of the McGill University Health Centre (MUHC). She is a Scientist at the Research Institute of the MUHC and member of the Respiratory Epidemiology and Clinical Research Unit. She is a Medical Director of the Quebec National Program for Home Ventilatory Assistance. Her research interests are sleep-disordered breathing in neurodegenerative disorders, neuromuscular disorders and COPD, as well as long-term non-invasive ventilation.

Dr. Francois Maltais

Dr. François Maltais is a pulmonologist at the Institut universitaire de cardiologie et de pneumologie de Québec where he is the current chief of the pulmonary and thoracic surgery department. He is a professor at the Faculté de médecine at Université Laval, and in 2009, he became the research chair on COPD at the same university. His major interests include the physiopathology of exercise intolerance in chronic obstructive pulmonary disease (COPD) and pulmonary rehabilitation. His research, which is supported by the Canadian Institutes of Health Research (CIHR), Canada’s premier funding agency for health research, is focused on understanding the mechanism of limb muscle dysfunction in COPD. In 2006, he won the Romain Pauwels Award and in 2016, the COPD Gold Medal, both given by the European Respiratory Society in recognition of his outstanding contribution to the field of COPD. Dr. Maltais has authored or co-authored 300 scientific publications, and he regularly speaks at international conferences.

Remote Assessment for Respiratory Management

1530 – 1600

Role of Automated Closed Loop Oxygen Administration

Dr. François Lellouche, Université Laval, Québec, QC

Automated oxygen titration, weaning and monitoring (FreeO2) allows oxygen management in spontaneously breathing patients receiving oxygen with nasal cannula, oxygen mask, nasal high flow, CPAP or NIV. Liberal oxygen therapy has been shown to increase mortality. Recent meta-analyses and guidelines underline the necessity to accurately titrate oxygen to avoid both hypoxemia and hyperoxemia. Studies conducted in hypoxemic (pneumonia, COVID-19, adult or pediatric patients) or hypercapnic patients (acute exacerbations of COPD) demonstrated that in comparison with manual titration, FreeO2 increased the time in the oxygenation target, reduced the episodes of hypoxemia and hyperoxemia, and decreased the duration of oxygen therapy and hospital length of stay. In addition, a continuous and remote monitoring of cardio-respiratory parameters and new scores (EWS.O2 Early Warning Score-O2) is possible to detect early worsening of patients’ clinical condition. Remote monitoring at home is a new strategy evaluated in patients with COPD exacerbation with this device (FreeDom strategy).

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the objectives of automated oxygen therapy;
  • Know the indications of automated oxygen therapy and practical solutions; and
  • Know the principles of remote and automated oxygen monitoring.
Dr. François Lellouche

Dr. François Lellouche is critical care physician at the Institut universitaire de cardiologie et de pneumologie de Québec and associate professor at the Faculté de médecine at Université Laval. His research interests include humidification of gas during mechanical ventilation, non-invasive mechanical ventilation, high-flow oxygen therapy and new modes of mechanical ventilation, focusing on automated modes of respiratory support and closed-loop oxygen supplementation. He conducts bench studies at the research centre of the Institut universitaire de cardiologie et de pneumologie de Québec, physiological studies focusing on breathing physiology and clinical trials to evaluate the clinical impact based on preliminary studies. His laboratory develops several innovative devices in the field of respiratory and oxygen support, including the FreeO2 device, a new breakthrough closed-loop device that titrates oxygen flow based on patient needs. He co-founded the Oxynov company that manufactures and commercializes the FreeO2 device in Europe and Canada. He is currently PI of several studies focusing on COVID-19 management including a CIHR-funded multicentric study on automated oxygen titration to reduce healthcare worker interventions and a pilot study on new COVID treatments.

1600 – 1630

Home Lung Function Monitoring: Where Are We Now and Where Are We Going?

Dr. Ron Dandurand, McGill University, Montréal, QC

This presentation will review currently available technologies for the home monitoring of lung function including peak flow rates, spirometry and lung mechanics. A historical perspective, current practices, technologies in development both in Canada and abroad, and the impact of the COVID-19 pandemic on home monitoring will be discussed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Educate their patients about home lung function monitoring;
  • Deploy home monitoring of lung function in their practice; and
  • Reduce in-person patient office visits.

CanMEDs Competencies addressed:
Collaborator, Communicator, Scholar

Dr. Ron Dandurand

Dr. Ron Dandurand is a full-time community-based practitioner and Director of Respiratory Medicine at the Lakeshore General Hospital, and a McGill University Assistant Professor affiliated with the Montreal Chest Institute. He is Director of the Oscillometry Unit at the Centre for Innovative Medicine and a Research Associate at the Meakins-Christie Labs of the McGill University Health Centre Research Institute. His research interests include oscillation mechanics, quantitative CT scanning, and alpha-1 antitrypsin deficiency. He is also Chair of the Technologies Working Group of the Cambridge, U.K., based Respiratory Effectiveness Group, Chair of the Oscillometry Harmonisation Project, and President of Spiro-Tech Medical Inc., which develops telemedicine technologies.

1630 - 1700

Outside the Box: Remote Functional Assessment to Support Home Rehabilitation

Dr. Tania Janaudis-Ferreira, McGill University, Montréal, QC

On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. As a consequence, many pulmonary rehabilitation (PR) programs in Canada and around the world have transitioned to remote delivery models. Home-based and tele-PR programs have been shown to be as effective as institution-based PR at improving functional exercise capacity and health-related quality of life; however, the existing trials have rarely described 100% remote delivery, as usually the assessments were conducted in person in order to evaluate safety during exercise and prescribe exercise accurately. However, during the COVID-19 pandemic, in-person assessment of exercise capacity may not be possible. This presentation will provide an overview of functional exercise tests that can be conducted remotely to assess patients participating in a home-based PR program.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • List the functional exercise tests that can be conducted remotely in the context of pulmonary rehabilitation and understand their psychometric properties;
  • Describe the relationship between functional exercise tests and recommended exercise capacity tests for pulmonary rehabilitation; and
  • Recognize how to conduct remote functional exercise testing safely and effectively.

CanMEDs Competencies addressed:
Medical expert, Scholar

Dr. Tania Janaudis-Ferreira

Dr. Tania Janaudis-Ferreira is an Assistant Professor with the School of Physical and Occupational Therapy at McGill University and a Junior Scientist with the Research Institute of the McGill University Health Centre. The overall goal of Dr. Janaudis-Ferreira’s research program is to improve care and rehabilitation outcomes of individuals with chronic lung disease and transplant candidates and recipients.

Epidemiology, Complications and Psychosocial Impact of COVID-19 in Children

1530 – 1600

Epidemiology of SARS-CoV-2 in Children: Results from the Alberta Serology Project

Dr. Piush Mandhane, University of Alberta, Edmonton, AB

The incidence of COVID-19 in children, defined by RT-PCR, is relatively low. Paediatric SARS-CoV-2 seropositivity studies may better estimate a history of COVID-19 in children and thus facilitate understanding of transmission risk factors. We present the interim results from the Alberta Serology project examining predictors of being likely seropositive, mask use in children, and duration of seropositivity in children after having COVID-19.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Recognize factors associated with seropositivity in school-age children;
  • Review the epidemiology of mask use in children; and
  • Describe duration of seropositivity in children after having COVID-19.

CanMEDs Competencies addressed:
Collaborator, Medical Expert

Dr. Piush Mandhane

Dr. Piush Mandhane is an Associate Professor in the Faculty of Medicine & Dentistry, Department of Pediatrics, at the University of Alberta. His research focuses on pediatric health, child development, and epidemiology. Dr. Mandhane is the principal investigator of the Alberta-government-funded project examining SARS-CoV-2 seroprevalence in school-age children in Alberta. He is also one of the five principal investigators for the CHILD cohort study and the CHILD study Edmonton site lead.

1600 – 1630

Pediatric Inflammatory Multisystem Syndrome (PIMS)

Dr. Rosie Scuccimarri, McGill University, Montréal, QC

With the worldwide COVID-19 pandemic, a “new” multisystem inflammatory syndrome was recognized in children. The Pediatric Inflammatory Multisystem Syndrome (PIMS) resembles Kawasaki disease. Is it the same disease? What are the differences described between these diseases? How can we identify these children? How should we manage these patients? These are a few of the questions to be answered at this presentation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the Pediatric Inflammatory Multisystem Syndrome associated with COVID-19; and
  • Integrate a management approach for caring for children with PIMS.

CanMEDs Competencies addressed:
Collaborator, Medical Expert

Dr. Rosie Scuccimarri

Dr. Rosie Scuccimarri is a Pediatric Rheumatologist at the Montreal Children’s Hospital and an Associate Professor in the Department of Pediatrics of McGill University. She was the Pediatric Rheumatology Residency program director from 2011 to 2018. Her research interests include Kawasaki disease and pediatric rheumatology global health. She is currently the chair of the Therapeutics Committee of the Canadian Rheumatology Association and previously served as board member and chair of the Pediatric Committee.

1630 – 1700

Psychosocial Impact of the COVID-19 Pandemic on Canadian Children in the CHILD Cohort Study

Dr. Meghan Azad, University of Manitoba, Winnipeg, MB

Children and families are facing major challenges during the COVID-19 pandemic related to social distancing measures and school closures. We are leveraging the ongoing CHILD Cohort Study, which has been following 3,500 families across 4 Canadian provinces for the past decade, to investigate these challenges, including a focus on mental health and well-being. By comparing new questionnaire data to pre-pandemic CHILD data, we can identify children and parents experiencing a decline in mental health and socioeconomic status, and investigate factors that may predict risk for, or resilience against, these negative impacts. This research will provide critical real-time data to support forecasting models and inform policy-making in an equitable and resource-effective manner.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the psychosocial impacts of the COVID-19 pandemic and its management on CHILD cohort study children;
  • Identify factors that predict risk for, or resilience against, the psychosocial impacts of the pandemic; and
  • Recognize the critical role of longitudinal cohort studies in studying the psychosocial impact of the pandemic.

CanMEDs Competencies addressed:
Communicator, Health Advocate, Leader, Medical Expert, Scholar

Dr. Meghan Azad

Dr. Meghan Azad is an Associate Professor of Pediatrics and Child Health at the University of Manitoba and holds a Canada Research Chair in Developmental Origins of Chronic Disease. She leads a dynamic team that studies infant nutrition and the microbiome (www.azadlab.ca). Dr. Azad co-leads the Manitoba site of the CHILD Cohort Study (www.childstudy.ca), following 3,500 Canadian children to understand the developmental origins of health and disease and is leveraging this study to investigate COVID-19 impacts on these children. She was recognized among Canada’s Top 100 Most Powerful Women by the Women’s Executive Network in 2020.

1530 – 1700

CTS-CHEST Conjoint Session: Don’t Forget Sepsis: Why It’s Relevant in a Viral Pandemic

Dr. Steven Q Simpson, President, CHEST – The American College of Chest Physicians, Kansas City, KS, USA

While the world’s attention has been occupied by COVID-19 for the past year, sepsis other than that caused by COVID-19 has continued to kill patients on approximately the same order of magnitude – just as it does every year. We’ll talk about why sepsis deserves more focused attention, how it relates to COVID-19, and what moves can be made to improve its high death toll and long term consequences.

Learning Objectives

At the end of this presentation, attendees will be able to:

  • Identify COVID-19 as sepsis
  • Have a framework for understand a global approach to sepsis
  • Diagnose sepsis and intervene earlier and better

CanMEDs Competencies Addressed:
Medical Expert, Health Advocate, Leader, Professional

Dr. Steven Simpson

Dr. Steven Simpson is a Professor of Medicine at the University of Kansas, in Kansas City, KS. He is the President of the American College of Chest Physicians (CHEST). Dr. Simpson has a long history of work in sepsis research and quality improvement, with projects ranging from cell biology and physiology to translational work to quality improvement and implementation science. He currently serves as a Senior Advisor and IPA to the US Dept. of Health and Human Services in BARDA’s Division of Research, Innovation, and Ventures. He is also the Senior Medical Advisor to Sepsis Alliance, the US’ largest patient advocacy organization for sepsis survivors and families of sepsis victims. Dr. Simpson serves on the Surviving Sepsis Campaign guidelines panel and the National Institute on Allergy and Infectious Disease’s COVID-19 guidelines panel.

 

Section 3

Cardiopulmonary Exercise Testing (CPET) Workshop

1530 – 1600

The Methodology and Interpretation of Inspiratory Capacity Manoeuvres and Flow Volume Loops during CPET

Dr. Jordan A. Guenette, University of British Columbia, Vancouver, BC

Inspiratory capacity manoeuvres and flow volume loops are increasingly being used to characterize ventilatory limitations during cardiopulmonary exercise testing (CPET). Accurately measuring inspiratory capacity is essential when examining dynamic hyperinflation and if using flow volume loops to measure expiratory flow limitation and other ventilatory abnormalities during exercise. This presentation will discuss key methodological factors to maximize the accuracy of these measurements and to ensure correct CPET interpretation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Determine how to accurately measure, analyze and interpret inspiratory capacity manoeuvres during CPET; and
  • Critically evaluate the factors involved in generating exercise flow volume loops and determine how key errors can affect your interpretation.

CanMEDs Competencies addressed:
Scholar

Dr. Jordan Guenette

Dr. Jordan A. Guenette is an Associate Professor in the Faculty of Medicine at the University of British Columbia and is the Associate Director of the Centre for Heart Lung Innovation at St. Paul’s Hospital. His research program examines the mechanisms and management of exercise intolerance and dyspnoea in athletes and patients with chronic cardiopulmonary conditions.

1600 – 1630

Exposing Critical Ventilatory Constraints during CPET: Case Studies

Dr. Denis O’Donnell, Queen’s University, Kingston, ON

Cardiopulmonary exercise testing is often performed to explore mechanisms of dyspnea and exercise limitation in individual patients presenting with these symptoms. Abnormalities in ventilatory mechanics often contribute to these symptoms and can be exposed by the stress of exercise even when resting pulmonary function tests are normal. This presentation will outline the main measurements of dynamic ventilatory mechanics based on ventilatory responses, breathing pattern, operating lung volumes, and flow volume loop analysis during incremental exercise testing. A number of case studies will be presented to illustrate how this simple approach can provide useful clinical information on the dynamic mechanical constraints on ventilation that might exist in symptomatic patients. The main objective is to enlighten the interpreter as to the major physiological contributors to exercise intolerance in individual patients.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the value of operating lung volumes, breathing pattern, flow volume loops, and dyspnea ratings in non-invasive assessments of respiratory mechanics during exercise;
  • Understand the connections between abnormalities of ventilatory mechanics during exercise, exercise limitation and intolerable symptoms; and
  • Know how this approach allows refinement in the clinical evaluation of symptomatic patients with pulmonary disease beyond traditional resting pulmonary function tests.

CanMEDs Competencies addressed:
Leader

Dr. Denis O’Donnell

Dr. Denis O’Donnell is a Professor of Medicine at Queen’s University, Kingston, Ontario. His research is focused on clinical integrative physiology in chronic lung diseases, including the physiological mechanisms of dyspnea and exercise limitation. At Queen’s, he assembled a highly productive research team, which has been successful over the past 30 years, contributing more than 360 papers and 50 chapters to date. The Respiratory Investigation Unit at Queen’s enjoys international recognition for scientific excellence and training in clinical physiology. Dr. O’Donnell has received numerous national and international awards, including the Lifetime Achievement Award from the European Respiratory Society in 2019, in recognition of his contribution to research and education in respiratory diseases.

1630 – 1700

Clinical Usefulness of Exercise Ventilatory Inefficiency: Case Studies

Dr. J. Alberto Neder, Queen’s University, Kingston, ON

In this session, Dr. Neder will present selected cases in which the relationship between ventilation and carbon dioxide output during incremental exercise provided unique insights into the mechanisms and consequences of exertional dyspnea in different clinical scenarios.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the physiological basis of ventilatory efficiency;
  • Recognize the different metrics of ventilatory efficiency and their potential to provide complementary information; and
  • Integrate measurements of ventilatory efficiency with other key CPET variables to maximize the yield of the test in answering clinically relevant questions.

CanMEDs Competencies addressed:
Medical Expert, Scholar

Dr. Alberto Neder

Dr. J. Alberto Neder is a Professor at the Division of Respirology, Department of Medicine, at Queen’s University in Kingston, Ontario. He is a clinician-scientist with a specific interest in clinical respiratory physiology applied to chronic cardiopulmonary diseases. Dr. Neder has authored over 200 peer-reviewed papers and several books and book chapters on respiratory and exercise physiology, pulmonary rehabilitation and integrated care in chronic respiratory diseases. He currently heads the Laboratory of Clinical Exercise Physiology at Kingston General Hospital and the Hotel Dieu Hospital’s Pulmonary Function Tests Laboratory.

1700 - 1800
1800 - 2000

Co-Developed Symposia

1800 - 1900

Optimizing Patient Outcomes through Accurate Identification of the PF-ILD Patient

Presenter: Dr. Nathan Hambly
Moderator: Dr. Kerri Johannson

Fibrotic interstitial lung diseases (ILD) are a spectrum of lung disorders characterized by parenchymal fibrosis. Fibrosis represents a final common pathway for conditions that can originate through distinct pathophysiological mechanisms including autoimmunity, granulomatous inflammation, organic and inorganic dust exposure, and other injurious insults. An important subset of patients with fibrotic ILD experience progressive clinical, physiological, and radiographic decline, with an associated reduced quality of life and long-term survival despite conventional therapies. Idiopathic pulmonary fibrosis (IPF) is the prototypical fibrotic ILD, however, other ILD subtypes behave comparatively.  During this presentation we will describe the PF-ILD phenotype and the implications its identification have on clinical management.

At the end of this presentation, attendees will be able to:

  • Describe the PF-ILD phenotype and identify progression in patients with Interstitial Lung Disease; and
  • Identify which ILD patient has the PF-ILD phenotype in clinical practice and understand appropriate treatment options.


CanMEDs Competencies Addressed

Collaborator, Leader, Medical Expert, Scholar

This session is co-developed by the Canadian Thoracic Society and Boehringer Ingelheim and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Nathan Hambly

Dr. Nathan Hambly earned his medical degree at the University of Ottawa (2009) and completed residency training at McMaster University. Thereafter he fulfilled clinical fellowships in pulmonary hypertension and interstitial lung disease at McMaster University, University of Toronto and Royal Brompton Hospital in London, United Kingdom. Dr. Hambly is the Director of the Firestone Institute Pulmonary Hypertension Program, Director of the ILD Fellowship training program at McMaster, and works as a consultant respirologist at St. Joseph’s Healthcare Hamilton. His clinical interests include pulmonary hypertension, interstitial lung disease, and sarcoidosis.

 

1900 - 2000

Redefining OCS Use in 2021: Evidence to Support Why & How We Aim for Zero

Presenter: Dr. Louis-Phillipe Boulet, Laval University, Quebec, QC
Moderator: Dr. Krystelle Godbout, Laval University, Quebec, QC

This presentation will review the current literature on clinical and metabolic consequences of frequent or continuous oral corticosteroid use (OCS) in asthma. Methods to avoid the use of OCS and/or minimize their untoward effects will be discussed. Strategies/methods for weaning OCS (procedure and monitoring) in severe asthmatic patients will be reported, including recent studies specifically on how this can be safely done in real-world.  Finally, sustainability of treatment effect post taper in severe eosinophilic asthma patients will be discussed.

Learning Objectives
At the end of the presentation, attendees will be able to:

  • Understand the clinical and metabolic consequences of frequent or continuous OCS use
  • Describe how to avoid OCS or minimize their use
  • Assess how to proceed with OCS withdrawal
  • Describe a real world perspective on how to conduct such OCS reduction safely
  • Understand sustainability of treatment effect post taper in severe eosinophilic asthma patients


CanMEDs Competencies Addressed

Medical Expert, Professional, Scholar

 

This session is co-developed by the Canadian Thoracic Society and AstraZeneca and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Louis-Philippe Boulet

Dr. Louis-Philippe Boulet is a respirologist at the Institut de cardiologie et de pneumologie de Québec (Quebec Heart and Lung Institute). He is a professor of medicine at Laval University, where he holds a chair in knowledge translation education and prevention in respiratory and cardiorespiratory health. He is a past president of the Canadian Thoracic Society (CTS), is the current chair of the Board of Directors of the Global Initiative for Asthma (GINA), and president of InterAsma, the Global Asthma Association. He has written more than 650 medical publications, including 410 peer-reviewed manuscripts, 43 book chapters and edited/authored 17 medical books.

Co-Developed Symposium

945 - 1045

Implications of the Effective Clinical and Practical use of FeNO in Canadian Practice?

Presenter: Dr. Del Dorscheid, University of British Columbia, Vancouver, BC
Moderator: Dr. Celine Bergeron, University of British Columbia, Vancouver, BC

The use of FeNO to monitor and/or assess “allergic inflammation” in the asthmatic population has not been fully embraced by respiratory practitioners nor supported by the consensus guidelines. Much of this was contributed to by variations in technology of the devices, variability in the results when applied to the entire population of “asthmatics” and a lack of translatable knowledge regarding whom would this benefit with respect to clinical outcomes. With a broader range of available therapeutic options the use of FeNO to identify personalized treatment plans needs to be revisited.

 Learning Objectives
At the end of this presentation, attendees will be able to:

  • Discuss the most up-to-date scientific and clinical evidence supporting the use of fractional exhaled nitric oxide (FeNO) as a biomarker to manage asthma and
  • Debate its utility in Canadian practice with the introduction of biologics.


CanMEDs Competencies Addressed:
Health Advocate, Leader, Medical Expert, Professional, Scholar

 

This session is co-developed by the Canadian Thoracic Society and Sanofi Genzyme and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Del Dorscheid

Dr Del Dorscheid obtained his MD and PhD degrees from McGill University in 1993. He moved onto the University of Chicago for Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine. He has now been at UBC since 2000 and is a tenured Associate Professor. Dr. Dorscheid attends in the medical intensive care unit at St. Pauls, is Director of the Severe Asthma Clinic and is a researcher in the UBC Center for Heart Lung Innovation. As a physician-scientist, he leads an active research group investigating the role of the airway epithelium in inflammatory airways disease that results from inappropriate injury-inflammation-repair cycles. Specific projects include the study of IL-13 in airway repair and the expression/function or the epithelium as an immune barrier. The goal for his research program is to promote and translate research findings into new treatments and improved patient care to reduce the burden of respiratory diseases.

 

1000 - 1100
1100 - 1200

Plenary Session

CIHR-ICRH/CTS Distinguished Lecture in Respiratory Sciences: COPD in the Era of Precision Health

Dr. Don D. Sin, University of British Columbia, Vancouver, BC

The ICRH and CTS established the Distinguished Lecture in Respiratory Sciences Award in 2006 to honour scholars in the respiratory field. Nominations are solicited from the respiratory research community and assessed against the following criteria:

  • impact of the nominee’s research on respiratory sciences in Canada and the extent to which the nominee has contributed significantly to the advancement of respiratory sciences in Canada over the last ten years;
  • relevance/application/impact of nominee’s research to a clinical setting; and
  • demonstrated strength and reputation of the nominee in the field of respiratory sciences in Canada.

It is with great pleasure that CIHR-ICRH and CTS announce that the 2020 Distinguished Lecture in Respiratory Sciences has been awarded to Dr. Don Sin from the University of British Columbia.

Session Description
Although there is a dearth of disease-modifying therapies for COPD currently, the omics technology, coupled with incredible improvements in in vivo phenotyping abilities, is poised to revolutionize the assessment and management of patients with COPD. These tools can accurately characterize patients and enable development of “personalized” treatment of patients. This talk will provide some examples of where COPD treatment has already moved from the “average” patient to the “individual” patient and discuss future strategies to accelerate precision health for millions of Canadians affected by this disease.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Define precision health in COPD;
  • Cite specific examples of “precision health” technologies/treatments in COPD; and
  • Describe the role of biomarkers in enabling precision health.

CanMEDs Competencies addressed:
Collaborator, Leader, Medical Expert, Scholar

Dr. Don Sin

Dr. Don D. Sin is the Director of the Centre for Heart Lung Innovation (HLI) and a Professor of Medicine at the University of British Columbia (UBC) in Vancouver, Canada. He holds a Tier 1 Canada Research Chair in COPD and the De Lazzari Family Chair at HLI. He has published more than 500 peer-reviewed papers and has an H-index of 90. He has served on the Global initiative for Chronic Obstructive Lung Disease (GOLD) scientific committee since 2009 and is the Section Editor for the European Respiratory Journal and an editorial board member of the American Journal of Respiratory and Critical Care Medicine. He obtained his medical degree at the University of Alberta and completed his postdoctoral research fellowship at the University of Toronto. His research focus is using “omics” data to discover novel biomarkers of disease activity and new therapeutic targets to reduce hospitalization and mortality in patients with COPD.

1200 - 1245
1245 - 1345

Concurrent Sessions

Career Pathways and Physician Wellness

1245 – 1305

Physician Wellness: Staying Healthy, Coping Strategies and Resilience

Dr. Joy Albuquerque, Ontario Medical Association, Toronto, ON

Burnout is a serious issue in healthcare impacting all members of the healthcare team and has received even more concern with the COVID-19 pandemic. This presentation will review the syndrome of burnout in the context of physician health including some reflections on what we have learned from the pandemic. The impact of burnout on physicians correlates with personal and professional outcomes. Burnout is seen increasingly as a systems issue, a cultural issue associated with transformative changes in the delivery of healthcare, organizational strains and rising professional expectations. Yet there is reason to be optimistic for change, which includes wellness programs and initiatives to address engagement and satisfaction of healthcare providers while improving the bottom line, patient care. The hope is that participants will become more aware of personal stressors that may impact their health and well-being and be encouraged to use tools and consider skills discussed in this session.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify drivers of physician burnout and potential consequences;
  • Differentiate between the responsibilities of the healthcare system and those of the individual with regard to burnout; and
  • List several factors relevant to a personal resiliency strategy.

CanMEDs Competencies addressed:
Health Advocate, Professional

Dr. Joy Albuquerque

Dr. Joy Albuquerque is the Medical Director of the Ontario Medical Association’s physician health program. She completed her medical training in Manitoba, psychiatric training in Ottawa (1997) and, with an interest in mental health advocacy, a Master’s in philosophy (2007). Dr. Albuquerque’s role has evolved beyond the management of mental health conditions to expertise in the risk management of physicians and their work. She contributes regularly to medical education events and publications on topics related to physician health. Dr. Albuquerque practices at St. Michael’s Hospital and is an Assistant Professor at the University of Toronto.

1305 – 1345

Community vs. Academia: What’s the Right Path for You?

Dr. M. Diane Lougheed, Queen’s University, Kingston, ON
Dr. Heather Racz, St. Mary’s General Hospital, Kitchener, ON and London Health Sciences Centre, London, ON

Navigating career decisions can be challenging. Targeted at respirology fellows and staff respirologists, this session focuses on high-impact strategies to manage your professional journey. Build a tool kit of resources, including mentors and advisors, who are right for you. Learn from an academic respirologist, a community respirologist and a physician wellness psychiatrist who have taken different professional pathways, including their decision criteria, the risks and the opportunities. The panel will invite audience participation with questions about their own career decisions.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the differences between academic- and community-based respirology practices;
  • Explore Practical Aspects of academic promotion and starting a practice; and
  • Learn how to stay up to date and build research into their practice.

CanMEDs Competencies addressed:
Collaborator, Communicator, Health Advocate, Leader, Professional, Scholar

Dr. Diane Lougheed

Dr. M. Diane Lougheed is a Professor of Medicine, Biomedical and Molecular Sciences and Public Health Sciences, and Chair of the Division of Respirology at Queen’s University. She is the Director of the Kingston Health Sciences Centre Asthma Program and Research Unit. Dr. Lougheed obtained her medical degree from McMaster University where she also completed her Internal Medicine residency. She completed her Respirology fellowship and obtained a Master’s degree in Epidemiology at Queen’s University. Dr. Lougheed has authored over 80 peer-reviewed publications and 2 book chapters. Her research interests include asthma symptom perception, asthma epidemiology, work-related asthma and guidelines implementation.

Dr. Heather Racz

Dr. Heather Racz completed fellowships in both adult cystic fibrosis and sleep medicine. She is a community-based respirologist who splits her time between her respirology practice in Kitchener-Waterloo and the London Health Sciences Centre where she works in both the Adult CF Program and the Sleep Medicine Program.

Interdisciplinary Management of COVID-19 Patients

1245 – 1315

Proning and Oxygen Escalation in Critical Care

Elizabeth Rohrs, Simon Fraser University, Burnaby, BC

COVID-19 pneumonia is a specific disease in which severe hypoxemia manifests with normal respiratory system compliance, a combination almost never seen in ARDS. The use of prone positioning has become the recommended method of ARDS management and increasingly in the treatment of COVID-19 patients. The physiological mechanisms causing respiratory function improvement with the change from supine to prone position are not yet fully understood. The main physiological aims of prone positioning are to improve oxygenation and respiratory mechanics, to homogenise the pleural pressure gradient and ventilation distribution, to increase lung volume by reducing the amount of atelectatic regions, and to reduce ventilator-associated lung injury. This presentation will describe the escalation of treatment of oxygen therapy to proning in COVID-19 patients, with a focus on current findings and recommendations.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand how COVID-19 is different from ARDS and what that means for treatment and support;
  • Understand the current recommendations around treatment of COVID-19 hypoxia; and
  • Understand why proning has positive effects.
Ms. Elizabeth Rohrs

Elizabeth Rohrs is a respiratory therapist who has worked clinically during COVID-19, seeing first-hand how challenging and unusual these patients were to ventilate. She is conducting research on the effects of proning in COVID-19 patients. She has spent eight years helping to develop and refine a long-term pre-clinical ventilation model and lead a multidisciplinary team that conducts long-term ventilation studies. She is completing a PhD thesis evaluating how atelectasis contributed to ventilator-induced lung injury and the effects of diaphragm pacing on lung injury over 50 hours in this pre-clinical model.

1315 – 1345

Action Stat! Deterioration of the Acutely Ill COVID-19 Patient in Hospital

Teddie Tanguay, Royal Alexandra Hospital, Edmonton, AB

As healthcare professionals, COVID-19 is a new and emerging virus that we continue to learn more about each and every day. While guidelines for the care of COVID-19 patients are continually being updated to reflect the latest evidence, it is important that staff working with these patients are aware of signs and symptoms that can indicate impending trouble. This presentation identifies the evolving but most recent information about COVID-19. Signs and symptoms of a deteriorating COVID-19 patient will be described, including the most recent evidence to support oxygenation and ventilation of hospitalized patients. The risks and benefits of awake-proning of hypoxic COVID-19 patients will also be discussed, including how to assist staff in safely implementing awake-proning in the wards and units.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the clinical presentation of COVID-19 patients requiring hospitalization;
  • Identify signs and symptoms of deterioration that require immediate intervention; and
  • Explain current best-practice strategies to optimize oxygenation and ventilation in COVID-19 patients, including awake-proning.

CanMEDs Competencies addressed:
Collaborator, Communicator, Leader, Professional

Teddie Tanguay

Teddie Tanguay, RN, MN, NP, CCNC(C), has worked in Critical Care in a variety of roles and is currently Nurse Practitioner in the adult Intensive Care Unit at the Royal Alexandra Hospital. She received both her Bachelor of Science and Master of Nursing from the University of Alberta with distinction. She is actively involved with the Canadian Association of Critical Care Nurses. She has spoken at many local and national Critical Care conferences. She also holds a Clinical Associate with the University of Alberta Faculty of Nursing, providing OSCE simulation and clinical mentorship for NP students.

Section 3

Pediatric Clinical Cases

1245 – 1315

A Case of Acute Hypoxemia – or Is It Chronic?

Dr. Dhenuka Radhakrishnan, Children’s Hospital of Eastern Ontario, Ottawa, ON

This session will describe an adolescent with incidentally noted acute hypoxemia. Causes of hypoxemia, a diagnostic algorithm and the final diagnosis will be discussed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify common and rare causes of hypoxemia in adolescents; and
  • Use a systematic approach to confirm the cause of hypoxemia in adolescents.

CanMEDs Competencies addressed:
Collaborator, Medical Expert

Dr. Dhenuka Radhakrishnan

Dr. Dhenuka Radhakrishnan is a pediatric respirologist and Director of the Asthma Program at the Children’s Hospital of Eastern Ontario and Assistant Professor in the Department of Pediatrics at the University of Ottawa. Her clinical interests include the care of children with airways diseases including asthma and cystic fibrosis. She is an advocate for lung health in children and has participated extensively in projects through the Lung Association in Ontario and at the Canadian Thoracic Society. She is the co-chair of the Health Quality Ontario Asthma Quality Standards Committee and sits on the Asthma Assembly at the CTS. Her research involves the use of health administrative data at ICES to investigate outcomes and healthcare delivery to children with asthma and other respiratory diseases.

1315 – 1345

Code Blue in the Pulmonary Function Testing Lab

Dr. Sophie Laberge, Centre hospitalier universitaire Sainte-Justine, Montréal, QC

This session will present a case of acute pneumothorax in a 16-year-old boy with past history of hemoptysis. Literature review in the field will be presented in an interactive manner with the participants.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Recognize the genetic contribution of spontaneous pneumothorax; and
  • Discuss the management recommendations specific to rare causes of pneumothorax.
Dr. Sophie Laberge

Dr. Sophie Laberge is a pediatricrespirologist at CHU Sainte-Justine and an associate professor in the Department of Pediatrics of the Université de Montréal. Following her clinical training in pediatric respirology, she completed a research fellowship at McGill University and at Boston University. She participated in various research projects in the field of asthma and pharmacogenomics. Her clinical interest comprises asthma, respiratory complications of esophageal atresia and sleepmedicine. She is the director of the Paediatric Respiratory Division at CHU Sainte-Justine.

1245 – 1345

CTS – American Thoracic Society (ATS) Conjoint Session: Diffuse Cystic Lung Disease

Dr. Gregory Downey, National Jewish Health, Denver, CO, USA

This presentation will begin with a series of clinical cases that represent actual clinical scenarios of patients who have presented for evaluation of diffuse cystic lung disease. It will include high-resolution chest CT images and a discussion of the differential diagnosis. A more detailed mechanistic discussion of selected diffuse cystic lung diseases will be provided including lymphangioleiomyomatosis (LAM), Birt Hogg Dubé Syndrome, lymphocytic interstitial pneumonitis (LIP), and Langerhans’ cell histiocytosis (LCH). A discussion of the genetic basis of specific diffuse cystic lung diseases and current treatment recommendations, where available, will be provided. Finally, a diagnostic algorithm that represents a logical approach to the differential diagnosis of diffuse cystic lung disease will be discussed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Review the diverse clinical presentations of patients with cystic lung disease;
  • Learn about the latest information on the genetic basis of cystic lung disease and the use of molecular diagnostic testing; and
  • Learn about an algorithmic clinical, radiological, and genetic analysis approach to patients with cystic lung disease.

CanMEDs Competencies addressed:
Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Gregory Downey

Dr. Gregory Downey began his career at the University of Toronto and rose through the ranks to become Professor and Director of the Division of Respirology and Vice-Chair of the Department of Medicine. He was awarded a Tier 1 Canada Research Chair in Respiration Sciences. In 2007, Dr. Downey returned to Denver to National Jewish Health, where he previously completed his postdoctoral training, and where he now leads a basic and translational science research laboratory focused on mechanisms of lung injury, repair and fibrosis. He maintains an active practice in general pulmonary medicine and is a member of the ILD and Rare Lung Disease clinic. Dr. Downey’s research program has been funded by the NIH, the Canadian Institutes of Health Research, and the U.S. Department of Defense for over 25 years. He has over 240 publications in top-ranked journals including the New England Journal of Medicine, Science, Science Translational Medicine, Nature Cell Biology, the Journal of Cell Biology, the American Journal of Respiratory and Critical Care Medicine, the Journal of Experimental Medicine, Blood, and the Journal of Immunology, and his work has been cited over 17,000 times by other authors (h-index 72). His contributions to research were recognized by an ATS Award for Scientific Accomplishments in 2010. Dr. Downey is currently Vice President of the American Thoracic Society.

Sleep Apnea in Selected Populations

1245 – 1315

How Your Breathing in Sleep Affects Your Brain: Sleep Apnea and Neurodegenerative Diseases

Dr. Marta Kaminska, McGill University Health Centre, Montréal, QC

With an aging population, neurodegenerative disorders are on the rise and a major burden on individuals and healthcare systems. Sleep disturbances are part of neurodegenerative disorders but are also increasingly recognized as adversely affecting brain health. Obstructive sleep apnea (OSA), which is common in the elderly, appears to be a risk factor for mild cognitive impairment, Alzheimer’s disease and Parkinson’s disease. There are no effective treatments for these disorders, and prevention through treatment of risk factors is currently the main intervention for reducing their incidence. Therefore, how OSA affects brain health and whether its treatment can slow neurodegeneration are highly relevant questions. This session will focus on the aging brain and the link between sleep, OSA and most common neurodegenerative diseases.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe epidemiologic evidence suggesting a link between obstructive sleep apnea (OSA) and neurodegenerative disorders;
  • Explain the proposed mechanisms whereby OSA can predispose to cognitive impairment; and
  • Describe how to prescribe and adjust home mechanical ventilation in stable COPD.

CanMEDs Competencies addressed:
Health Advocate, Medical Expert, Scholar

Dr. Marta Kaminska

Dr. Marta Kaminska is an Associate Professor and a sleep-trained pulmonologist in the Respiratory Division of the McGill University Health Centre (MUHC). She is a Scientist at the Research Institute of the MUHC and member of the Respiratory Epidemiology and Clinical Research Unit. She is a Medical Director of the Quebec National Program for Home Ventilatory Assistance. Her research interests are sleep-disordered breathing in neurodegenerative disorders, neuromuscular disorders and COPD, as well as long-term non-invasive ventilation.

1315 – 1345

Breathing for Two: Specific Considerations of Sleep Apnea in Pregnancy

Dr. Sushmita Pamidi, McGill University Health Centre, Montréal, QC

This presentation will provide an overview of sleep-disordered breathing (SDB) in pregnancy and the latest studies investigating the associations between maternal SDB in pregnancy and adverse maternal and child outcomes.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the prevalence of SDB across the trimesters of pregnancy and its associated risk factors;
  • Summarize the current literature investigating the relationship between SDB in pregnancy and associated maternal and fetal outcomes; and
  • Become aware of the studies investigating the treatment of SDB in pregnancy.

CanMEDs Roles addressed:
Leader, Medical Expert, Scholar

Dr. Sushmita Pamidi

Dr. Sushmita Pamidi is a respirologist and sleep physician and Associate Professor of Medicine at McGill University. She is a clinical scientist with expertise in epidemiology and health outcomes research using observational and clinical trial designs. She completed her medical degree at the University of Toronto, her internal medicine and respirology residency at the University of Western Ontario, and sleep training at the University of Chicago (2009-2011). She came to McGill University in 2011 to do a Master’s in epidemiology and has stayed there since. Dr. Pamidi is the Director of the Respiratory Epidemiology and Clinical Research Unit at McGill and Associate Leader of the Translational Research in Respiratory Diseases Program. Her research program focuses on cardiometabolic disease as it relates to obstructive sleep apnea (OSA) both in the general adult population as well as during pregnancy.

1345 - 1400
1400 - 1530

Concurrent Sessions

Clinical Management and the Impact of COVID-19 on Diagnostic Testing

1400 – 1430

Pulmonary Function Testing in the Era of COVID-19

Dr. Sanja Stanojevic, Dalhousie University, Halifax, NS

Pulmonary function tests (PFTs) are important for the diagnosis, management and monitoring of disease. At the onset of the COVID-19 pandemic, PFT laboratories around the world cancelled services or significantly scaled down services to reduce the potential risk of transmission. However, it was quickly recognized that services needed to urgently resume, and to resume safely. The CTS and CSRT convened a working group to review available evidence and reach a consensus on recommendations for the resumption of services during the post-peak phase of the pandemic. This talk will highlight the considerations of the working group, summarize the rationale for the recommendations, and discuss what the future of PFTs might look like.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the factors that contribute to the potential increased risk of COVID-19 transmission in the PFT laboratory;
  • Describe strategies to reduce the risk of transmission within the PFT laboratory; and
  • Be able to consider the CTS/CSRT recommendations for resumption of PFT services within their local context.
Dr. Sanja Stanojevic

Dr. Sanja Stanojevic is an Assistant Professor in the Department of Community Health and Epidemiology at Dalhousie University, Halifax, Nova Scotia. Her research focuses on epidemiology of respiratory diseases and application of novel statistical methods to improve interpretation of objective measures of lung function. Dr. Stanojevic is Chair of the ERS Global Lung Function Initiative Clinical Research Collaborative and Vice-Chair of the ATS Pulmonary Function Testing Proficiency Committee. She also co-chaired the CTS/CSRT position statement for the Resumption of Pulmonary Function Testing during the post-peak phase of the COVID-19 pandemic.

1430 – 1500

ARDS, Mechanical and Non-invasive Ventilation

Dr. Laurent Brochard, St. Michael’s Hospital, Toronto, ON

Patients with acute respiratory failure related to COVID-19 often present the criteria for ARDS. They however may differ on a number of characteristics, which may modify the management of ventilation. Those specific features include the possible dissociation between the extent of lung injury on the X-ray or as measured by compliance and the degree of hypoxemia, the presence of silent hypoxemia in some patients and an abnormal lung vasculature (observed at autopsy), which may explain shunt not responding to positive pressure. Individualization of therapy is essential. Management with high-flow nasal therapy before intubation is an interesting approach but needs adequate protection. The decision for intubation may be difficult in case of pure hypoxemia and different techniques may help to improve oxygenation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the specific aspects of COVID-19 related to respiratory physiology;
  • Explore the pros and cons of non-invasive techniques versus intubation; and
  • Explain how to individualize mechanical ventilation.
Dr. Laurent Brochard

Dr. Laurent Brochard obtained his MD in Paris, France, in 1986. Since 2014, he is Director of the Division of Critical Care Medicine at the University of Toronto. He is Professor of Medicine, Keenan Chair in Critical Care and Respiratory Failure, at St. Michael’s Hospital in Toronto. He has been Editor-in-Chief of Intensive Care Medicine and is Deputy Editor of the American Journal of Respiratory and Critical Care Medicine. He is leading an international group of respiratory physiology (PLUG https://www.plugwgroup.org/) and runs the Centre of Excellence in Mechanical Ventilation (CoEMV.ca). He has published over 550 peer-reviewed publications (H-index 102).

1500 – 1530

COVID-19 Therapeutics: Anticoagulants and beyond

Dr. Ryan Zarychanski, University of Manitoba, Winnipeg, MB

This session will provide an overview of COVID-19 therapeutic strategies including anti-virals, immunomodulation, and anti-inflammatory drugs. Given emerging data, the presentation of data will focus on anti-coagulant and anti-platelet therapies both on the ward and in the ICU.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Discuss current evidence-informed strategies to treat COVID-19
  • Select patients who are likely to benefit from empiric therapeutic anticoagulation

CanMEDs Competencies Addressed:
Medical Expert

Dr. Ryan Zarychanski

Dr. Ryan Zarychanski is a Hematologist, Critical Care physician, and Clinician-Scientist at the University of Manitoba and CancerCare Manitoba. He is also a Senior Scientist at the Research Institute of Oncology and Hematology and an affiliate member of the George and Fay Yee Centre for Healthcare Innovation. His research focuses on the hematologic aspects of critical illness where he leads several national and international randomized trials in the fields of sepsis and transfusion medicine. Dr. Zarychanski is the chair of the COVID-19 clinical trials team in Manitoba and serves as the chair for 2 international trials evaluating anticoagulation strategies in COVID-19 and sepsis.

Timely Topics in Tele-pulmonary Rehabilitation

1400 – 1430

Restarting Pulmonary Rehabilitation during/after the COVID-19 Pandemic

Dr. Michael Stickland, University of Alberta, Edmonton, AB

The COVID-19 pandemic has profoundly impacted how pulmonary rehabilitation can be delivered. In this session, we will review recent CTS recommendations on delivering pulmonary rehabilitation during the COVID-19 pandemic. In addition, we will detail tools available so that PR and exercise programs can be adapted for safe delivery in clinic and remotely during the COVID-19 pandemic.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Demonstrate how pulmonary rehabilitation should be adapted during the COVID-19 pandemic;
  • Apply new tools to facilitate the delivery of pulmonary rehabilitation through virtual platforms; and
  • Appraise the current data available examining the impact of face masks on exercise and dyspnea.

CanMEDs Competencies addressed:
Medical Expert, Professional, Scholar

Dr. Michael Stickland

Dr. Michael Stickland obtained his PhD at the University of Alberta and conducted postdoctoral training at the University of Wisconsin–Madison. He is a Professor in the Pulmonary Division of the Faculty of Medicine & Dentistry at the University of Alberta. He is the Director of the G. F. MacDonald Centre for Lung Health, which delivers the primary pulmonary rehabilitation program in Edmonton. He is also the Scientific Director for the Respiratory Section of the Alberta Health Services Medicine Strategic Clinical Network. Dr. Stickland’s research interests include developing clinical innovations to improve the delivery of pulmonary rehabilitation, understanding exercise intolerance in patients with pulmonary and cardiovascular disease, and examining the cardiovascular consequences of chronic lung disease. His research is funded by the: Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council, Canadian Respiratory Research Network, Canadian Foundation of Innovation, Alberta Innovates – Health Solutions, and the Lung Association of Alberta.

1430 – 1500

Considerations to Manage Virtual Exercise Training

Patrick Maranda, Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval, Québec, QC

Needs to address pulmonary rehabilitation using new strategies such as tele-pulmonary rehabilitation are growing faster with the global pandemic. Delivering exercise testing and prescription may be challenging with face-to-face restrictions. To maintain exercise as the core component of pulmonary rehabilitation, adapting to this new reality is necessary but involves integrations of new tools and practices. This presentation aims to share key considerations when implementing virtual exercise training programs in order to reach the same centre-based standards with respect to the international pulmonary rehabilitation guidelines.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Name core components of a safe and effective exercise intervention in a virtual context;
  • Identify potential challenges and limitations to virtual exercise training; and
  • Debate on different ways to successfully manage virtual exercise training.

CanMEDs Competencies addressed:
Health Advocate

Mr. Patrick Maranda

Patrick Maranda is a devoted kinesiologist who has trained COPD patients for over ten years within a well-established pulmonary rehabilitation program at the Institut universitaire de cardiologie et de pneumologie de Québec pneumologie – Université Laval. He is also an ACSM Certified Clinical Exercise Physiologist and an ACSM Certified Cancer Exercise Trainer.

1500 – 1530

Utilizing Telehealth to Enhance Self-Efficacy and Improve Outcomes and Behaviour

Dr. Anne-Marie Selzler, University of Alberta and Alberta Health Services, Edmonton, AB

The purpose of this presentation is to increase understanding of the self-efficacy concept and provide guidance on how to enhance self-efficacy to improve patient behaviour and outcomes within telehealth platforms. This session will begin with a conceptual discussion of self-efficacy and its importance to patient behaviour and clinical outcomes. This will be followed by a description of approaches to enhance self-efficacy and suggestions of how to apply those approaches to interactions with patients in a telehealth platform. While the focus of this presentation will be on enhancing self-efficacy in telehealth platforms, most of the content will apply to face-to-face interactions with patients. The content of this presentation will draw on theory, previous research and clinical observation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe self-efficacy and its importance to patient behaviour and clinical outcomes;
  • Describe the four approaches to enhancing self-efficacy; and
  • Implement various approaches for enhancing patient self-efficacy within a telehealth platform.

CanMEDs Competencies addressed:
Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Anne-Marie Selzler

Dr. Anne-Marie (Annie) Selzler is a Research Associate at Alberta Health Services and the University of Alberta. She studies psychosocial theories as they relate to behaviour change in varying contexts and populations, with a focus on exercise and physical activity in pulmonary rehabilitation. Her work examines individual level motivational characteristics and contextual factors as they relate to supporting and impeding behaviour change efforts. Dr. Selzler completed her postdoctoral training at West Park Healthcare Centre in Toronto. She is an alumna of the University of Northern British Columbia, completing a BSc (Hons) in psychology in 2009, and an alumna of the University of Alberta, completing a MA in 2013 and PhD in 2018.

Hot Topics in Pediatric Asthma

1400 – 1430

Controversies in the Management of Pediatric Asthma

Dr. Connie Yang, BC Children’s Hospital, Vancouver, BC

This presentation will discuss current controversies in the management of asthma in children including the use of short courses of inhaled corticosteroids (ICS), as needed use of ICS-formoterol and as needed use of ICS-short acting beta agonists.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the evidence and rationale for the as needed use of ICS-formoterol in children over 12 years of age;
  • Understand the evidence and rationale for the recommendation against the use of short course very high dose ICS in children under 6 years of age; and
  • Understand the evidence and rationale for the recommendation against the as needed use of ICS-short acting beta agonist in children.

CanMEDs Competencies addressed:
Communicator, Leader, Medical Expert, Scholar

Dr. Connie Yang

Dr. Connie Yang is a pediatric respirologist at BC Children’s Hospital in Vancouver where she is the director of the Pediatric Asthma Program. She is currently the co-chair of the Asthma Assembly and led the development of the latest CTS Asthma Guideline on the Management of Very Mild and Mild Asthma. She is also the president of the Respiratory Health section of the Canadian Pediatric Society where she helps disseminate unified information on pediatric respiratory health topics.

1430 – 1500

Clinical Utility of Oscillometry in Childhood Asthma: Where Are We Now?

Dr. Francine M. Ducharme, Centre hospitalier universitaire Sainte-Justine, Montréal, QC

An alternative means to spirometry is needed to assess lung function in children who cannot cooperate with spirometry because of young age, developmental ability, etc. Several lung function tests have been developed for preschoolers, including oscillometry, that must meet crucial psychometric properties required of lung function tests to be indicated for clinical use. In the 2013 ATS workshop, oscillometry met most of the prerequisites, but discriminative properties were unclear and clinical utility remained to be assessed. This presentation will review the current status of oscillometry and its prerequisites for clinical use in childhood asthma/wheezing illnesses.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the lung properties measured by oscillometry;
  • Recognize the psychometric properties of oscillometry;
  • Consider the scientific evidence regarding the clinical utility of oscillometry in clinical pediatric practice; and
  • Discuss the interpretation criteria.

CanMEDs Competencies addressed:
Communicator, Medical Expert, Professional, Scholar

Dr. Francine Ducharme

Dr. Francine M. Ducharme is a Professor in the Departments of Paediatrics and Social and Preventive Medicine at the Université de Montréal. As a paediatrician and clinical epidemiologist at the CHU Sainte-Justine, she leads a productive career as physician caring for asthmatic children, teacher, research mentor and scientist. Her research program, which has received uninterrupted research funding, focuses on improving paediatric morbidity through the development of instruments specific to children, educational and drug interventions, systematic reviews and dissemination of evidence-based guidelines. Her research program has led to over 200 publications, 200 invited talks, numerous research awards, and co-authorship on several Canadian Asthma Consensus and international statements.

1500 – 1530

Impact of Gene-Environment Interactions on Asthma

Dr. Qingling Duan, Queen’s University, Kingston, ON

Asthma is a multifactorial disease with numerous genetic and environmental risk factors. Using data from the CHILD Cohort Study, we demonstrate that childhood-onset asthma may be determined by polygenic effects of multiple genetic loci (i.e. genetic risk scores, GRS) and interactions with environmental exposures including traffic air pollution (NO2) and breastfeeding until one year of age. Moreover, our study uniquely addresses the complex and dynamic nature of the mother-breastmilk-infant triad by investigating maternal genetics that regulate secretion of human milk oligosaccharides (HMO) in breastmilk, and the protective effects of specific HMOs on genetic risk of asthma and recurrent wheeze among breastfed infants. These findings advance our understanding of the early determinants of asthma and identify modifiable factors such as HMOs, which could offer a personalized approach to reduce asthma risk.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify that risk of asthma is determined by the polygenic effects of multiple genetic loci;
  • Recognize that risk of asthma is modulated by interactions among genetics factors and environmental exposures; and
  • Demonstrate that breastfeeding and breastmilk is not a single homogeneous exposure but that specific breastmilk components can modulate risk of asthma in breastfed infants.

CanMEDs Competencies addressed:
Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Qingling Duan

Dr. Qingling Duan is a principal investigator of the CHILD Cohort Study and in this role, her team leads the integrative analyses of the genomics data with environmental exposures as well as multiple microbiomes (i.e. gut, breastmilk and nasal) for the study of asthma and related outcomes. The overarching goal of her research program is to identify and characterize novel biological mechanisms underlying multifactorial traits such as childhood asthma and atopic diseases.

1400 – 1530

CTS-European Respiratory Society Conjoint Session: Digital Advances in Respiratory Sleep Medicine and Home Ventilation

Prof. Anita Simonds, European Respiratory Society, London, United Kingdom

This presentation will be an overview of progress made in remote sleep studies, virtual sleep services, and remote management of home-ventilated patients, including learning points from the COVID-19 pandemic, and advantages and disadvantages of these new digital methodologies.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand how to set up a virtual sleep service;
  • Be familiar with remote monitoring of home-ventilated patients; and
  • Appreciate the advantages and limitations of these approaches.

CanMEDs Competencies addressed:
Health Advocate

Prof. Anita K. Simonds

Prof. Anita K. Simonds is Professor of Respiratory & Sleep Medicine at the National Heart & Lung Institute, Imperial College London, and Honorary Consultant in Respiratory & Sleep Medicine at Royal Brompton & Harefield NHS Foundation Trust, London, UK. She has a long-term research interest in non-invasive ventilation, respiratory sleep disorders, and ventilatory support in adults and children. She is President of the European Respiratory Society (ERS) 2020-2021. She worked frontline weaning severe COVID-19 patients from invasive ventilation in the first wave and is a member of the European Medicines Agency COVID-19 Task Force, regulating new vaccines and therapies for SARS-CoV-2. A particular focus for her ERS presidential year is evaluating digital approaches in respiratory and sleep medicine.

Section 3

Update in Lung Cancer: From Screening to Treatment

1400 – 1430

Screening Lung Cancer

Dr. Stephen Lam, BC Cancer, Vancouver, BC

Lung cancer screening using low-dose computed tomography has been shown to reduce lung cancer mortality by 20% to 24% in two large randomized trials. It has also been shown to be cost-effective. Organized lung cancer screening programs are being implemented in Canada. This presentation will focus on key elements of an organized screening program such as selection criteria and management of screen detected lung nodules.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe who should be screened for lung cancer;
  • Know how screen detected lung nodules are managed; and
  • Discuss the principles behind standardized reporting.

CanMEDs Competencies addressed:
Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Stephen Lam

Dr. Stephen Lam is Professor of Medicine at the University of British Columbia (UBC), distinguished scientist, the Leon Judah Blackmore chair in lung cancer research and MDS-Rix endowed director of translation lung cancer research at the BC Cancer Research Centre. He chairs the Pan-Canadian Lung Cancer Screening Network. He was the recipient of the International Association for the Study of Lung Cancer (IASLC) Joseph Cullen Award for life-time scientific achievements in lung cancer prevention research. Dr. Lam received his medical training at the University of Toronto. He joined the UBC Faculty of Medicine in 1979 and BC Cancer in 1984.

1430 – 1500

Hone Your Lung Cancer Staging Skills: Case-Based

Dr. Christine McDonald, University of Toronto, Toronto, ON

A case-based review of lung cancer staging.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe how lung cancer staging influences prognosis and treatment;
  • Summarize non-invasive and invasive staging modalities in lung cancer; and
  • Review the role of endobronchial ultrasound for invasive mediastinal staging.

CanMEDs Competencies addressed:
Collaborator

Dr. Christine McDonald

Dr. Christine McDonald completed her specialty training in Adult Respirology at the University of Toronto and further fellowship training in Interventional Pulmonology at the Toronto General Hospital. She completed her MSc through the Institute of Health Policy, Management and Evaluation at the University of Toronto, with a concentration in Quality Improvement and Patient Safety. Dr. McDonald is an Assistant Professor at the University of Toronto. Her areas of academic interest include improving access to minimally invasive pulmonary procedures, lung cancer diagnostic pathways, and patient safety surrounding chest procedures.

1500 – 1530

Novelty in Lung Cancer Treatment

Dr. Catherine Labbé, Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval, Québec, QC

Lung cancer treatment is rapidly evolving with many advances in molecular testing, the development of next-generation tyrosine kinase inhibitors, and the continued broad study of immunotherapy in new settings and potential combinations. The goal of this presentation will be to review recent pivotal and practice-changing trials and to discuss current guidelines for the management of NSCLC and SCLC.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Review the role and benefit of tyrosine kinase inhibitors in various settings;
  • Review the role and benefit of immunotherapy in NSCLC and SCLC; and
  • Choose appropriate therapy based on stage of disease and molecular testing.

CanMEDs Competencies addressed:
Health Advocate, Medical Expert, Scholar

Dr. Catherine Labbé

Dr. Catherine Labbé is the Head of the Respiratory Medicine Service at the Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval. She is also the Program Director for the Respirology residency training program at the Université Laval. She completed a Clinical research fellowship in Thoracic Oncology at Princess Margaret Cancer Centre in Toronto from 2014 to 2016. She has several research interests including targeted therapies, immuno-oncology, treatment toxicities and patient-reported outcome measures.

1600 - 1730

Co-Developed Symposium

1800 - 1900

Quality of life measurements in PH and how to integrate them into clinical decision making

Presenter: Dr. Jason Weatherald
Moderator: Dr. Lisa Mielniczuk

Pulmonary hypertension (PH) results in progressive symptoms and a risk of right heart failure. Therapeutic studies have largely focussed on exercise capacity, hemodynamics and long-term morbidity outcomes. Quality of life (QoL) is an important outcome for patients with PH but measurement in clinical practice can be cumbersome. Recently, there has been a focus on disease-specific patient reported quality of life measurements to guide clinical decision making. After this symposium, attendees will be able to use simple and validated tools to measure quality of life for patients with PH, understand how quality of life relates to other clinical variables and can be impacted by therapies, and appreciate how to integrate quality of life tools with other risk-based clinical decision tools.

Learning objectives
At the end of this presentation, attendees will be able to:

  • Identify the current approach to patient management and associated risk parameters;
  • Describe the QoL indicators commonly used in PH; and
  • Discuss the latest evidence for clinical decision-making strategies and potential impact on QoL.

CanMEDs Roles Addressed:
Medical Expert, Health Advocate

 

This session is co-developed by the Canadian Thoracic Society and Janssen and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Jason Weatherald

Dr. Jason Weatherald is a respirologist and Assistant Professor at the University of Calgary. He completed his respiratory medicine training in Calgary in 2014 followed by a post-doctoral research fellowship at the University of South Paris in 2016-2017. He has over 60 peer-reviewed publications in the field of pulmonary vascular disease and has received research funding from the Lung Association, Heart & Stroke Foundation of Canada, and CIHR. He is a founding member of the Canadian Pulmonary Hypertension Registry and currently leading a patient-oriented project to establish priorities for future research on pulmonary hypertension along with patients, caregivers and clinicians across Canada.

Co-Developed Symposia

945 - 1045

Alpha-1 Antitrypsin Disease, have you ruled it out?

Presenter: Dr. Ken Chapman, University of Toronto, ON
Moderator: Dr. Robert Sandhaus, National Jewish Health, Denver, CO

Pulmonary disease caused by alpha-1 antitrypsin deficiency is typically diagnosed late or missed completely.  This presentation will review practical strategies for screening and for confirming the diagnosis.  Appropriate use of augmentation therapy will be discussed as well as the evidence behind current recommendations.  Comprehensive care issues such as family screening, patient education and screening for liver disease will be reviewed.

Learning objectives
At the end of the presentation, attendees will be able to:

  • Understand the pathogenesis of Alpha-1 Antitrypsin Deficiency (AATD) as a genetic risk factor for COPD;
  • Summarize the latest evidence for use of augmentation therapy for AATD; and
  • Efficiently screen for AATD using Canadian tools and resources.


CanMEDs roles addressed:

Health Advocate

 

This session is co-developed by the Canadian Thoracic Society and Grifols and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Ken Chapman

Dr. Chapman is Director of the Asthma and Airway Centre of the University Health Network, President of the Canadian Network for Respiratory Care and Director of the Canadian Registry for Alpha-1 Antitrypsin Deficiency.

A Professor of Medicine at the University of Toronto, Dr. Chapman is an internationally respected researcher and lecturer in the fields of asthma and COPD.  With more that 20,000 citations to his published work, he is in the top 1% of cited medical researchers.

 

945 - 1045

Chronic Refractory Cough: When Inhalers, Nasal Sprays and Pills Don’t Work

Presenter: Dr. Stephen Field, University of Calgary
Moderator: Dr. Imran Satia, McMaster University

Chronic cough is the most common complaint in general practice and accounts for up to 40% of referrals to respirologists. Most will respond to anatomic-based approach but approximately a third   are refractory to this strategy. Speech therapy techniques are effective in half of these refractory cases. Others may respond to gabapentin or pregabalin but unfortunately, side effects are common. Several medications that target vagal afferent pathways look promising as treatment options and will be discussed.

 Learning Objectives
At the end of this presentation, attendees will be able to:

  • Appreciate the burden of chronic cough
  • Define and manage chronic refractory cough
  • Discuss new treatments on the horizon

CanMEDs Competencies Addressed
Medical Expert

This session is co-developed by the Canadian Thoracic Society and Merck and is planned to achieve scientific integrity, objectivity and balance.

Dr. Stephen Field

Dr. Stephen Field is a respirologist at Foothills Medical Centre and clinical professor at the University of Calgary.  He is a McGill University graduate and completed his internal medicine residency and respiratory fellowship at McGill. He was a CLA research fellow at the Meakins-Christie Laboratory supervised by Drs. Peter Macklem and Alejandro Grassino. He joined the University of Calgary in 1983 and has won awards for undergraduate, resident, and continuing medical education. He has a large respiratory consultative practice and worked in the tuberculosis, nontuberculous mycobacterial, asthma and CF clinics. He cofounded the Calgary COPD and asthma program and founded the Calgary chronic cough clinic. Dr. Field has participated in numerous clinical investigations and published over 100 articles in peer-reviewed journals as well as many abstracts, book chapters, and communications.

1000 - 1100
1100 - 1200

Concurrent Sessions

Path to Recovery for COVID-19 Patients and Their Health Care Providers

1100 – 1130

Mental Health of Health Care Workers in the Era of the COVID-19 Pandemic

Dr. Shannon Ruzycki, University of Calgary, Calgary, AB

The COVID-19 pandemic has amplified personal and work-related stress. At baseline, healthcare workers experience unique threats to their well-being; during the pandemic, the loss of usual supports, addition of caregiving and schooling responsibilities for those with children, and uncertainty at work compounded existing mental health burdens among healthcare workers. In addition, these threats to well-being are borne inequitably, with documented disparities for Black, Indigenous and People of Colour, women, and low socioeconomic status healthcare workers. In this presentation, we will discuss systems and individual-level threats to well-being for healthcare workers specific to the COVID-19 pandemic and identify evidence-informed ways to improve well-being.

Learning objectives
At the end of the presentation, attendees will be able to:

  • Describe how personal demographics influence well-being during the COVID-19 pandemic.
  • Understand the differences between burnout, mental illness, and moral distress.
  • List evidence-informed systems-level and individual-level strategies to mitigate threats to well-being during the COVID-19 pandemic.


CanMEDs Roles addressed:

Health advocate, Leader, Professional

Dr. Shannon Ruzycki

Dr. Shannon Ruzycki is a general internist in Calgary, Alberta. She is the Associate Director of Physician Wellness and Vitality in the Department of Medicine and a physician collaborator for Well Doc Alberta.

Dr Ruzycki has an MPH in Epidemiology and Quality, Patient Safety, and Outcomes Research from Johns Hopkins University. Her research focuses on perioperative quality improvement and equity, diversity, and inclusion in the medical workplace.

1130 – 1200

Functional Recovery of Hospitalised Patients with COVID-19: A Prospective Cohort Study

Dr. Marla Beauchamp, McMaster University, Hamilton, ON

Emerging data on the long-term sequelae after COVID-19 suggests that many patients suffer from persistent and relapsing symptoms including mobility problems, dyspnea, and fatigue. The Functional Recovery of Hospitalized Patients with COVID-19 prospective cohort study is an extension to the McMaster Multi-Regional COVID-19 Hospital Case Registry (COREG) in order to track functional recovery over 1 year among all COVID-19 patients admitted to hospital in Hamilton and Kitchener-Waterloo regions. Outcomes measured on admission, discharge, and at 3-month intervals include: mobility, dyspnea, fatigue, psychosocial outcomes, cognition, spirometry, and health-related quality of life. This presentation will focus on preliminary results from the first cohort of patients enrolled in the study. These data will be important for understanding the trajectory of recovery from the disease and for informing optimal rehabilitative management of patients who survive serious COVID-19 illness.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Cite emerging data on the long-term sequelae after COVID-19; and
  • Describe preliminary evidence on the trajectory of functional recovery after hospitalisation for COVID-19.

CanMEDs Competencies addressed:
Scholar

Dr. Marla Beauchamp

Dr. Marla Beauchamp is a Physical Therapist and Assistant Professor in the School of Rehabilitation Science at McMaster University. She is also an Associate Member in the Department of Medicine and holds a tier 2 Canada Research Chair in Mobility, Aging and Chronic Disease. Dr. Beauchamp’s research program is focused on developing evidence-based strategies to improve mobility among older adults, including those with COPD. Her ongoing research is supported by CIHR, AGE-WELL, and the McMaster Institute for Research on Aging.

Management of IPF in the Community

1100 – 1130

Managing Disabling Symptoms

Dr. Martin Kolb, McMaster University, Hamilton, ON

IPF is a progressive disease with high morbidity and mortality. The past years have brought significant improvements in the pharmacological therapy of IPF but disease progression nevertheless occurs in most patients, albeit at a slower rate. This means that symptomatic treatment of patients with IPF (and other fibrotic lung disorders) remains a major element of patient care.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the progressive nature of fibrotic lung disorders, especially IPF;
  • Make decisions about pharmacological therapies that affect the disease progression versus interventions that aim at symptom control; and
  • Understand the potential benefit of collaborating with palliative care at an earlier stage of IPF.

CanMEDs Competencies addressed:
Medical Expert, Professional, Scholar

Dr. Martin Kolb

Dr. Martin Kolb is the Moran Campbell Chair and Professor in Respiratory Medicine and Director of the Division of Respirology, McMaster University. His major research interest is fibrotic lung disease, with a particular interest in the role of growth factors and matrix abnormalities in disease progression. He leads activities in biomarker development for lung fibrosis and is a Principal Investigator and steering committee member in numerous ILD clinical trials. Dr. Kolb has authored over 130 peer-reviewed publications on different basic science and clinical topics. He is the Chief Editor of the European Respiratory Journal (2018-2023).

1130 – 1200

Supporting Exertional Oxygen Needs and Physical Activity Over Time

Dr. Lisa Wickerson, University Health Network, Toronto, ON

Despite the prevalence of domiciliary oxygen therapy in ILD/IPF, there is a paucity of disease-specific evidence alongside heterogeneity in clinical guidelines and practices. This presentation will provide an overview of the oxygen needs of people with ILD/IPF, summarize the recent studies on oxygen therapy in ILD/IPF, and discuss potential strategies to manage hypoxemia and support physical activity over the course of disease progression.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the epidemiology and significance of hypoxemia in IPF;
  • Discuss the current evidence and gaps around long-term, ambulatory and nocturnal oxygen therapy in ILD/IPF; and
  • Identify challenges and clinical strategies for managing exertional oxygen needs and supporting physical activity over time in IPF.

CanMEDs Competencies addressed:
Collaborator, Communicator, Health Advocate, Professional

Dr. Lisa Wickerson

Dr. Lisa Wickerson is a physical therapist and clinician-investigator in the Lung Transplant Program at the University Health Network. She completed her PhD in Rehabilitation Science examining oxygenation during exercise in interstitial lung disease. Her postdoctoral fellowship at Women’s College Hospital and the University Health Network focused on digital health evaluation and remote rehabilitation monitoring. Her current clinical and research program is centred around optimizing tele-rehabilitation for lung transplant candidates and recipients.

New Developments in Pediatric Neuromuscular Diseases

1100 - 1130

New Developments in Pediatric Neuromuscular Disease from a Neurologist

Dr. Maryam Oskoui, McGill University, Montréal, QC

The therapeutic landscape in pediatric neuromuscular disorders has exploded in recent years. We will review the most recent advances, highlighting the level of evidence and challenges in conducting trials in rare disease. Treatment options for spinal muscular atrophy and Duchenne muscular dystrophy will be outlined.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Know the treatment options in spinal muscular atrophy;
  • Outline the therapeutic pipeline in Duchenne muscular dystrophy; and
  • Describe challenges in conducting clinical trials in rare disease.

CanMEDs Competencies addressed:
Communicator, Medical Expert, Professional, Scholar

Dr. Maryam Oskoui

Dr. Maryam Oskoui is the Director of the Pediatric Neurology Division at the Montreal Children’s Hospital. She is Associate Professor in the Departments of Pediatrics and Neuroscience and Associate Member of the Department of Epidemiology and Biostatistics at McGill University. She is a recipient of a Clinical Research Scholar Junior 2 award from the Fonds de recherche du Québec – Santé. Dr. Oskoui serves as an evidence-based methodologist for the American Academy of Neurology and on the scientific and medical advisory board for Muscular Dystrophy Canada. She chairs the Canadian Neuromuscular Disease Registry Spinal Muscular Atrophy Working Group and is an investigator in clinical trials in pediatric neuromuscular disorders.

1130 – 1200

The Changing Landscape of the Respiratory Management of Children with Neuromuscular Disease

Dr. Reshma Amin, The Hospital for Sick Children and University of Toronto, Toronto, ON

This presentation will provide an overview of respiratory care and the evolving natural history of neuromuscular diseases such as spinal muscular atrophy with the recent approvals of disease-modifying therapies such as Spinraza and the implementation of newborn screening in Ontario. The pathophysiology of the impact of neuromuscular disease on the respiratory system and sleep-disordered breathing will be discussed. Data from recent clinical trials highlighting the impact of disease-modifying therapies on neuromuscular disease will be presented with a focus on the respiratory outcomes. In addition, an updated approach to the traditional respiratory management of individuals with neuromuscular disease will be discussed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the impact of neuromuscular disease on the respiratory system and sleep-disordered breathing;
  • Be presented with data from recent clinical trials highlighting the impact of disease-modifying therapies for neuromuscular diseases on respiratory outcomes; and
  • Gain an appreciation for the need of a revised approach to the respiratory management of neuromuscular disease in 2021.

CanMEDs Competencies addressed:
Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Reshma Amin

Dr. Reshma Amin is the Director of the Long-term Ventilation (LTV) Program at SickKids and an Associate Professor at the University of Toronto. She is also the Program Director for the Sleep Medicine and Long-term Ventilation training program. She is lead author for the Canadian Guidelines for Pediatric Long-term Mechanical Ventilation at home. Her research focuses on improving the impact of LTV on the patient, the family and the healthcare system. She is currently leading a provincial randomized controlled trial to evaluate the impact of an eHealth app for children and adults transitioning home on long-term ventilation on healthcare utilization.

Research Highlights from Young Investigators

1100 – 1130

Lung Imaging and Biomarkers: Relevance to the Management of Severe Asthma

Dr. Sarah Svenningsen, McMaster University, Hamilton, ON

Novel pulmonary CT and MRI biomarkers of airways disease relevant to the clinical understanding, decision making and therapy guidance of severe asthma will be introduced, and recent scientific literature will be reviewed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe and interpret novel CT and functional MRI biomarkers of asthma;
  • Understand the contributors to ventilation defects visualized by MRI in asthma and their clinical relevance; and
  • Understand the potential role of pulmonary imaging in asthma clinical decision making and therapy guidance.
Dr. Sarah Svenningsen

Dr. Sarah Svenningsen is a translational pulmonary imaging scientist who recently joined McMaster University faculty (2020) as an Assistant Professor in the Department of Medicine (Division of Respirology). She is an Affiliate Scientist at the Firestone Institute for Respiratory Health and The Research Institute of St. Joe’s Hamilton. She graduated with an Honours Specialization degree in Medical Biophysics (2011) and a PhD in Medical Biophysics (2015) at Western University. Her research focuses on the development and application of novel pulmonary imaging methods to better understand complex airways diseases such as asthma and chronic obstructive pulmonary disease. Dr. Svenningsen has authored 46 publications in the fields of pulmonary medicine and medical imaging and has an h-index of 19 (i10-index 31, >1400 citations). She was a Banting Postdoctoral Fellow (2018-2020) and the recipient of the 2017 Charles Polanyi Prize in Physiology/Medicine.

1130 – 1200

Airway Trees in the Anthropocene

Dr. Benjamin Smith, McGill University, Montréal ,QC

The airway tree is the gateway for inhaled particulates, both noxious and therapeutic, and variation in airway tree structure is common in the general population. Dr. Smith will present recent research suggesting that variation in airway tree structure may play a critical role in clinical susceptibility to inhaled noxious particulates and, by extension, inhaled pharmacotherapy efficacy. Understanding the biological basis of airway tree variation may lead to interventions that promote resilient lung development and maintenance across the lifespan.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Provide an evolutionary perspective on human airway tree structure;
  • Describe variation in native airway tree structure in the general population; and
  • Relate this variation in airway structure to chronic obstructive lung disease susceptibility.

CanMEDs Competencies addressed:
Collaborator, Medical Expert

Dr. Benjamin Smith

Dr. Benjamin Smith is a physician-scientist at the McGill University Health Centre Research Institute. His research program aims to reduce the burden of chronic obstructive lung disease by understanding the heterogeneity of disease susceptibility and impairment. Leveraging contemporary deeply phenotyped cohorts, Dr. Smith uses epidemiological methods to test mechanistic hypotheses in humans (‘translational epidemiology’). His research is supported by the Quebec Health Research Fund (FRQS), the Canadian Institutes of Health Research, and the National Institutes of Health (USA). Dr. Smith’s training is in epidemiology, respiratory medicine, physiology, and mathematics, and was obtained at McGill and Columbia Universities.

1200 - 1215
1215 - 1315

Closing Plenary Session

1215 - 1245

Vaping/E-Cigarettes and Effects on Lung Health

Dr. Albert A. Rizzo, American Lung Association, Newark, DE, USA

This lecture will discuss the entry of electronic inhalation delivery systems into the U.S. markets and the consequences of misinformation, lax regulation and a mixed public health message regarding harm reduction and efforts regarding education and advocacy that are being used to help correct the situation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the development and evolution of electronic inhalational drug delivery systems as they entered the U.S. markets;
  • Appreciate the concern over the youth epidemic of e-cigarettes in the U.S. and the E-cigarette and Vaping Associated Lung Illness (EVALI); and
  • Understand the public health measures needed to help prevent the medical consequences of vaping devices.
Dr. Albert A. Rizzo

Dr. Albert A. Rizzo is the Chief Medical Officer for the American Lung Association. He is responsible for ensuring that the American Lung Association uses the best science and medicine to formulate and deliver its mission. He oversees the medical aspects of the organization’s research, education and advocacy arms of its mission. Dr. Rizzo practices at Christiana Care Health System in Newark, Delaware (USA). He is board certified in internal medicine, pulmonary, critical care and sleep medicine and is a clinical assistant professor of medicine at Thomas Jefferson University Medical School in Philadelphia, Pennsylvania (USA).

1245 - 1315

Canada and the Vaping Landscape

Dr. Erika Penz, University of Saskatchewan, Saskatoon, SK

Manufacturers of electronic cigarettes promised a cleaner and safer nicotine delivery device to assist smokers to quit smoking and ultimately reduce the harm from smoking tobacco. However, what has evolved in practice is a product that is wildly popular among youth and young adults, a reactive approach to regulating these products and to date, minimal high quality evidence to suggest the effectiveness of e-cigarettes to help smokers quit smoking. This lecture will review how this ‘state of affairs’ has played out in Canada and discuss how research and policy can work together to minimize further harms to the Canadian population.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the vaping regulatory landscape and epidemiology of vaping in Canada;
  • Interpret the most recent data related to the role of e-cigarettes in smoking cessation; and
  • Discuss how research and policy can intersect to minimize harm for users of e-cigarettes.

CanMEDs Competencies Addressed
Health Advocate, Medical Expert, Scholar

Dr. Erika Penz

Dr. Erika Penz is Associate Professor in the Division of Respirology, Critical Care and Sleep Medicine at the University of Saskatchewan and Program Director for the Respirology Training Program. She is Vice Co-Chair of the COPD Assembly of the Canadian Thoracic Society. Her research focuses on health economic evaluation and understanding burden of disease in patients with lung disease. She has a particular interest in smoking cessation and the interaction of vaping and smoking amongst youth and is co-founder and co-facilitator of Youth4Change Saskatchewan, an education and advocacy group aimed at protecting children and youth from the harms of vaping.

1315 - 1330

Poster Award Presentations and Closing Remarks

By Dr. Dina Brooks and Dr. Paul Hernandez – CTS Board of Directors.

Co-Developed Symposia

1400 - 1500

Can We Offer Our Patients with COPD a Longer and Better Life with Optimal Pharmacotherapy?

Presenter: Dr. Darcy Marciniuk, University of Saskatchewan, Saskatoon, SK
Moderator: Dr. Erika Penz, University of Saskatchewan, Saskatoon, SK

At the end of this presentation, attendees will be able to:

  • Understand new published results from reports of inhaled pharmacologic therapy in COPD
  • Appreciate the mortality findings from recently published studies
  • Leverage this recent evidence, and reflect on the clinical implications, to align patients with the most appropriate inhaled pharmacologic therapy, and improve the care and outcomes for patients suffering from COPD

 


This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

 

1500 - 1600

Panel Discussion: Precision Medicine for Severe Asthma: Which Biologic for Which Patient?

Panelists: Dr. Krystelle Godbout, Dr. Richard Leigh, Dr. Diane Lougheed, Harold Kim, Dr. Param Nair, Dr. Padmaja Subbarao
Moderator: Dr. Clare Ramsey

A panel discussion on key questions related to use of a precision medicine approach to manage patients with severe asthma.

Learning objectives
At the end of the session, attendees will be able to:

  • Choose the right treatment for the right patient when it comes to biologics for severe asthma (including discussion of different mechanisms of action, and how to determine responsiveness);
  • Identify key patient characteristics to assess and considerations for those patients with comorbid conditions;
  • Discuss if eosinophils are a valuable biomarker for responsiveness to biologics (consider sputum vs blood); and
  • Identify and discuss merit of other potential biomarkers for use of biologics in severe asthma (e.g. FeNO)

 


This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Krystelle Godbout

Dr. Krystelle Godbout is a young respirologist working at the Institut de Cardiologie et Pneumologie de Québec (Quebec Heart and Lung Institute). She completed a fellowship in severe asthma in Newcastle, Australia, where she developed an interest in airway disease phenotyping and laryngeal dysfunction. Back in Quebec since 2017, she is now the head of the severe asthma clinic and collaborates closely with Dr. Louis-Philippe Boulet through clinical and research projects.

Dr. Harold Kim

Dr. Harold Kim has been practicing as an allergist in Kitchener, Ontario for 23 years. His clinics are in Kitchener and in London. He has appointments at Western University and McMaster University. He graduated with his MD from UWO and completed Internal Medicine and Allergy training at UWO. His clinical interests include allergic conditions including asthma, biologics therapy, allergic rhinitis and food allergy. Dr. Kim has been involved in a number of national guidelines projects. His research interests have included biologics in asthma, diagnostics in allergy, allergen immunotherapy, anaphylaxis and food allergy. He is co-chief editor of Allergy, Asthma and Clinical Immunology. He is the past president of the Canadian Society of Allergy and Clinical Immunology. He is the Chief/Chair of the Division of Clinical Immunology and Allergy at Western University.

Dr. Richard Leigh

Dr. Richard Leigh is a physician-scientist and the Senior Associate Dean – Faculty Affairs in the Cumming School of Medicine at the University of Calgary. He obtained his medical degree from the University of Cape Town and subsequently undertook additional research training at McMaster University. Dr. Leigh’s areas of interest include understanding the basic mechanisms underlying airway remodeling in asthma and early phase clinical trials in asthma and COPD. His clinical practice focuses on severe asthma and other airways diseases. He previously served as the Chair of the Department of Medicine before taking up his current appointment in January 2020.

Dr. Diane Lougheed

Dr. M. Diane Lougheed is a Professor of Medicine, Biomedical and Molecular Sciences and Public Health Sciences, and Chair of the Division of Respirology at Queen’s University. She is the Director of the Kingston Health Sciences Centre Asthma Program and Research Unit. Dr. Lougheed obtained her medical degree from McMaster University where she also completed her Internal Medicine residency. She completed her Respirology fellowship and obtained a Master’s degree in Epidemiology at Queen’s University. Dr. Lougheed has authored over 80 peer-reviewed publications and 2 book chapters. Her research interests include asthma symptom perception, asthma epidemiology, work-related asthma and guidelines implementation.

Dr. Parameswaran Nair

Dr. Parameswaran Nair is the Frederick E. Hargreave Teva Innovation Chair in Airway Diseases and Professor of Medicine in the Division of Respirology at McMaster University in Hamilton, Ontario, providing tertiary care to patients with severe asthma and other complex airway diseases. He directs a patient-centred translational research program centred on charactering bronchitis using sputum biomarkers and targeted therapy. The research program has been recognized by a Canada Research Chair, the American Thoracic Society’s Ann Woolcock Award, the Asthma Society of Canada’s Bastable Potts Award, and Fellowships of the European Respiratory Society and the Collegium Internationale Allergologicum, and has contributed to over 270 peer-reviewed publications (h-index 57, >15,500 citations).

Dr. Padmaja Subbarao

Dr. Padmaja Subbarao is a Clinician-Scientist in Pediatric Respiratory Medicine specializing clinically in severe asthma. She is trained in both epidemiology and infant and preschool lung function. She holds a CRC Tier 1 Chair in Pediatric Asthma and Lung Health at the University of Toronto and is a Severe Asthma Specialist at The Hospital for Sick Children. Dr. Subbarao’s research program focuses on disentangling preschool wheeze heterogeneity to precisely predict who will develop each type of asthma, monitor its progression and discover the risk factors, exposures and underlying biology associated with each asthma subtype. She is the Director of the CHILD cohort study (www.childstudy.ca), one of the largest, most intensively characterized asthma birth cohorts in the world. This world-leading study enabled the discovery of the importance of the gut microbiome for the protection against asthma (cited >500). She also established the first infant lung function laboratory in Canada, and her early work on the novel multiple breath washout (MBW) lung test paved the way for its acceptance by the Federal Drug Agency as an objective outcome measure for clinical trials in Cystic Fibrosis (CF). Her research in early life lung function as a biomarker and risk factors in asthma have enabled the earlier precise prediction of asthma and monitoring of its progression, thus advancing the diagnosis and treatment of children with asthma. Dr. Subbarao is also an international leader in pediatric severe asthma, co-authoring clinical practice guidelines and position statements. She serves as an Advisor to the National Institutes of Health (NIH) to review other asthma cohort studies. She is a committed mentor and teacher and at the institutional level serves as the Director of the Clinician-Scientist Training Program at SickKids.

THURSDAY APRIL 8, 2021

1800 - 1900

Optimizing Patient Outcomes through Accurate Identification of the PF-ILD Patient

Presenter: Dr. Nathan Hambly
Moderator: Dr. Kerri Johannson

Fibrotic interstitial lung diseases (ILD) are a spectrum of lung disorders characterized by parenchymal fibrosis. Fibrosis represents a final common pathway for conditions that can originate through distinct pathophysiological mechanisms including autoimmunity, granulomatous inflammation, organic and inorganic dust exposure, and other injurious insults. An important subset of patients with fibrotic ILD experience progressive clinical, physiological, and radiographic decline, with an associated reduced quality of life and long-term survival despite conventional therapies. Idiopathic pulmonary fibrosis (IPF) is the prototypical fibrotic ILD, however, other ILD subtypes behave comparatively.  During this presentation we will describe the PF-ILD phenotype and the implications its identification have on clinical management.

At the end of this presentation, attendees will be able to:

  • Describe the PF-ILD phenotype and identify progression in patients with Interstitial Lung Disease; and
  • Identify which ILD patient has the PF-ILD phenotype in clinical practice and understand appropriate treatment options.


CanMEDs Competencies Addressed

Collaborator, Leader, Medical Expert, Scholar

This session is co-developed by the Canadian Thoracic Society and Boehringer Ingelheim and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Nathan Hambly

Dr. Nathan Hambly earned his medical degree at the University of Ottawa (2009) and completed residency training at McMaster University. Thereafter he fulfilled clinical fellowships in pulmonary hypertension and interstitial lung disease at McMaster University, University of Toronto and Royal Brompton Hospital in London, United Kingdom. Dr. Hambly is the Director of the Firestone Institute Pulmonary Hypertension Program, Director of the ILD Fellowship training program at McMaster, and works as a consultant respirologist at St. Joseph’s Healthcare Hamilton. His clinical interests include pulmonary hypertension, interstitial lung disease, and sarcoidosis.

 

1900 - 2000

Redefining OCS Use in 2021: Evidence to Support Why & How We Aim for Zero

Presenter: Dr. Louis-Phillipe Boulet, Laval University, Quebec, QC
Moderator: Dr. Krystelle Godbout, Laval University, Quebec, QC

This presentation will review the current literature on clinical and metabolic consequences of frequent or continuous oral corticosteroid use (OCS) in asthma. Methods to avoid the use of OCS and/or minimize their untoward effects will be discussed. Strategies/methods for weaning OCS (procedure and monitoring) in severe asthmatic patients will be reported, including recent studies specifically on how this can be safely done in real-world.  Finally, sustainability of treatment effect post taper in severe eosinophilic asthma patients will be discussed.

Learning Objectives
At the end of the presentation, attendees will be able to:

  • Understand the clinical and metabolic consequences of frequent or continuous OCS use
  • Describe how to avoid OCS or minimize their use
  • Assess how to proceed with OCS withdrawal
  • Describe a real world perspective on how to conduct such OCS reduction safely
  • Understand sustainability of treatment effect post taper in severe eosinophilic asthma patients


CanMEDs Competencies Addressed

Medical Expert, Professional, Scholar

 

This session is co-developed by the Canadian Thoracic Society and AstraZeneca and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Louis-Philippe Boulet

Dr. Louis-Philippe Boulet is a respirologist at the Institut de cardiologie et de pneumologie de Québec (Quebec Heart and Lung Institute). He is a professor of medicine at Laval University, where he holds a chair in knowledge translation education and prevention in respiratory and cardiorespiratory health. He is a past president of the Canadian Thoracic Society (CTS), is the current chair of the Board of Directors of the Global Initiative for Asthma (GINA), and president of InterAsma, the Global Asthma Association. He has written more than 650 medical publications, including 410 peer-reviewed manuscripts, 43 book chapters and edited/authored 17 medical books.

FRIDAY APRIL 9, 2021

945 - 1045

Implications of the Effective Clinical and Practical use of FeNO in Canadian Practice?

Presenter: Dr. Del Dorscheid, University of British Columbia, Vancouver, BC
Moderator: Dr. Celine Bergeron, University of British Columbia, Vancouver, BC

The use of FeNO to monitor and/or assess “allergic inflammation” in the asthmatic population has not been fully embraced by respiratory practitioners nor supported by the consensus guidelines. Much of this was contributed to by variations in technology of the devices, variability in the results when applied to the entire population of “asthmatics” and a lack of translatable knowledge regarding whom would this benefit with respect to clinical outcomes. With a broader range of available therapeutic options the use of FeNO to identify personalized treatment plans needs to be revisited.

 Learning Objectives
At the end of this presentation, attendees will be able to:

  • Discuss the most up-to-date scientific and clinical evidence supporting the use of fractional exhaled nitric oxide (FeNO) as a biomarker to manage asthma and
  • Debate its utility in Canadian practice with the introduction of biologics.


CanMEDs Competencies Addressed:
Health Advocate, Leader, Medical Expert, Professional, Scholar

 

This session is co-developed by the Canadian Thoracic Society and Sanofi Genzyme and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Del Dorscheid

Dr Del Dorscheid obtained his MD and PhD degrees from McGill University in 1993. He moved onto the University of Chicago for Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine. He has now been at UBC since 2000 and is a tenured Associate Professor. Dr. Dorscheid attends in the medical intensive care unit at St. Pauls, is Director of the Severe Asthma Clinic and is a researcher in the UBC Center for Heart Lung Innovation. As a physician-scientist, he leads an active research group investigating the role of the airway epithelium in inflammatory airways disease that results from inappropriate injury-inflammation-repair cycles. Specific projects include the study of IL-13 in airway repair and the expression/function or the epithelium as an immune barrier. The goal for his research program is to promote and translate research findings into new treatments and improved patient care to reduce the burden of respiratory diseases.

 

1800 - 1900

Quality of life measurements in PH and how to integrate them into clinical decision making

Presenter: Dr. Jason Weatherald
Moderator: Dr. Lisa Mielniczuk

Pulmonary hypertension (PH) results in progressive symptoms and a risk of right heart failure. Therapeutic studies have largely focussed on exercise capacity, hemodynamics and long-term morbidity outcomes. Quality of life (QoL) is an important outcome for patients with PH but measurement in clinical practice can be cumbersome. Recently, there has been a focus on disease-specific patient reported quality of life measurements to guide clinical decision making. After this symposium, attendees will be able to use simple and validated tools to measure quality of life for patients with PH, understand how quality of life relates to other clinical variables and can be impacted by therapies, and appreciate how to integrate quality of life tools with other risk-based clinical decision tools.

Learning objectives
At the end of this presentation, attendees will be able to:

  • Identify the current approach to patient management and associated risk parameters;
  • Describe the QoL indicators commonly used in PH; and
  • Discuss the latest evidence for clinical decision-making strategies and potential impact on QoL.

CanMEDs Roles Addressed:
Medical Expert, Health Advocate

 

This session is co-developed by the Canadian Thoracic Society and Janssen and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Jason Weatherald

Dr. Jason Weatherald is a respirologist and Assistant Professor at the University of Calgary. He completed his respiratory medicine training in Calgary in 2014 followed by a post-doctoral research fellowship at the University of South Paris in 2016-2017. He has over 60 peer-reviewed publications in the field of pulmonary vascular disease and has received research funding from the Lung Association, Heart & Stroke Foundation of Canada, and CIHR. He is a founding member of the Canadian Pulmonary Hypertension Registry and currently leading a patient-oriented project to establish priorities for future research on pulmonary hypertension along with patients, caregivers and clinicians across Canada.

SATURDAY APRIL 10, 2021

945 - 1045

Alpha-1 Antitrypsin Deficiency, Have You Ruled It Out?

Presenter: Dr. Ken Chapman, University of Toronto, ON
Moderator: Dr. Robert Sandhaus, National Jewish Health, Denver, CO

Pulmonary disease caused by alpha-1 antitrypsin deficiency is typically diagnosed late or missed completely.  This presentation will review practical strategies for screening and for confirming the diagnosis.  Appropriate use of augmentation therapy will be discussed as well as the evidence behind current recommendations.  Comprehensive care issues such as family screening, patient education and screening for liver disease will be reviewed.

Learning objectives
At the end of the presentation, attendees will be able to:

  • Understand the pathogenesis of Alpha-1 Antitrypsin Deficiency (AATD) as a genetic risk factor for COPD;
  • Summarize the latest evidence for use of augmentation therapy for AATD; and
  • Efficiently screen for AATD using Canadian tools and resources.


CanMEDs roles addressed:

Health Advocate

 

This session is co-developed by the Canadian Thoracic Society and Grifols and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Ken Chapman

Dr. Chapman is Director of the Asthma and Airway Centre of the University Health Network, President of the Canadian Network for Respiratory Care and Director of the Canadian Registry for Alpha-1 Antitrypsin Deficiency.

A Professor of Medicine at the University of Toronto, Dr. Chapman is an internationally respected researcher and lecturer in the fields of asthma and COPD.  With more that 20,000 citations to his published work, he is in the top 1% of cited medical researchers.

 

945 - 1045

Chronic Refractory Cough: When Inhalers, Nasal Sprays and Pills Don’t Work

Presenter: Dr. Stephen Field, University of Calgary
Moderator: Dr. Imran Satia, McMaster University

Chronic cough is the most common complaint in general practice and accounts for up to 40% of referrals to respirologists. Most will respond to anatomic-based approach but approximately a third   are refractory to this strategy. Speech therapy techniques are effective in half of these refractory cases. Others may respond to gabapentin or pregabalin but unfortunately, side effects are common. Several medications that target vagal afferent pathways look promising as treatment options and will be discussed.

 Learning Objectives
At the end of this presentation, attendees will be able to:

  • Appreciate the burden of chronic cough
  • Define and manage chronic refractory cough
  • Discuss new treatments on the horizon

CanMEDs Competencies Addressed
Medical Expert

This session is co-developed by the Canadian Thoracic Society and Merck and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Stephen Field

Dr. Stephen Field is a respirologist at Foothills Medical Centre and clinical professor at the University of Calgary.  He is a McGill University graduate and completed his internal medicine residency and respiratory fellowship at McGill. He was a CLA research fellow at the Meakins-Christie Laboratory supervised by Drs. Peter Macklem and Alejandro Grassino. He joined the University of Calgary in 1983 and has won awards for undergraduate, resident, and continuing medical education. He has a large respiratory consultative practice and worked in the tuberculosis, nontuberculous mycobacterial, asthma and CF clinics. He cofounded the Calgary COPD and asthma program and founded the Calgary chronic cough clinic. Dr. Field has participated in numerous clinical investigations and published over 100 articles in peer-reviewed journals as well as many abstracts, book chapters, and communications.

1400 - 1500

Can We Offer Our Patients with COPD a Longer and Better Life with Optimal Pharmacotherapy?

Presenter: Dr. Darcy Marciniuk, University of Saskatchewan, Saskatoon, SK
Moderator: Dr. Erika Penz, University of Saskatchewan, Saskatoon, SK

At the end of this presentation, attendees will be able to:

  • Understand new published results from reports of inhaled pharmacologic therapy in COPD
  • Appreciate the mortality findings from recently published studies
  • Leverage this recent evidence, and reflect on the clinical implications, to align patients with the most appropriate inhaled pharmacologic therapy, and improve the care and outcomes for patients suffering from COPD

 


This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

 

1500 - 1600

Panel Discussion: Precision Medicine for Severe Asthma: Which Biologic for Which Patient?

Panelists: Dr. Krystelle Godbout, Dr. Richard Leigh, Dr. Diane Lougheed, Harold Kim, Dr. Param Nair, Dr. Padmaja Subbarao
Moderator: Dr. Clare Ramsey

A panel discussion on key questions related to use of a precision medicine approach to manage patients with severe asthma.

Learning objectives
At the end of the session, attendees will be able to:

  • Choose the right treatment for the right patient when it comes to biologics for severe asthma (including discussion of different mechanisms of action, and how to determine responsiveness);
  • Identify key patient characteristics to assess and considerations for those patients with comorbid conditions;
  • Discuss if eosinophils are a valuable biomarker for responsiveness to biologics (consider sputum vs blood); and
  • Identify and discuss merit of other potential biomarkers for use of biologics in severe asthma (e.g. FeNO)

 


This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Krystelle Godbout

Dr. Krystelle Godbout is a young respirologist working at the Institut de Cardiologie et Pneumologie de Québec (Quebec Heart and Lung Institute). She completed a fellowship in severe asthma in Newcastle, Australia, where she developed an interest in airway disease phenotyping and laryngeal dysfunction. Back in Quebec since 2017, she is now the head of the severe asthma clinic and collaborates closely with Dr. Louis-Philippe Boulet through clinical and research projects.

Dr. Harold Kim

Dr. Harold Kim has been practicing as an allergist in Kitchener, Ontario for 23 years. His clinics are in Kitchener and in London. He has appointments at Western University and McMaster University. He graduated with his MD from UWO and completed Internal Medicine and Allergy training at UWO. His clinical interests include allergic conditions including asthma, biologics therapy, allergic rhinitis and food allergy. Dr. Kim has been involved in a number of national guidelines projects. His research interests have included biologics in asthma, diagnostics in allergy, allergen immunotherapy, anaphylaxis and food allergy. He is co-chief editor of Allergy, Asthma and Clinical Immunology. He is the past president of the Canadian Society of Allergy and Clinical Immunology. He is the Chief/Chair of the Division of Clinical Immunology and Allergy at Western University.

Dr. Richard Leigh

Dr. Richard Leigh is a physician-scientist and the Senior Associate Dean – Faculty Affairs in the Cumming School of Medicine at the University of Calgary. He obtained his medical degree from the University of Cape Town and subsequently undertook additional research training at McMaster University. Dr. Leigh’s areas of interest include understanding the basic mechanisms underlying airway remodeling in asthma and early phase clinical trials in asthma and COPD. His clinical practice focuses on severe asthma and other airways diseases. He previously served as the Chair of the Department of Medicine before taking up his current appointment in January 2020.

Dr. Diane Lougheed

Dr. M. Diane Lougheed is a Professor of Medicine, Biomedical and Molecular Sciences and Public Health Sciences, and Chair of the Division of Respirology at Queen’s University. She is the Director of the Kingston Health Sciences Centre Asthma Program and Research Unit. Dr. Lougheed obtained her medical degree from McMaster University where she also completed her Internal Medicine residency. She completed her Respirology fellowship and obtained a Master’s degree in Epidemiology at Queen’s University. Dr. Lougheed has authored over 80 peer-reviewed publications and 2 book chapters. Her research interests include asthma symptom perception, asthma epidemiology, work-related asthma and guidelines implementation.

Dr. Parameswaran Nair

Dr. Parameswaran Nair is the Frederick E. Hargreave Teva Innovation Chair in Airway Diseases and Professor of Medicine in the Division of Respirology at McMaster University in Hamilton, Ontario, providing tertiary care to patients with severe asthma and other complex airway diseases. He directs a patient-centred translational research program centred on charactering bronchitis using sputum biomarkers and targeted therapy. The research program has been recognized by a Canada Research Chair, the American Thoracic Society’s Ann Woolcock Award, the Asthma Society of Canada’s Bastable Potts Award, and Fellowships of the European Respiratory Society and the Collegium Internationale Allergologicum, and has contributed to over 270 peer-reviewed publications (h-index 57, >15,500 citations).

Dr. Padmaja Subbarao

Dr. Padmaja Subbarao is a Clinician-Scientist in Pediatric Respiratory Medicine specializing clinically in severe asthma. She is trained in both epidemiology and infant and preschool lung function. She holds a CRC Tier 1 Chair in Pediatric Asthma and Lung Health at the University of Toronto and is a Severe Asthma Specialist at The Hospital for Sick Children. Dr. Subbarao’s research program focuses on disentangling preschool wheeze heterogeneity to precisely predict who will develop each type of asthma, monitor its progression and discover the risk factors, exposures and underlying biology associated with each asthma subtype. She is the Director of the CHILD cohort study (www.childstudy.ca), one of the largest, most intensively characterized asthma birth cohorts in the world. This world-leading study enabled the discovery of the importance of the gut microbiome for the protection against asthma (cited >500). She also established the first infant lung function laboratory in Canada, and her early work on the novel multiple breath washout (MBW) lung test paved the way for its acceptance by the Federal Drug Agency as an objective outcome measure for clinical trials in Cystic Fibrosis (CF). Her research in early life lung function as a biomarker and risk factors in asthma have enabled the earlier precise prediction of asthma and monitoring of its progression, thus advancing the diagnosis and treatment of children with asthma. Dr. Subbarao is also an international leader in pediatric severe asthma, co-authoring clinical practice guidelines and position statements. She serves as an Advisor to the National Institutes of Health (NIH) to review other asthma cohort studies. She is a committed mentor and teacher and at the institutional level serves as the Director of the Clinician-Scientist Training Program at SickKids.