News From CHEST Physician®

Clinical outcomes and healthcare resource utilization associated with reslizumab treatment in adults with severe eosinophilic asthma in real-world practice. By Dr. M. Wechsler et al.



Corticosteroid therapy is associated with improved outcome in critically ill COVID-19 patients with hyperinflammatory phenotype. By Dr. H. Qiu, et al.



Quantitative emphysema on low-dose computed tomography of the chest and risk of lung cancer and airflow obstruction: An analysis of the National Lung Screening Trial.By Dr. M. Han, et al.



How I Do It: Endobronchial valves for the treatment of advanced emphysema. By Dr. D-J. Slebos, et al.



Prolonged hospitalization following acute respiratory failure. By Dr. M. Marmor, et al.



How I Do It: Assessing patients for air travel. By Dr. J. Mandel, et al.



Development and validation of algorithms to identify pulmonary arterial hypertension in administrative data. By Dr. K. Gillmeyer, et al.



Sleep apnea and insomnia: Emerging evidence for effective clinical management. By Dr. J. Ong, et al.



Shades of gray: Subsolid nodule considerations and management. By Dr. L. Azour, et al.

Clinical outcomes and healthcare resource utilization associated with reslizumab treatment in adults with severe eosinophilic asthma in real-world practice. By Dr. M. Wechsler et al.



Corticosteroid therapy is associated with improved outcome in critically ill COVID-19 patients with hyperinflammatory phenotype. By Dr. H. Qiu, et al.



Quantitative emphysema on low-dose computed tomography of the chest and risk of lung cancer and airflow obstruction: An analysis of the National Lung Screening Trial.By Dr. M. Han, et al.



How I Do It: Endobronchial valves for the treatment of advanced emphysema. By Dr. D-J. Slebos, et al.



Prolonged hospitalization following acute respiratory failure. By Dr. M. Marmor, et al.



How I Do It: Assessing patients for air travel. By Dr. J. Mandel, et al.



Development and validation of algorithms to identify pulmonary arterial hypertension in administrative data. By Dr. K. Gillmeyer, et al.



Sleep apnea and insomnia: Emerging evidence for effective clinical management. By Dr. J. Ong, et al.



Shades of gray: Subsolid nodule considerations and management. By Dr. L. Azour, et al.

Clinical outcomes and healthcare resource utilization associated with reslizumab treatment in adults with severe eosinophilic asthma in real-world practice. By Dr. M. Wechsler et al.



Corticosteroid therapy is associated with improved outcome in critically ill COVID-19 patients with hyperinflammatory phenotype. By Dr. H. Qiu, et al.



Quantitative emphysema on low-dose computed tomography of the chest and risk of lung cancer and airflow obstruction: An analysis of the National Lung Screening Trial.By Dr. M. Han, et al.



How I Do It: Endobronchial valves for the treatment of advanced emphysema. By Dr. D-J. Slebos, et al.



Prolonged hospitalization following acute respiratory failure. By Dr. M. Marmor, et al.



How I Do It: Assessing patients for air travel. By Dr. J. Mandel, et al.



Development and validation of algorithms to identify pulmonary arterial hypertension in administrative data. By Dr. K. Gillmeyer, et al.



Sleep apnea and insomnia: Emerging evidence for effective clinical management. By Dr. J. Ong, et al.



Shades of gray: Subsolid nodule considerations and management. By Dr. L. Azour, et al.

Interventional chest and diagnostic procedures

Risk stratification and management of pleural infections

Pleural infection carries a significant health care burden with an estimated mortality rate between 10% and 20% in adults. Standard of care for pleural infections has traditionally included antibiotics and tube thoracostomy, with select patients requiring a surgical intervention. The landmark MIST II trial demonstrated that combination intrapleural fibrinolytic and DNase therapy led to reduced length of stay and lower surgical referral rates compared with placebo.¹ While the use of combination intrapleural therapy has become common in the management of these patients, controversies still exist regarding nuances related to the various aspects of this therapy. A recent position paper published in Lancet Respiratory Medicine² addresses these knowledge gaps and provides recommendations to offer guidance in decision-making. The consensus statement by the authors addresses the topics of intrapleural monotherapy, dosing regimen, sequence of dosing, and cost considerations amongst other things. The authors also summarize evidence and discuss a surgery first vs. intrapleural enzyme therapy first approach based on stage of empyema and presence of surgical expertise and surgical candidacy. However, the debate between early surgical intervention vs early intrapleural enzyme therapy has not been settled yet. A large prospective randomized control trial is currently ongoing to help answer this question [https://doi.org/10.1186/ISRCTN18192121].

Meanwhile, there has been a lack of robust validated prediction methods for selecting high-risk patients at presentation with pleural infection for an early aggressive intervention. Based on previous studies, Rahman et al.³ had described the RAPID (Renal[urea], Age, fluid Purulence, Infection Source, Dietary [albumin]) score for risk stratification of these patients. Corcoran et al.⁴ recently conducted a prospective, observational study and validated that the RAPID risk category (Low-risk [0-2], Medium-risk [3-4], and High-risk [5-7]) can help predict mortality at 3 months. This score may prove to be a useful tool for future research directed at improving outcomes in patients with pleural infections.

Abhinav Agrawal, MD

Samaan Rafeq , MD

NetWork Members

References

1. Rahman NM, et al. N Engl J Med. 2011 Aug 11;365(6):518.

doi: 10.1056/NEJMoa1012740.

2. Chaddha U, et al. Lancet Respir Med. 2021. S2213-2600(20)30533-6. doi: 10.1016/S2213-2600(20)30533-6.

3. Rahman NM, et al. Chest. 2014 Apr;145(4):848. doi: 10.1378/chest.13-1558.

4. Corcoran JP, et al. Eur Respir J. 2020 Nov 26;56(5):2000130. doi: 10.1183/13993003.00130-2020.
 

Pediatric chest medicine

Appendicitis and COVID-19

During the 2020-21 year, there was an unprecedent amount of literature and studies released to the scientific and general public about the severe, acute respiratory Coronavirus 2 (SARS-CoV-2) syndrome, commonly referred to as COVID-19. The impressive focus on SARS-CoV-2 appeared appropriately featured given the public health concerns with contraction of the disease.

While it is important to understand the potential presentations, complications, and treatments in the adult population, clinicians must be aware of the impact of this disease on children. Contrary to reports early in the pandemic, SARS-CoV-2 infection can lead to serious complications in the pediatric population. One complication is a condition called multisystem inflammation syndrome in children (MIS-C) that can mimic Kawasaki disease or toxic shock syndrome. In addition to the expected common clinical presentation of respiratory symptoms and fever, gastrointestinal complaints were reported in up to 84% of the infected children. Gastrointestinal symptoms may be the only complaint in this population, typically presenting with nausea, emesis, abdominal pain, and diarrhea. The Pediatric Chest NetWork intends to highlight these gastrointestinal complaints and make clinicians aware of an appendicitis-like syndrome or even true acute appendicitis that seems to occur in association with SARS-CoV-2 infection. There is a handful of case reports and case series that discussed this phenomenon. Due to the overlap of presenting symptoms in SARS-CoV-2 infection and acute appendicitis, clinicians must astutely evaluate patients to prevent worsening complications of a missed diagnosed appendicitis.

Eric Mull, DO

NetWork Fellow-in-Training

Pulmonary physiology, function, and rehabilitation

Lung function testing during the COVID-19 pandemic

The COVID-19 pandemic poses unique challenges to caring for patients with established lung disease or new onset respiratory complaints. Although maneuvers differ across individual tests, most involve forced expiration or high ventilatory rates. They also tend to generate cough. Because the SARS-CoV-2 virus is predominantly spread via respiratory droplets, coughing, forced expiration, and high ventilatory rates will increase the risk for transmission.

Respiratory societies across the world have developed recommendations for operating a pulmonary function lab during the pandemic (Pulmonology. 2020 Aug 5;S2531-0437[20]30175-6; Ann Am Thorac Soc. 2020;17[11]:1343). In general, deferring all non-ssential testing and adjusting precautions and testing volume by local infection rates is recommended. Using proper personal protective equipment (PPE), including N95 respirators for staff, enhanced cleaning of rooms and PFT equipment (per manufacturer recommendations), and allowing time for adequate air exchange between tests are recommended practices. Screening for symptoms prior to testing is mandatory, with the recognition that for pulmonary patients, the specificity for COVID-19 will be poor. Finally, testing for SARS-CoV-2, generally within 72 hours, and using negative pressure rooms, has been encouraged by all, though there is variation by institution and resources.

It remains imperative that lung function labs provide a safe environment for patients and staff. However, delays related to deferrals and the increased turnover time required for cleaning and air circulation grow worse over time. As the pandemic persists, the mounting toll on our pulmonary patients looms large – so please, get vaccinated and use proper precautions.

Thomas Decato, MD, FCCP

Vice-Chair

Aaron Holley, MD, FCCP

NetWork Member

Pulmonary vascular disease

I screen, you screen, we all screen for ... PAH

Although rare in the general population, pulmonary arterial hypertension (PAH) occurs more frequently in connective tissue disease, congenital heart disease, HIV, portal hypertension, and in carriers of gene mutations of heritable PAH. Given the high morbidity and mortality, and improved outcomes with earlier diagnosis and treatment, guidelines recommend aggressive assessment and screening for PAH in these high-risk groups (Frost A, et al. Eur Respir J. 2019; 53:1801904).

Effective PAH screening algorithms have been developed in systemic sclerosis. The best validated screening tool is the DETECT algorithm (Coghlan JG, et al. Ann Rheum Dis. 2014;73:1340), which uses clinical, laboratory, and pulmonary function test parameters in conjunction with echocardiographic findings to recommend right heart catheterization (RHC) for PH diagnosis. Multimodal assessments are more sensitive than echocardiography alone in diagnosing PAH in systemic sclerosis (Hao Y, et al. Arthritis Res Ther. 2015;17:7) and should be developed in other at-risk cohorts.

Recently, the DELPHI-2 study prospectively screened 55 asymptomatic adult carriers of a BMPR2 mutation- the most common genetic mutation in heritable PAH- for minimum of 2 years (Montani D, et al. Eur Respir J. 2020 Dec 30;2004229. doi: 10.1183/13993003.04229-2020). Using predefined symptomatic, echocardiographic, and cardiopulmonary exercise testing criteria for referral for RHC, the incidence of PAH was 2.3% per year. This study lays the foundation for a multimodal approach to screening carriers of BMPR2 mutations and emphasizes the importance of genetic counseling for idiopathic and familial PAH patients to identify mutation carriers who stand to benefit from appropriate PAH screening.

Christopher J. Mullin, MD, MHS

Steering Committee Member

Interventional chest and diagnostic procedures

Risk stratification and management of pleural infections

Pleural infection carries a significant health care burden with an estimated mortality rate between 10% and 20% in adults. Standard of care for pleural infections has traditionally included antibiotics and tube thoracostomy, with select patients requiring a surgical intervention. The landmark MIST II trial demonstrated that combination intrapleural fibrinolytic and DNase therapy led to reduced length of stay and lower surgical referral rates compared with placebo.¹ While the use of combination intrapleural therapy has become common in the management of these patients, controversies still exist regarding nuances related to the various aspects of this therapy. A recent position paper published in Lancet Respiratory Medicine² addresses these knowledge gaps and provides recommendations to offer guidance in decision-making. The consensus statement by the authors addresses the topics of intrapleural monotherapy, dosing regimen, sequence of dosing, and cost considerations amongst other things. The authors also summarize evidence and discuss a surgery first vs. intrapleural enzyme therapy first approach based on stage of empyema and presence of surgical expertise and surgical candidacy. However, the debate between early surgical intervention vs early intrapleural enzyme therapy has not been settled yet. A large prospective randomized control trial is currently ongoing to help answer this question [https://doi.org/10.1186/ISRCTN18192121].

Meanwhile, there has been a lack of robust validated prediction methods for selecting high-risk patients at presentation with pleural infection for an early aggressive intervention. Based on previous studies, Rahman et al.³ had described the RAPID (Renal[urea], Age, fluid Purulence, Infection Source, Dietary [albumin]) score for risk stratification of these patients. Corcoran et al.⁴ recently conducted a prospective, observational study and validated that the RAPID risk category (Low-risk [0-2], Medium-risk [3-4], and High-risk [5-7]) can help predict mortality at 3 months. This score may prove to be a useful tool for future research directed at improving outcomes in patients with pleural infections.

Abhinav Agrawal, MD

Samaan Rafeq , MD

NetWork Members

References

1. Rahman NM, et al. N Engl J Med. 2011 Aug 11;365(6):518.

doi: 10.1056/NEJMoa1012740.

2. Chaddha U, et al. Lancet Respir Med. 2021. S2213-2600(20)30533-6. doi: 10.1016/S2213-2600(20)30533-6.

3. Rahman NM, et al. Chest. 2014 Apr;145(4):848. doi: 10.1378/chest.13-1558.

4. Corcoran JP, et al. Eur Respir J. 2020 Nov 26;56(5):2000130. doi: 10.1183/13993003.00130-2020.
 

Pediatric chest medicine

Appendicitis and COVID-19

During the 2020-21 year, there was an unprecedent amount of literature and studies released to the scientific and general public about the severe, acute respiratory Coronavirus 2 (SARS-CoV-2) syndrome, commonly referred to as COVID-19. The impressive focus on SARS-CoV-2 appeared appropriately featured given the public health concerns with contraction of the disease.

While it is important to understand the potential presentations, complications, and treatments in the adult population, clinicians must be aware of the impact of this disease on children. Contrary to reports early in the pandemic, SARS-CoV-2 infection can lead to serious complications in the pediatric population. One complication is a condition called multisystem inflammation syndrome in children (MIS-C) that can mimic Kawasaki disease or toxic shock syndrome. In addition to the expected common clinical presentation of respiratory symptoms and fever, gastrointestinal complaints were reported in up to 84% of the infected children. Gastrointestinal symptoms may be the only complaint in this population, typically presenting with nausea, emesis, abdominal pain, and diarrhea. The Pediatric Chest NetWork intends to highlight these gastrointestinal complaints and make clinicians aware of an appendicitis-like syndrome or even true acute appendicitis that seems to occur in association with SARS-CoV-2 infection. There is a handful of case reports and case series that discussed this phenomenon. Due to the overlap of presenting symptoms in SARS-CoV-2 infection and acute appendicitis, clinicians must astutely evaluate patients to prevent worsening complications of a missed diagnosed appendicitis.

Eric Mull, DO

NetWork Fellow-in-Training

Pulmonary physiology, function, and rehabilitation

Lung function testing during the COVID-19 pandemic

The COVID-19 pandemic poses unique challenges to caring for patients with established lung disease or new onset respiratory complaints. Although maneuvers differ across individual tests, most involve forced expiration or high ventilatory rates. They also tend to generate cough. Because the SARS-CoV-2 virus is predominantly spread via respiratory droplets, coughing, forced expiration, and high ventilatory rates will increase the risk for transmission.

Respiratory societies across the world have developed recommendations for operating a pulmonary function lab during the pandemic (Pulmonology. 2020 Aug 5;S2531-0437[20]30175-6; Ann Am Thorac Soc. 2020;17[11]:1343). In general, deferring all non-ssential testing and adjusting precautions and testing volume by local infection rates is recommended. Using proper personal protective equipment (PPE), including N95 respirators for staff, enhanced cleaning of rooms and PFT equipment (per manufacturer recommendations), and allowing time for adequate air exchange between tests are recommended practices. Screening for symptoms prior to testing is mandatory, with the recognition that for pulmonary patients, the specificity for COVID-19 will be poor. Finally, testing for SARS-CoV-2, generally within 72 hours, and using negative pressure rooms, has been encouraged by all, though there is variation by institution and resources.

It remains imperative that lung function labs provide a safe environment for patients and staff. However, delays related to deferrals and the increased turnover time required for cleaning and air circulation grow worse over time. As the pandemic persists, the mounting toll on our pulmonary patients looms large – so please, get vaccinated and use proper precautions.

Thomas Decato, MD, FCCP

Vice-Chair

Aaron Holley, MD, FCCP

NetWork Member

Pulmonary vascular disease

I screen, you screen, we all screen for ... PAH

Although rare in the general population, pulmonary arterial hypertension (PAH) occurs more frequently in connective tissue disease, congenital heart disease, HIV, portal hypertension, and in carriers of gene mutations of heritable PAH. Given the high morbidity and mortality, and improved outcomes with earlier diagnosis and treatment, guidelines recommend aggressive assessment and screening for PAH in these high-risk groups (Frost A, et al. Eur Respir J. 2019; 53:1801904).

Effective PAH screening algorithms have been developed in systemic sclerosis. The best validated screening tool is the DETECT algorithm (Coghlan JG, et al. Ann Rheum Dis. 2014;73:1340), which uses clinical, laboratory, and pulmonary function test parameters in conjunction with echocardiographic findings to recommend right heart catheterization (RHC) for PH diagnosis. Multimodal assessments are more sensitive than echocardiography alone in diagnosing PAH in systemic sclerosis (Hao Y, et al. Arthritis Res Ther. 2015;17:7) and should be developed in other at-risk cohorts.

Recently, the DELPHI-2 study prospectively screened 55 asymptomatic adult carriers of a BMPR2 mutation- the most common genetic mutation in heritable PAH- for minimum of 2 years (Montani D, et al. Eur Respir J. 2020 Dec 30;2004229. doi: 10.1183/13993003.04229-2020). Using predefined symptomatic, echocardiographic, and cardiopulmonary exercise testing criteria for referral for RHC, the incidence of PAH was 2.3% per year. This study lays the foundation for a multimodal approach to screening carriers of BMPR2 mutations and emphasizes the importance of genetic counseling for idiopathic and familial PAH patients to identify mutation carriers who stand to benefit from appropriate PAH screening.

Christopher J. Mullin, MD, MHS

Steering Committee Member

Interventional chest and diagnostic procedures

Risk stratification and management of pleural infections

Pleural infection carries a significant health care burden with an estimated mortality rate between 10% and 20% in adults. Standard of care for pleural infections has traditionally included antibiotics and tube thoracostomy, with select patients requiring a surgical intervention. The landmark MIST II trial demonstrated that combination intrapleural fibrinolytic and DNase therapy led to reduced length of stay and lower surgical referral rates compared with placebo.¹ While the use of combination intrapleural therapy has become common in the management of these patients, controversies still exist regarding nuances related to the various aspects of this therapy. A recent position paper published in Lancet Respiratory Medicine² addresses these knowledge gaps and provides recommendations to offer guidance in decision-making. The consensus statement by the authors addresses the topics of intrapleural monotherapy, dosing regimen, sequence of dosing, and cost considerations amongst other things. The authors also summarize evidence and discuss a surgery first vs. intrapleural enzyme therapy first approach based on stage of empyema and presence of surgical expertise and surgical candidacy. However, the debate between early surgical intervention vs early intrapleural enzyme therapy has not been settled yet. A large prospective randomized control trial is currently ongoing to help answer this question [https://doi.org/10.1186/ISRCTN18192121].

Meanwhile, there has been a lack of robust validated prediction methods for selecting high-risk patients at presentation with pleural infection for an early aggressive intervention. Based on previous studies, Rahman et al.³ had described the RAPID (Renal[urea], Age, fluid Purulence, Infection Source, Dietary [albumin]) score for risk stratification of these patients. Corcoran et al.⁴ recently conducted a prospective, observational study and validated that the RAPID risk category (Low-risk [0-2], Medium-risk [3-4], and High-risk [5-7]) can help predict mortality at 3 months. This score may prove to be a useful tool for future research directed at improving outcomes in patients with pleural infections.

Abhinav Agrawal, MD

Samaan Rafeq , MD

NetWork Members

References

1. Rahman NM, et al. N Engl J Med. 2011 Aug 11;365(6):518.

doi: 10.1056/NEJMoa1012740.

2. Chaddha U, et al. Lancet Respir Med. 2021. S2213-2600(20)30533-6. doi: 10.1016/S2213-2600(20)30533-6.

3. Rahman NM, et al. Chest. 2014 Apr;145(4):848. doi: 10.1378/chest.13-1558.

4. Corcoran JP, et al. Eur Respir J. 2020 Nov 26;56(5):2000130. doi: 10.1183/13993003.00130-2020.
 

Pediatric chest medicine

Appendicitis and COVID-19

During the 2020-21 year, there was an unprecedent amount of literature and studies released to the scientific and general public about the severe, acute respiratory Coronavirus 2 (SARS-CoV-2) syndrome, commonly referred to as COVID-19. The impressive focus on SARS-CoV-2 appeared appropriately featured given the public health concerns with contraction of the disease.

While it is important to understand the potential presentations, complications, and treatments in the adult population, clinicians must be aware of the impact of this disease on children. Contrary to reports early in the pandemic, SARS-CoV-2 infection can lead to serious complications in the pediatric population. One complication is a condition called multisystem inflammation syndrome in children (MIS-C) that can mimic Kawasaki disease or toxic shock syndrome. In addition to the expected common clinical presentation of respiratory symptoms and fever, gastrointestinal complaints were reported in up to 84% of the infected children. Gastrointestinal symptoms may be the only complaint in this population, typically presenting with nausea, emesis, abdominal pain, and diarrhea. The Pediatric Chest NetWork intends to highlight these gastrointestinal complaints and make clinicians aware of an appendicitis-like syndrome or even true acute appendicitis that seems to occur in association with SARS-CoV-2 infection. There is a handful of case reports and case series that discussed this phenomenon. Due to the overlap of presenting symptoms in SARS-CoV-2 infection and acute appendicitis, clinicians must astutely evaluate patients to prevent worsening complications of a missed diagnosed appendicitis.

Eric Mull, DO

NetWork Fellow-in-Training

Pulmonary physiology, function, and rehabilitation

Lung function testing during the COVID-19 pandemic

The COVID-19 pandemic poses unique challenges to caring for patients with established lung disease or new onset respiratory complaints. Although maneuvers differ across individual tests, most involve forced expiration or high ventilatory rates. They also tend to generate cough. Because the SARS-CoV-2 virus is predominantly spread via respiratory droplets, coughing, forced expiration, and high ventilatory rates will increase the risk for transmission.

Respiratory societies across the world have developed recommendations for operating a pulmonary function lab during the pandemic (Pulmonology. 2020 Aug 5;S2531-0437[20]30175-6; Ann Am Thorac Soc. 2020;17[11]:1343). In general, deferring all non-ssential testing and adjusting precautions and testing volume by local infection rates is recommended. Using proper personal protective equipment (PPE), including N95 respirators for staff, enhanced cleaning of rooms and PFT equipment (per manufacturer recommendations), and allowing time for adequate air exchange between tests are recommended practices. Screening for symptoms prior to testing is mandatory, with the recognition that for pulmonary patients, the specificity for COVID-19 will be poor. Finally, testing for SARS-CoV-2, generally within 72 hours, and using negative pressure rooms, has been encouraged by all, though there is variation by institution and resources.

It remains imperative that lung function labs provide a safe environment for patients and staff. However, delays related to deferrals and the increased turnover time required for cleaning and air circulation grow worse over time. As the pandemic persists, the mounting toll on our pulmonary patients looms large – so please, get vaccinated and use proper precautions.

Thomas Decato, MD, FCCP

Vice-Chair

Aaron Holley, MD, FCCP

NetWork Member

Pulmonary vascular disease

I screen, you screen, we all screen for ... PAH

Although rare in the general population, pulmonary arterial hypertension (PAH) occurs more frequently in connective tissue disease, congenital heart disease, HIV, portal hypertension, and in carriers of gene mutations of heritable PAH. Given the high morbidity and mortality, and improved outcomes with earlier diagnosis and treatment, guidelines recommend aggressive assessment and screening for PAH in these high-risk groups (Frost A, et al. Eur Respir J. 2019; 53:1801904).

Effective PAH screening algorithms have been developed in systemic sclerosis. The best validated screening tool is the DETECT algorithm (Coghlan JG, et al. Ann Rheum Dis. 2014;73:1340), which uses clinical, laboratory, and pulmonary function test parameters in conjunction with echocardiographic findings to recommend right heart catheterization (RHC) for PH diagnosis. Multimodal assessments are more sensitive than echocardiography alone in diagnosing PAH in systemic sclerosis (Hao Y, et al. Arthritis Res Ther. 2015;17:7) and should be developed in other at-risk cohorts.

Recently, the DELPHI-2 study prospectively screened 55 asymptomatic adult carriers of a BMPR2 mutation- the most common genetic mutation in heritable PAH- for minimum of 2 years (Montani D, et al. Eur Respir J. 2020 Dec 30;2004229. doi: 10.1183/13993003.04229-2020). Using predefined symptomatic, echocardiographic, and cardiopulmonary exercise testing criteria for referral for RHC, the incidence of PAH was 2.3% per year. This study lays the foundation for a multimodal approach to screening carriers of BMPR2 mutations and emphasizes the importance of genetic counseling for idiopathic and familial PAH patients to identify mutation carriers who stand to benefit from appropriate PAH screening.

Christopher J. Mullin, MD, MHS

Steering Committee Member

CHEST has been informed of the following deaths of CHEST members.

We extend our sincere condolences.

Noe Zamel, MD (2020)

Stuart Craig Lennox, MD (2018)

Teruo Hirose, MD, PhD, FCCP

Priscilla S. A Sarinas, MD, FCCP

Stephen Jenkinson, MD, FCCP (2021)

CHEST has been informed of the following deaths of CHEST members.

We extend our sincere condolences.

Noe Zamel, MD (2020)

Stuart Craig Lennox, MD (2018)

Teruo Hirose, MD, PhD, FCCP

Priscilla S. A Sarinas, MD, FCCP

Stephen Jenkinson, MD, FCCP (2021)

CHEST has been informed of the following deaths of CHEST members.

We extend our sincere condolences.

Noe Zamel, MD (2020)

Stuart Craig Lennox, MD (2018)

Teruo Hirose, MD, PhD, FCCP

Priscilla S. A Sarinas, MD, FCCP

Stephen Jenkinson, MD, FCCP (2021)

Feeling lonely is one of the biggest challenges that we are faced with during this pandemic. It doesn’t matter who you are – a patient, a caregiver, or a physician – it affects us all.

Social distancing practices make it almost impossible to host in-person gatherings, which is hard on everyone, but as a philanthropic organization that focuses on community events, it’s down-right devastating. Not only does the Foundation look to events to help form a sense of camaraderie among our donors, we rely on them to help fund our projects.

That’s why we had to get creative last year and quickly reimagine our events in a totally new space ... cyberspace to be exact.
 

New takes on old favorites

We’re proud to say that we hosted seven online events in 2020, including Irv Feldman’s Poker Tournament, one of our most popular fundraisers. “We wanted to continue our traditions but knew we had to do it in a different format. We learned to pivot quickly and get everything online, but we then had to cross our fingers that our donors would get onboard,” said Angela Perillo, Director, Development & Foundation Operations. To the Foundation’s delight, the events not only piqued people’s interest, they brought in more than $150,000!

The impact of your ticket purchase

The Foundation has a new motto in 2021: “When you attend an event, you tend to our mission.” In other words, every event we host raises funds for our initiatives. “We want our donors to know that while they’re having a great time, they’re also doing their part in helping the Foundation enable more people to get access to the resources they need. A ticket sale today might help a patient get better care tomorrow, “ said Perillo.

Now’s the time to attend

Several events have been planned for this spring and summer. We hope you’ll join us by registering at chestfoundation.org and following #CHESTFoundation25 on social media:

• Irv’s Spring Splash Poker Tournament: Thursday, May 20 at 7 pm CT
• Belmont Stakes Reception & Auction: June 5 at 5 pm CT
• Irv’s Spring Splash Poker Tournament: June 18 at 7 pm CT
• Wine Tasting: June 24 at 7 pm CT
• Trivia Night: July 21 at 7 pm CT

Chestfoundation.org

Feeling lonely is one of the biggest challenges that we are faced with during this pandemic. It doesn’t matter who you are – a patient, a caregiver, or a physician – it affects us all.

Social distancing practices make it almost impossible to host in-person gatherings, which is hard on everyone, but as a philanthropic organization that focuses on community events, it’s down-right devastating. Not only does the Foundation look to events to help form a sense of camaraderie among our donors, we rely on them to help fund our projects.

That’s why we had to get creative last year and quickly reimagine our events in a totally new space ... cyberspace to be exact.
 

New takes on old favorites

We’re proud to say that we hosted seven online events in 2020, including Irv Feldman’s Poker Tournament, one of our most popular fundraisers. “We wanted to continue our traditions but knew we had to do it in a different format. We learned to pivot quickly and get everything online, but we then had to cross our fingers that our donors would get onboard,” said Angela Perillo, Director, Development & Foundation Operations. To the Foundation’s delight, the events not only piqued people’s interest, they brought in more than $150,000!

The impact of your ticket purchase

The Foundation has a new motto in 2021: “When you attend an event, you tend to our mission.” In other words, every event we host raises funds for our initiatives. “We want our donors to know that while they’re having a great time, they’re also doing their part in helping the Foundation enable more people to get access to the resources they need. A ticket sale today might help a patient get better care tomorrow, “ said Perillo.

Now’s the time to attend

Several events have been planned for this spring and summer. We hope you’ll join us by registering at chestfoundation.org and following #CHESTFoundation25 on social media:

• Irv’s Spring Splash Poker Tournament: Thursday, May 20 at 7 pm CT
• Belmont Stakes Reception & Auction: June 5 at 5 pm CT
• Irv’s Spring Splash Poker Tournament: June 18 at 7 pm CT
• Wine Tasting: June 24 at 7 pm CT
• Trivia Night: July 21 at 7 pm CT

Chestfoundation.org

Feeling lonely is one of the biggest challenges that we are faced with during this pandemic. It doesn’t matter who you are – a patient, a caregiver, or a physician – it affects us all.

Social distancing practices make it almost impossible to host in-person gatherings, which is hard on everyone, but as a philanthropic organization that focuses on community events, it’s down-right devastating. Not only does the Foundation look to events to help form a sense of camaraderie among our donors, we rely on them to help fund our projects.

That’s why we had to get creative last year and quickly reimagine our events in a totally new space ... cyberspace to be exact.
 

New takes on old favorites

We’re proud to say that we hosted seven online events in 2020, including Irv Feldman’s Poker Tournament, one of our most popular fundraisers. “We wanted to continue our traditions but knew we had to do it in a different format. We learned to pivot quickly and get everything online, but we then had to cross our fingers that our donors would get onboard,” said Angela Perillo, Director, Development & Foundation Operations. To the Foundation’s delight, the events not only piqued people’s interest, they brought in more than $150,000!

The impact of your ticket purchase

The Foundation has a new motto in 2021: “When you attend an event, you tend to our mission.” In other words, every event we host raises funds for our initiatives. “We want our donors to know that while they’re having a great time, they’re also doing their part in helping the Foundation enable more people to get access to the resources they need. A ticket sale today might help a patient get better care tomorrow, “ said Perillo.

Now’s the time to attend

Several events have been planned for this spring and summer. We hope you’ll join us by registering at chestfoundation.org and following #CHESTFoundation25 on social media:

• Irv’s Spring Splash Poker Tournament: Thursday, May 20 at 7 pm CT
• Belmont Stakes Reception & Auction: June 5 at 5 pm CT
• Irv’s Spring Splash Poker Tournament: June 18 at 7 pm CT
• Wine Tasting: June 24 at 7 pm CT
• Trivia Night: July 21 at 7 pm CT

Chestfoundation.org

COVID-19 vaccination efforts were initially restricted to health department control, and physician practices were not often included as vaccination sites. However, as vaccine availability improves ,physician offices will become a place where vaccines can be delivered conveniently and efficiently. It is important to understand the current and future coding and billing requirements for COVID-19 vaccination so that one’s practice may be appropriately reimbursed.

The provision of COVID-19 vaccination in an office setting is not as simple as influenza or pneumonia vaccination. One can find useful information about all vaccines and specifically about COVID-19 vaccines at https://www.cdc.gov/vaccines/ed/index.html. This site includes video training modules and downloadable resources for clinical use, as well as patient education. This information is important as providing vaccinations may require a change in infrastructure, equipment, and clinical flow. It may not be financially advantageous for one’s practice to provide COVID-19 vaccination.

If the decision is made to provide COVID-19 vaccinations, there are specific CPT codes for each vaccine and its administration (Table 1). These codes are valid for the vaccines with emergency use authorization (Pfizer, Moderna, Janssen) but not yet for as yet unauthorized vaccines (AstraZeneca). Should additional vaccines be authorized, it is expected that new CPT codes will be added.

When a patient is vaccinated, only the administration code is used at this time. The CPT codes for the vaccine (91300-3) should not be used because the cost of the vaccine is currently born by the federal government. When the vaccines are available for purchase by a practice, it will then be appropriate to use the vaccine CPT code. If an evaluation and management (E/M) service is performed, the appropriate E/M service code should be reported in addition to the vaccine administration code.

For payment of the vaccine administration by Medicare, either a single claim or roster claim can be submitted. When five or more patients are vaccinated using the same vaccine on the same day, one may submit a roster claim. Instructions on how to appropriately bill the various Medicare plans can be found at https://tinyurl.com/hfya8888. Guidelines for payment by private insurers should also be reviewed as well, as they will have their own requirements. If a vaccine is given to an individual who does not have any insurance coverage, reimbursement may be available through the Provider Relief Fund. These funds were made available by legislation, including the CARES act and information about claim submittal for the uninsured can be found at https://www.hrsa.gov/CovidUninsuredClaim.

COVID-19 vaccination efforts were initially restricted to health department control, and physician practices were not often included as vaccination sites. However, as vaccine availability improves ,physician offices will become a place where vaccines can be delivered conveniently and efficiently. It is important to understand the current and future coding and billing requirements for COVID-19 vaccination so that one’s practice may be appropriately reimbursed.

The provision of COVID-19 vaccination in an office setting is not as simple as influenza or pneumonia vaccination. One can find useful information about all vaccines and specifically about COVID-19 vaccines at https://www.cdc.gov/vaccines/ed/index.html. This site includes video training modules and downloadable resources for clinical use, as well as patient education. This information is important as providing vaccinations may require a change in infrastructure, equipment, and clinical flow. It may not be financially advantageous for one’s practice to provide COVID-19 vaccination.

If the decision is made to provide COVID-19 vaccinations, there are specific CPT codes for each vaccine and its administration (Table 1). These codes are valid for the vaccines with emergency use authorization (Pfizer, Moderna, Janssen) but not yet for as yet unauthorized vaccines (AstraZeneca). Should additional vaccines be authorized, it is expected that new CPT codes will be added.

When a patient is vaccinated, only the administration code is used at this time. The CPT codes for the vaccine (91300-3) should not be used because the cost of the vaccine is currently born by the federal government. When the vaccines are available for purchase by a practice, it will then be appropriate to use the vaccine CPT code. If an evaluation and management (E/M) service is performed, the appropriate E/M service code should be reported in addition to the vaccine administration code.

For payment of the vaccine administration by Medicare, either a single claim or roster claim can be submitted. When five or more patients are vaccinated using the same vaccine on the same day, one may submit a roster claim. Instructions on how to appropriately bill the various Medicare plans can be found at https://tinyurl.com/hfya8888. Guidelines for payment by private insurers should also be reviewed as well, as they will have their own requirements. If a vaccine is given to an individual who does not have any insurance coverage, reimbursement may be available through the Provider Relief Fund. These funds were made available by legislation, including the CARES act and information about claim submittal for the uninsured can be found at https://www.hrsa.gov/CovidUninsuredClaim.

COVID-19 vaccination efforts were initially restricted to health department control, and physician practices were not often included as vaccination sites. However, as vaccine availability improves ,physician offices will become a place where vaccines can be delivered conveniently and efficiently. It is important to understand the current and future coding and billing requirements for COVID-19 vaccination so that one’s practice may be appropriately reimbursed.

The provision of COVID-19 vaccination in an office setting is not as simple as influenza or pneumonia vaccination. One can find useful information about all vaccines and specifically about COVID-19 vaccines at https://www.cdc.gov/vaccines/ed/index.html. This site includes video training modules and downloadable resources for clinical use, as well as patient education. This information is important as providing vaccinations may require a change in infrastructure, equipment, and clinical flow. It may not be financially advantageous for one’s practice to provide COVID-19 vaccination.

If the decision is made to provide COVID-19 vaccinations, there are specific CPT codes for each vaccine and its administration (Table 1). These codes are valid for the vaccines with emergency use authorization (Pfizer, Moderna, Janssen) but not yet for as yet unauthorized vaccines (AstraZeneca). Should additional vaccines be authorized, it is expected that new CPT codes will be added.

When a patient is vaccinated, only the administration code is used at this time. The CPT codes for the vaccine (91300-3) should not be used because the cost of the vaccine is currently born by the federal government. When the vaccines are available for purchase by a practice, it will then be appropriate to use the vaccine CPT code. If an evaluation and management (E/M) service is performed, the appropriate E/M service code should be reported in addition to the vaccine administration code.

For payment of the vaccine administration by Medicare, either a single claim or roster claim can be submitted. When five or more patients are vaccinated using the same vaccine on the same day, one may submit a roster claim. Instructions on how to appropriately bill the various Medicare plans can be found at https://tinyurl.com/hfya8888. Guidelines for payment by private insurers should also be reviewed as well, as they will have their own requirements. If a vaccine is given to an individual who does not have any insurance coverage, reimbursement may be available through the Provider Relief Fund. These funds were made available by legislation, including the CARES act and information about claim submittal for the uninsured can be found at https://www.hrsa.gov/CovidUninsuredClaim.

Recognizing that caring for patients with COVID continues to be the focus of many physicians, in March, the American Board of Internal Medicine (ABIM) announced that it extended all MOC requirement deadlines until 12/31/22. For those ABIM Board Certified in Critical Care Medicine, Hospital Medicine, Infectious Disease, or Pulmonary Disease, MOC requirements have been extended until the end of 2023.

In a letter to the internal medicine community, Richard J. Baron, MD, MACP, ABIM President and CEO; and Marianne M. Green, MD, Chair of the ABIM Board of Directors, said, “We know internists and internal medicine subspecialists have been on the front lines meeting the country’s needs, many experiencing the tragedy of COVID in deeply personal ways…We also recognize the high levels of stress you may have faced over the last 12 months, and that it will likely be some time until it subsides…We hope this gives you one less thing to worry about.”

The decision means that nobody will lose ABIM certification if they are unable to complete MOC requirements this year. Recognizing every physician’s situation is different, all ABIM MOC exams will be administered as scheduled in 2021 for those who wish to take one.

In January 2022, ABIM will launch a new Longitudinal Knowledge Assessment (LKATM) (www.abim.org/lka/), a more flexible and convenient way to maintain certification. Physicians who decide to delay their 2021 assessment will be able to enroll in the LKA when it rolls out (pending availability), or can choose to take the traditional, 10-year MOC exam if they prefer.

The LKA for Critical Care, Hospital Medicine, Infectious Disease, and Pulmonary Disease will launch in January 2023. As these were among the disciplines most impacted by COVID, additional time is needed to create the requisite content for a high-quality assessment and is why MOC requirement deadlines for these specialties is extended an additional year to provide a transition pathway to the LKA.

Through the LKA, questions can be answered on almost any internet-connected device at any time, and physicians can access all the resources used in practice (except another person). ABIM will release 30 questions each quarter that can be answered a few at a time, or all at once. Immediate feedback with rationale and reference will be provided. As long as at least 500 of the 600 questions are answered over the 5-year cycle, the LKA Participation Requirement will be met.

ABIM is in the process of updating the Physician Portal in light of the MOC requirements deadline extension. If you have any questions about your requirements, call 1-800-441-ABIM or email [email protected]. For further information about the LKA, visit abim.org/lka/.

Recognizing that caring for patients with COVID continues to be the focus of many physicians, in March, the American Board of Internal Medicine (ABIM) announced that it extended all MOC requirement deadlines until 12/31/22. For those ABIM Board Certified in Critical Care Medicine, Hospital Medicine, Infectious Disease, or Pulmonary Disease, MOC requirements have been extended until the end of 2023.

In a letter to the internal medicine community, Richard J. Baron, MD, MACP, ABIM President and CEO; and Marianne M. Green, MD, Chair of the ABIM Board of Directors, said, “We know internists and internal medicine subspecialists have been on the front lines meeting the country’s needs, many experiencing the tragedy of COVID in deeply personal ways…We also recognize the high levels of stress you may have faced over the last 12 months, and that it will likely be some time until it subsides…We hope this gives you one less thing to worry about.”

The decision means that nobody will lose ABIM certification if they are unable to complete MOC requirements this year. Recognizing every physician’s situation is different, all ABIM MOC exams will be administered as scheduled in 2021 for those who wish to take one.

In January 2022, ABIM will launch a new Longitudinal Knowledge Assessment (LKATM) (www.abim.org/lka/), a more flexible and convenient way to maintain certification. Physicians who decide to delay their 2021 assessment will be able to enroll in the LKA when it rolls out (pending availability), or can choose to take the traditional, 10-year MOC exam if they prefer.

The LKA for Critical Care, Hospital Medicine, Infectious Disease, and Pulmonary Disease will launch in January 2023. As these were among the disciplines most impacted by COVID, additional time is needed to create the requisite content for a high-quality assessment and is why MOC requirement deadlines for these specialties is extended an additional year to provide a transition pathway to the LKA.

Through the LKA, questions can be answered on almost any internet-connected device at any time, and physicians can access all the resources used in practice (except another person). ABIM will release 30 questions each quarter that can be answered a few at a time, or all at once. Immediate feedback with rationale and reference will be provided. As long as at least 500 of the 600 questions are answered over the 5-year cycle, the LKA Participation Requirement will be met.

ABIM is in the process of updating the Physician Portal in light of the MOC requirements deadline extension. If you have any questions about your requirements, call 1-800-441-ABIM or email [email protected]. For further information about the LKA, visit abim.org/lka/.

Recognizing that caring for patients with COVID continues to be the focus of many physicians, in March, the American Board of Internal Medicine (ABIM) announced that it extended all MOC requirement deadlines until 12/31/22. For those ABIM Board Certified in Critical Care Medicine, Hospital Medicine, Infectious Disease, or Pulmonary Disease, MOC requirements have been extended until the end of 2023.

In a letter to the internal medicine community, Richard J. Baron, MD, MACP, ABIM President and CEO; and Marianne M. Green, MD, Chair of the ABIM Board of Directors, said, “We know internists and internal medicine subspecialists have been on the front lines meeting the country’s needs, many experiencing the tragedy of COVID in deeply personal ways…We also recognize the high levels of stress you may have faced over the last 12 months, and that it will likely be some time until it subsides…We hope this gives you one less thing to worry about.”

The decision means that nobody will lose ABIM certification if they are unable to complete MOC requirements this year. Recognizing every physician’s situation is different, all ABIM MOC exams will be administered as scheduled in 2021 for those who wish to take one.

In January 2022, ABIM will launch a new Longitudinal Knowledge Assessment (LKATM) (www.abim.org/lka/), a more flexible and convenient way to maintain certification. Physicians who decide to delay their 2021 assessment will be able to enroll in the LKA when it rolls out (pending availability), or can choose to take the traditional, 10-year MOC exam if they prefer.

The LKA for Critical Care, Hospital Medicine, Infectious Disease, and Pulmonary Disease will launch in January 2023. As these were among the disciplines most impacted by COVID, additional time is needed to create the requisite content for a high-quality assessment and is why MOC requirement deadlines for these specialties is extended an additional year to provide a transition pathway to the LKA.

Through the LKA, questions can be answered on almost any internet-connected device at any time, and physicians can access all the resources used in practice (except another person). ABIM will release 30 questions each quarter that can be answered a few at a time, or all at once. Immediate feedback with rationale and reference will be provided. As long as at least 500 of the 600 questions are answered over the 5-year cycle, the LKA Participation Requirement will be met.

ABIM is in the process of updating the Physician Portal in light of the MOC requirements deadline extension. If you have any questions about your requirements, call 1-800-441-ABIM or email [email protected]. For further information about the LKA, visit abim.org/lka/.

A little over a year ago, none of us imagined we’d be where we are right now. The pandemic has deeply affected us all, and there have been so many losses, both professional and personal. I’m proud of how our CHEST community responded to the pandemic. The incredibly rapid pace of knowledge acquisition and the speed at which we disseminated that knowledge took a lot of combined effort, but that’s nothing new to our CHEST community.

Throughout the pandemic, CHEST pushed digital education with an array of webinars, podcasts, bite-sized educational modules, and infographics. We held a highly successful, well-received CHEST 2020 online conference with just a few months of planning. I’m so excited to take what we learned about offering high-quality, digital education and turn that into a hybrid meeting for CHEST 2021 that meets the educational needs of every participant!

At CHEST 2021, you will be presented with the latest in pulmonary, critical care, and sleep medicine for clinicians at all levels. Whether you are a trainee or an experienced clinician, there is something to learn at CHEST 2021. We are packing the agenda with experiences from live learning and simulation to high-quality education sessions and smaller problem-based learning classes.

On top of this, you have an amazing opportunity to network and reconnect with colleagues you haven’t seen in months! Whether at Experience CHEST, in the gaming area, the Trainee and Transition Lounge, and more, CHEST 2021, as always, is the best at providing top-tier education, team-based learning, and community connections.

This will be the first hybrid meeting put on by CHEST. We came to the decision knowing that while some people are hungry to get back to having an in-person experience, others found that an online conference better fits their needs. I strongly encourage you to join us October 17-20 in Orlando, Florida, to experience the networking and growth opportunities that come from attending in person. We are following strict protocols, as recommended by the CDC, and will be requiring all attendees to attest to being vaccinated. However, if travel isn’t possible, join us for livestreamed, immersive digital learning from wherever you are in the world. Regardless of your choice, both options will allow you to engage in fun experiences, learn, and connect.

As Co-Chair of CHEST 2021, I’d like to personally invite you to participate, whether this is your first time or you’ve lost count how many times you’ve attended our annual meeting. The community at CHEST is what makes the CHEST conference special, and we are proud to be able to keep you all connected despite geographic restrictions.

Looking forward to seeing you there and connecting on Twitter at #CHEST2021.

Chris Carroll, MD

Co-Chair, CHEST 2021

A little over a year ago, none of us imagined we’d be where we are right now. The pandemic has deeply affected us all, and there have been so many losses, both professional and personal. I’m proud of how our CHEST community responded to the pandemic. The incredibly rapid pace of knowledge acquisition and the speed at which we disseminated that knowledge took a lot of combined effort, but that’s nothing new to our CHEST community.

Throughout the pandemic, CHEST pushed digital education with an array of webinars, podcasts, bite-sized educational modules, and infographics. We held a highly successful, well-received CHEST 2020 online conference with just a few months of planning. I’m so excited to take what we learned about offering high-quality, digital education and turn that into a hybrid meeting for CHEST 2021 that meets the educational needs of every participant!

At CHEST 2021, you will be presented with the latest in pulmonary, critical care, and sleep medicine for clinicians at all levels. Whether you are a trainee or an experienced clinician, there is something to learn at CHEST 2021. We are packing the agenda with experiences from live learning and simulation to high-quality education sessions and smaller problem-based learning classes.

On top of this, you have an amazing opportunity to network and reconnect with colleagues you haven’t seen in months! Whether at Experience CHEST, in the gaming area, the Trainee and Transition Lounge, and more, CHEST 2021, as always, is the best at providing top-tier education, team-based learning, and community connections.

This will be the first hybrid meeting put on by CHEST. We came to the decision knowing that while some people are hungry to get back to having an in-person experience, others found that an online conference better fits their needs. I strongly encourage you to join us October 17-20 in Orlando, Florida, to experience the networking and growth opportunities that come from attending in person. We are following strict protocols, as recommended by the CDC, and will be requiring all attendees to attest to being vaccinated. However, if travel isn’t possible, join us for livestreamed, immersive digital learning from wherever you are in the world. Regardless of your choice, both options will allow you to engage in fun experiences, learn, and connect.

As Co-Chair of CHEST 2021, I’d like to personally invite you to participate, whether this is your first time or you’ve lost count how many times you’ve attended our annual meeting. The community at CHEST is what makes the CHEST conference special, and we are proud to be able to keep you all connected despite geographic restrictions.

Looking forward to seeing you there and connecting on Twitter at #CHEST2021.

Chris Carroll, MD

Co-Chair, CHEST 2021

A little over a year ago, none of us imagined we’d be where we are right now. The pandemic has deeply affected us all, and there have been so many losses, both professional and personal. I’m proud of how our CHEST community responded to the pandemic. The incredibly rapid pace of knowledge acquisition and the speed at which we disseminated that knowledge took a lot of combined effort, but that’s nothing new to our CHEST community.

Throughout the pandemic, CHEST pushed digital education with an array of webinars, podcasts, bite-sized educational modules, and infographics. We held a highly successful, well-received CHEST 2020 online conference with just a few months of planning. I’m so excited to take what we learned about offering high-quality, digital education and turn that into a hybrid meeting for CHEST 2021 that meets the educational needs of every participant!

At CHEST 2021, you will be presented with the latest in pulmonary, critical care, and sleep medicine for clinicians at all levels. Whether you are a trainee or an experienced clinician, there is something to learn at CHEST 2021. We are packing the agenda with experiences from live learning and simulation to high-quality education sessions and smaller problem-based learning classes.

On top of this, you have an amazing opportunity to network and reconnect with colleagues you haven’t seen in months! Whether at Experience CHEST, in the gaming area, the Trainee and Transition Lounge, and more, CHEST 2021, as always, is the best at providing top-tier education, team-based learning, and community connections.

This will be the first hybrid meeting put on by CHEST. We came to the decision knowing that while some people are hungry to get back to having an in-person experience, others found that an online conference better fits their needs. I strongly encourage you to join us October 17-20 in Orlando, Florida, to experience the networking and growth opportunities that come from attending in person. We are following strict protocols, as recommended by the CDC, and will be requiring all attendees to attest to being vaccinated. However, if travel isn’t possible, join us for livestreamed, immersive digital learning from wherever you are in the world. Regardless of your choice, both options will allow you to engage in fun experiences, learn, and connect.

As Co-Chair of CHEST 2021, I’d like to personally invite you to participate, whether this is your first time or you’ve lost count how many times you’ve attended our annual meeting. The community at CHEST is what makes the CHEST conference special, and we are proud to be able to keep you all connected despite geographic restrictions.

Looking forward to seeing you there and connecting on Twitter at #CHEST2021.

Chris Carroll, MD

Co-Chair, CHEST 2021

Palliative and end-of-life care

Communicating serious news over video

Critical care consultation using telemedicine is increasingly prevalent. Having serious conversations regarding end-of life care over video can be extremely challenging. Here are some suggestions and sample phrases to make palliative-focused conversations more successful

Prior to initiating the conversation, communicate with the bedside team. Ensure they want you to discuss palliative options and make an outline of discussion topics together. Identify and include all important decision-makers. Family may need to be connected over a digital meeting platform such as Zoom^© or WEBex^© and arrange for interpreter services if needed.

Prepare the virtual meeting place ahead of time. Test the connection, and make sure the audiovisual quality is clear. Have the camera centrally positioned, and ensure adequate lighting to easily see facial expressions. Remove distracting background furniture, and clear your space of confidential material. Have a quiet area planned to avoid interruptions (J Gen Intern Med. 2020 Oct 27:1-4. doi: 10.1007/s11606-020-06278-z. Online ahead of print).

Open the conversation with introductions, and explore perceptions with open-ended questions: “So I know where to begin, tell me about your understanding of what has been happening?” Get a sense of the patient’s previous function, quality of life, and their values as an individual. Maintain good eye contact throughout. When ready to give an update, use simple language and avoid details: “Unfortunately, your condition is worse. You have not been responding to treatments as hoped. Your lungs are needing much more support, and I’m worried they are not going to get better.”Anticipate emotions, and provide empathetic responses: “I wish we had better news. This must be overwhelming for you” (Back, et al. Ann Int Med. 2020;172[11]:759). Finally, offer a recommendation. Most patients and families are interested in your advice and want guidance. Use the patient’s previously stated values to support your recommendation.

Andrew Badke, MD

Steering Committee Member

Respiratory care

COVID-19 pandemic bringing protocols to the forefront

COVID-19 has health care organizations threatened like never before. Staffing requirements, equipment necessities, and personnel training happen in a whirlwind.¹ Information could change daily/hourly, and the need to protocolize guidelines became more evident each day.

While protocols have existed long before COVID-19, many institutions and organizations responded to the ever-changing pandemic by creating clinical practice guidelines (CPGs) to help not only their experienced staff members but also the non-traditional ICU caregivers thrust onto the front lines.3 Organizations worked on PPE protocols, respiratory care management, and ECMO guidelines to name a few.^2,3 Protocols with algorithms and CPGs have been shown to reduce patient harm and improve standardization and communication.

A CPG is a general principle that guides the management of care, in which specific questions are posed, a literature review is completed, and the quality of the research evaluated. The questions are answered using the strength of the available research. CPG decision points are then based on the evidence or on the consensus of experts, resulting in a protocol that are descriptions of detailed behaviors to be followed in specific situations. These behaviors are provided in a list format or a flow diagram. Using a universal language for protocols with algorithms has aided many hospitals ensure effective care for patients and has even helped develop multidisciplinary relationships not present prior to the pandemic (onepagericu.com).

DeDe Gardner, RRT, DrPh, FCCP

Donna Tanner, RRT-ACCS, MBA, FCCP

Steering Committee Members



1. epub JAMA 2/2021.

2. WHO, Guidelines 1/2021.

3. CHEST, Clinical Resources.

4. Curr Treat Options Ped 2015,1:347


 

Sleep medicine

Time to move the dial: Sleep and burnout in health care workers during the COVID-19 pandemic

Although the interaction between sleep, mood disorders, and burnout is well established, many of us are still sleep-deprived. A cross-sectional study of over 800 health care workers during the pandemic stay-at-home orders in March 2020 reported that those working in-person had shorter sleep times and worse mood, while those with longer sleep times had improved mood (Conroy DA, et al. J Clin Sleep Med. 2021;17[2]:185). Even prior to COVID-19, many trainees were facing issues with sleep deprivation and burnout (Sharp M, et al. Chest. 2021;159[2]:733).

One year into the pandemic, we continue to face a unique set of hardships, exacerbating underlying sleep disorders such as insomnia, feelings of burnout, and mental health problems. An international team led by Dr. Joel Goh calculated the cost of burnout and its economic impact on the nation’s health care system and estimated this at $4.6 billion per year (Han S, et al. Ann Intern Med. 2019;170[11]:784). National medical organizations, including the National Academy of Medicine and the American Medical Association, have also placed greater emphasis on clinician well-being and resilience. Practical frameworks for creating wellness during the pandemic exist; however. senior-level executive champions are critical for implementation (Adibe B, et al. N Engl J Med Catalyst. Jun 2020). While the long-term impact remains unknown, the current state of sleep and mental health problems and the cost of burnout should be a warning to health systems and institutions to implement remedial interventions now.(“Taking action against burnout: A systems approach to professional well-being,” National Academies of Sciences, Engineering, and Medicine, October 2019.
 

Nancy H. Stewart, DO, MS, Steering Committee Member

Thoracic oncology

Impact of COVID-19 on lung cancer screening

Lung cancer is the leading cause of cancer-related death worldwide and COVID-19 is making this worse. Prior to the COVID-19 pandemic, despite evidence of improved mortality, the uptake of lung cancer screening (LCS) was quite low with only 4% of those eligible having undergone screening in 2015 (Jemal A, et al. JAMA Oncol. 2017;3[9]:1278).

As the COVID-19 pandemic unfolded, health care resources were re-allocated to critically ill patients and areas, and nonurgent care was postponed. Therefore, LCS programs were halted (Mazzone PJ, et al. Chest. 2020;158[1]:406). This led to concerns that fewer patients would undergo screening and more patients would experience delays in cancer diagnosis.

Using population-based modeling, researchers in England estimated the COVID-19 pandemic will result in decreased lung cancer survival and a subsequent increase in avoidable cancer deaths (Maringe C, et al. Lancet Oncol. 2020;21[8]:1023). And in fact, investigators in Spain found fewer new lung cancer diagnoses during the COVID-19 pandemic compared with the same time-period pre-pandemic, and those that were diagnosed were later stage disease (Reyes R, et al. IASCL World Conference. 2020. A3700).

As we learn more about COVID-19 and communities become vaccinated, it becomes critical to both resume LCS programs and improve participation. While the pandemic has hampered efforts to screening patients, it has also facilitated the uptake of new technologies such as telemedicine. In March 2020, due to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services relaxed the rules for telehealth, and now covers shared decisions making (SDM) virtual visits for LCS (Centers for Medicare & Medicaid Services, “Telehealth Services.” ICN MLN901705, March 2020). This new tool, amongst others, could increase access to LCS, facilitate more widespread adoption of screening, and ultimately improve lung cancer outcomes.

Max Wayne, MD, and Jose Cardenas-Garcia, MD

Steering Committee Members

Palliative and end-of-life care

Communicating serious news over video

Critical care consultation using telemedicine is increasingly prevalent. Having serious conversations regarding end-of life care over video can be extremely challenging. Here are some suggestions and sample phrases to make palliative-focused conversations more successful

Prior to initiating the conversation, communicate with the bedside team. Ensure they want you to discuss palliative options and make an outline of discussion topics together. Identify and include all important decision-makers. Family may need to be connected over a digital meeting platform such as Zoom^© or WEBex^© and arrange for interpreter services if needed.

Prepare the virtual meeting place ahead of time. Test the connection, and make sure the audiovisual quality is clear. Have the camera centrally positioned, and ensure adequate lighting to easily see facial expressions. Remove distracting background furniture, and clear your space of confidential material. Have a quiet area planned to avoid interruptions (J Gen Intern Med. 2020 Oct 27:1-4. doi: 10.1007/s11606-020-06278-z. Online ahead of print).

Open the conversation with introductions, and explore perceptions with open-ended questions: “So I know where to begin, tell me about your understanding of what has been happening?” Get a sense of the patient’s previous function, quality of life, and their values as an individual. Maintain good eye contact throughout. When ready to give an update, use simple language and avoid details: “Unfortunately, your condition is worse. You have not been responding to treatments as hoped. Your lungs are needing much more support, and I’m worried they are not going to get better.”Anticipate emotions, and provide empathetic responses: “I wish we had better news. This must be overwhelming for you” (Back, et al. Ann Int Med. 2020;172[11]:759). Finally, offer a recommendation. Most patients and families are interested in your advice and want guidance. Use the patient’s previously stated values to support your recommendation.

Andrew Badke, MD

Steering Committee Member

Respiratory care

COVID-19 pandemic bringing protocols to the forefront

COVID-19 has health care organizations threatened like never before. Staffing requirements, equipment necessities, and personnel training happen in a whirlwind.¹ Information could change daily/hourly, and the need to protocolize guidelines became more evident each day.

While protocols have existed long before COVID-19, many institutions and organizations responded to the ever-changing pandemic by creating clinical practice guidelines (CPGs) to help not only their experienced staff members but also the non-traditional ICU caregivers thrust onto the front lines.3 Organizations worked on PPE protocols, respiratory care management, and ECMO guidelines to name a few.^2,3 Protocols with algorithms and CPGs have been shown to reduce patient harm and improve standardization and communication.

A CPG is a general principle that guides the management of care, in which specific questions are posed, a literature review is completed, and the quality of the research evaluated. The questions are answered using the strength of the available research. CPG decision points are then based on the evidence or on the consensus of experts, resulting in a protocol that are descriptions of detailed behaviors to be followed in specific situations. These behaviors are provided in a list format or a flow diagram. Using a universal language for protocols with algorithms has aided many hospitals ensure effective care for patients and has even helped develop multidisciplinary relationships not present prior to the pandemic (onepagericu.com).

DeDe Gardner, RRT, DrPh, FCCP

Donna Tanner, RRT-ACCS, MBA, FCCP

Steering Committee Members



1. epub JAMA 2/2021.

2. WHO, Guidelines 1/2021.

3. CHEST, Clinical Resources.

4. Curr Treat Options Ped 2015,1:347


 

Sleep medicine

Time to move the dial: Sleep and burnout in health care workers during the COVID-19 pandemic

Although the interaction between sleep, mood disorders, and burnout is well established, many of us are still sleep-deprived. A cross-sectional study of over 800 health care workers during the pandemic stay-at-home orders in March 2020 reported that those working in-person had shorter sleep times and worse mood, while those with longer sleep times had improved mood (Conroy DA, et al. J Clin Sleep Med. 2021;17[2]:185). Even prior to COVID-19, many trainees were facing issues with sleep deprivation and burnout (Sharp M, et al. Chest. 2021;159[2]:733).

One year into the pandemic, we continue to face a unique set of hardships, exacerbating underlying sleep disorders such as insomnia, feelings of burnout, and mental health problems. An international team led by Dr. Joel Goh calculated the cost of burnout and its economic impact on the nation’s health care system and estimated this at $4.6 billion per year (Han S, et al. Ann Intern Med. 2019;170[11]:784). National medical organizations, including the National Academy of Medicine and the American Medical Association, have also placed greater emphasis on clinician well-being and resilience. Practical frameworks for creating wellness during the pandemic exist; however. senior-level executive champions are critical for implementation (Adibe B, et al. N Engl J Med Catalyst. Jun 2020). While the long-term impact remains unknown, the current state of sleep and mental health problems and the cost of burnout should be a warning to health systems and institutions to implement remedial interventions now.(“Taking action against burnout: A systems approach to professional well-being,” National Academies of Sciences, Engineering, and Medicine, October 2019.
 

Nancy H. Stewart, DO, MS, Steering Committee Member

Thoracic oncology

Impact of COVID-19 on lung cancer screening

Lung cancer is the leading cause of cancer-related death worldwide and COVID-19 is making this worse. Prior to the COVID-19 pandemic, despite evidence of improved mortality, the uptake of lung cancer screening (LCS) was quite low with only 4% of those eligible having undergone screening in 2015 (Jemal A, et al. JAMA Oncol. 2017;3[9]:1278).

As the COVID-19 pandemic unfolded, health care resources were re-allocated to critically ill patients and areas, and nonurgent care was postponed. Therefore, LCS programs were halted (Mazzone PJ, et al. Chest. 2020;158[1]:406). This led to concerns that fewer patients would undergo screening and more patients would experience delays in cancer diagnosis.

Using population-based modeling, researchers in England estimated the COVID-19 pandemic will result in decreased lung cancer survival and a subsequent increase in avoidable cancer deaths (Maringe C, et al. Lancet Oncol. 2020;21[8]:1023). And in fact, investigators in Spain found fewer new lung cancer diagnoses during the COVID-19 pandemic compared with the same time-period pre-pandemic, and those that were diagnosed were later stage disease (Reyes R, et al. IASCL World Conference. 2020. A3700).

As we learn more about COVID-19 and communities become vaccinated, it becomes critical to both resume LCS programs and improve participation. While the pandemic has hampered efforts to screening patients, it has also facilitated the uptake of new technologies such as telemedicine. In March 2020, due to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services relaxed the rules for telehealth, and now covers shared decisions making (SDM) virtual visits for LCS (Centers for Medicare & Medicaid Services, “Telehealth Services.” ICN MLN901705, March 2020). This new tool, amongst others, could increase access to LCS, facilitate more widespread adoption of screening, and ultimately improve lung cancer outcomes.

Max Wayne, MD, and Jose Cardenas-Garcia, MD

Steering Committee Members

Palliative and end-of-life care

Communicating serious news over video

Critical care consultation using telemedicine is increasingly prevalent. Having serious conversations regarding end-of life care over video can be extremely challenging. Here are some suggestions and sample phrases to make palliative-focused conversations more successful

Prior to initiating the conversation, communicate with the bedside team. Ensure they want you to discuss palliative options and make an outline of discussion topics together. Identify and include all important decision-makers. Family may need to be connected over a digital meeting platform such as Zoom^© or WEBex^© and arrange for interpreter services if needed.

Prepare the virtual meeting place ahead of time. Test the connection, and make sure the audiovisual quality is clear. Have the camera centrally positioned, and ensure adequate lighting to easily see facial expressions. Remove distracting background furniture, and clear your space of confidential material. Have a quiet area planned to avoid interruptions (J Gen Intern Med. 2020 Oct 27:1-4. doi: 10.1007/s11606-020-06278-z. Online ahead of print).

Open the conversation with introductions, and explore perceptions with open-ended questions: “So I know where to begin, tell me about your understanding of what has been happening?” Get a sense of the patient’s previous function, quality of life, and their values as an individual. Maintain good eye contact throughout. When ready to give an update, use simple language and avoid details: “Unfortunately, your condition is worse. You have not been responding to treatments as hoped. Your lungs are needing much more support, and I’m worried they are not going to get better.”Anticipate emotions, and provide empathetic responses: “I wish we had better news. This must be overwhelming for you” (Back, et al. Ann Int Med. 2020;172[11]:759). Finally, offer a recommendation. Most patients and families are interested in your advice and want guidance. Use the patient’s previously stated values to support your recommendation.

Andrew Badke, MD

Steering Committee Member

Respiratory care

COVID-19 pandemic bringing protocols to the forefront

COVID-19 has health care organizations threatened like never before. Staffing requirements, equipment necessities, and personnel training happen in a whirlwind.¹ Information could change daily/hourly, and the need to protocolize guidelines became more evident each day.

While protocols have existed long before COVID-19, many institutions and organizations responded to the ever-changing pandemic by creating clinical practice guidelines (CPGs) to help not only their experienced staff members but also the non-traditional ICU caregivers thrust onto the front lines.3 Organizations worked on PPE protocols, respiratory care management, and ECMO guidelines to name a few.^2,3 Protocols with algorithms and CPGs have been shown to reduce patient harm and improve standardization and communication.

A CPG is a general principle that guides the management of care, in which specific questions are posed, a literature review is completed, and the quality of the research evaluated. The questions are answered using the strength of the available research. CPG decision points are then based on the evidence or on the consensus of experts, resulting in a protocol that are descriptions of detailed behaviors to be followed in specific situations. These behaviors are provided in a list format or a flow diagram. Using a universal language for protocols with algorithms has aided many hospitals ensure effective care for patients and has even helped develop multidisciplinary relationships not present prior to the pandemic (onepagericu.com).

DeDe Gardner, RRT, DrPh, FCCP

Donna Tanner, RRT-ACCS, MBA, FCCP

Steering Committee Members



1. epub JAMA 2/2021.

2. WHO, Guidelines 1/2021.

3. CHEST, Clinical Resources.

4. Curr Treat Options Ped 2015,1:347


 

Sleep medicine

Time to move the dial: Sleep and burnout in health care workers during the COVID-19 pandemic

Although the interaction between sleep, mood disorders, and burnout is well established, many of us are still sleep-deprived. A cross-sectional study of over 800 health care workers during the pandemic stay-at-home orders in March 2020 reported that those working in-person had shorter sleep times and worse mood, while those with longer sleep times had improved mood (Conroy DA, et al. J Clin Sleep Med. 2021;17[2]:185). Even prior to COVID-19, many trainees were facing issues with sleep deprivation and burnout (Sharp M, et al. Chest. 2021;159[2]:733).

One year into the pandemic, we continue to face a unique set of hardships, exacerbating underlying sleep disorders such as insomnia, feelings of burnout, and mental health problems. An international team led by Dr. Joel Goh calculated the cost of burnout and its economic impact on the nation’s health care system and estimated this at $4.6 billion per year (Han S, et al. Ann Intern Med. 2019;170[11]:784). National medical organizations, including the National Academy of Medicine and the American Medical Association, have also placed greater emphasis on clinician well-being and resilience. Practical frameworks for creating wellness during the pandemic exist; however. senior-level executive champions are critical for implementation (Adibe B, et al. N Engl J Med Catalyst. Jun 2020). While the long-term impact remains unknown, the current state of sleep and mental health problems and the cost of burnout should be a warning to health systems and institutions to implement remedial interventions now.(“Taking action against burnout: A systems approach to professional well-being,” National Academies of Sciences, Engineering, and Medicine, October 2019.
 

Nancy H. Stewart, DO, MS, Steering Committee Member

Thoracic oncology

Impact of COVID-19 on lung cancer screening

Lung cancer is the leading cause of cancer-related death worldwide and COVID-19 is making this worse. Prior to the COVID-19 pandemic, despite evidence of improved mortality, the uptake of lung cancer screening (LCS) was quite low with only 4% of those eligible having undergone screening in 2015 (Jemal A, et al. JAMA Oncol. 2017;3[9]:1278).

As the COVID-19 pandemic unfolded, health care resources were re-allocated to critically ill patients and areas, and nonurgent care was postponed. Therefore, LCS programs were halted (Mazzone PJ, et al. Chest. 2020;158[1]:406). This led to concerns that fewer patients would undergo screening and more patients would experience delays in cancer diagnosis.

Using population-based modeling, researchers in England estimated the COVID-19 pandemic will result in decreased lung cancer survival and a subsequent increase in avoidable cancer deaths (Maringe C, et al. Lancet Oncol. 2020;21[8]:1023). And in fact, investigators in Spain found fewer new lung cancer diagnoses during the COVID-19 pandemic compared with the same time-period pre-pandemic, and those that were diagnosed were later stage disease (Reyes R, et al. IASCL World Conference. 2020. A3700).

As we learn more about COVID-19 and communities become vaccinated, it becomes critical to both resume LCS programs and improve participation. While the pandemic has hampered efforts to screening patients, it has also facilitated the uptake of new technologies such as telemedicine. In March 2020, due to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services relaxed the rules for telehealth, and now covers shared decisions making (SDM) virtual visits for LCS (Centers for Medicare & Medicaid Services, “Telehealth Services.” ICN MLN901705, March 2020). This new tool, amongst others, could increase access to LCS, facilitate more widespread adoption of screening, and ultimately improve lung cancer outcomes.

Max Wayne, MD, and Jose Cardenas-Garcia, MD

Steering Committee Members

The relationship between asthma and cardiovascular disease: An examination of the Framingham offspring study. By Dr M. Pollevick, et al.

Projecting long-term health and economic burden of chronic obstructive pulmonary disease in the United States. By Dr. Z. Zafari, et al.



How I do it: Dosing fluids in early septic shock. By Dr. D. Chaudhuri, et al.



Essential components of an interstitial lung disease clinic: Results from a Delphi survey and patient focus group analysis. By Dr. B. A. Graney, et al.



Change: Leadership essentials for chest medicine professionals. By Dr. J. Stoller, et al.



Race correction and spirometry: Why history matters. By Dr. L. Braun.

The relationship between asthma and cardiovascular disease: An examination of the Framingham offspring study. By Dr M. Pollevick, et al.

Projecting long-term health and economic burden of chronic obstructive pulmonary disease in the United States. By Dr. Z. Zafari, et al.



How I do it: Dosing fluids in early septic shock. By Dr. D. Chaudhuri, et al.



Essential components of an interstitial lung disease clinic: Results from a Delphi survey and patient focus group analysis. By Dr. B. A. Graney, et al.



Change: Leadership essentials for chest medicine professionals. By Dr. J. Stoller, et al.



Race correction and spirometry: Why history matters. By Dr. L. Braun.

The relationship between asthma and cardiovascular disease: An examination of the Framingham offspring study. By Dr M. Pollevick, et al.

Projecting long-term health and economic burden of chronic obstructive pulmonary disease in the United States. By Dr. Z. Zafari, et al.



How I do it: Dosing fluids in early septic shock. By Dr. D. Chaudhuri, et al.



Essential components of an interstitial lung disease clinic: Results from a Delphi survey and patient focus group analysis. By Dr. B. A. Graney, et al.



Change: Leadership essentials for chest medicine professionals. By Dr. J. Stoller, et al.



Race correction and spirometry: Why history matters. By Dr. L. Braun.

With the confidence that comes from 25 years of strong guidance and inspired leadership, the CHEST Foundation is ready to step into a new role as conversation starters, access granters, and change makers. The Foundation will spend this anniversary year celebrating the past and sharing the bold future ahead with our community.

Leaders of the past

Founded on the promise of delivering grants and branching into education and outreach, the Foundation’s accomplishments are endless:

• Creating engaging tobacco cessation and educational programming.
• Launching the “Beyond Our Walls” campaign to support CHEST’s Simulation Center.
• Partnering with the Popovich family to secure a substantial ILD endowment.
• Providing COVID-19 microgrants aimed at community outreach.
• Launching a Listening Tours campaign to address health disparities.
• Producing a complimentary oxygen toolkit for patients across the United States.

Trailblazers of the future

The CHEST Foundation is rising to a new level of philanthropic work by – creating premier patient education tools, aggressively tackling health disparities in marginalized communities, awarding millions in community grants, and partnering with physicians to offer better resources to patients.

While we remember the journey here, it’s now time to blaze into the future. We hope you’ll join us by learning more about our anniversary, attending our virtual events, and getting involved with the Foundation.

Visit chestfoundation.org/25th-anniversary to learn more.



Title: Share Our Story on Social Media

Paragraph: Follow the hashtag #CHESTFoundation25 on Twitter, Instagram, and Facebook. We’ll be asking questions every month and would love to hear from you!


 

With the confidence that comes from 25 years of strong guidance and inspired leadership, the CHEST Foundation is ready to step into a new role as conversation starters, access granters, and change makers. The Foundation will spend this anniversary year celebrating the past and sharing the bold future ahead with our community.

Leaders of the past

Founded on the promise of delivering grants and branching into education and outreach, the Foundation’s accomplishments are endless:

• Creating engaging tobacco cessation and educational programming.
• Launching the “Beyond Our Walls” campaign to support CHEST’s Simulation Center.
• Partnering with the Popovich family to secure a substantial ILD endowment.
• Providing COVID-19 microgrants aimed at community outreach.
• Launching a Listening Tours campaign to address health disparities.
• Producing a complimentary oxygen toolkit for patients across the United States.

Trailblazers of the future

The CHEST Foundation is rising to a new level of philanthropic work by – creating premier patient education tools, aggressively tackling health disparities in marginalized communities, awarding millions in community grants, and partnering with physicians to offer better resources to patients.

While we remember the journey here, it’s now time to blaze into the future. We hope you’ll join us by learning more about our anniversary, attending our virtual events, and getting involved with the Foundation.

Visit chestfoundation.org/25th-anniversary to learn more.



Title: Share Our Story on Social Media

Paragraph: Follow the hashtag #CHESTFoundation25 on Twitter, Instagram, and Facebook. We’ll be asking questions every month and would love to hear from you!


 

With the confidence that comes from 25 years of strong guidance and inspired leadership, the CHEST Foundation is ready to step into a new role as conversation starters, access granters, and change makers. The Foundation will spend this anniversary year celebrating the past and sharing the bold future ahead with our community.

Leaders of the past

Founded on the promise of delivering grants and branching into education and outreach, the Foundation’s accomplishments are endless:

• Creating engaging tobacco cessation and educational programming.
• Launching the “Beyond Our Walls” campaign to support CHEST’s Simulation Center.
• Partnering with the Popovich family to secure a substantial ILD endowment.
• Providing COVID-19 microgrants aimed at community outreach.
• Launching a Listening Tours campaign to address health disparities.
• Producing a complimentary oxygen toolkit for patients across the United States.

Trailblazers of the future

The CHEST Foundation is rising to a new level of philanthropic work by – creating premier patient education tools, aggressively tackling health disparities in marginalized communities, awarding millions in community grants, and partnering with physicians to offer better resources to patients.

While we remember the journey here, it’s now time to blaze into the future. We hope you’ll join us by learning more about our anniversary, attending our virtual events, and getting involved with the Foundation.

Visit chestfoundation.org/25th-anniversary to learn more.



Title: Share Our Story on Social Media

Paragraph: Follow the hashtag #CHESTFoundation25 on Twitter, Instagram, and Facebook. We’ll be asking questions every month and would love to hear from you!