Development of the Advancing the Patient Experience (APEX) in COPD Registry: A Modified Delphi Study

Chelsea L. Edwards, Alan G. Kaplan, Barbara P. Yawn, Janwillem W. H. Kocks, Lakmini Bulathsinhala, Victoria A. Carter, Ku-Lang Chang, Chester Fox, Gokul Gopalan, MeiLan K. Han, Maja Kruszyk, Chantal E. Le Lievre, Cathy Mahle, Barry Make, Wilson D. Pace, Chris Price, Asif Shaikh, Neil Skolnik, David B. Price* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
1 Downloads (Pure)


Background: Chronic obstructive pulmonary disease (COPD) is commonly managed by family physicians, but little is known about specifics of management and how this may be improved. The Advancing the Patient Experience in COPD (APEX COPD) registry will be the first U.S. primary care, health system-based registry following patients diagnosed with COPD longitudinally, using a standardized set of variables to investigate how patients are managed in real-life and assess outcomes of various management strategies.

Objective: Gaining expert consensus on a standardized list of variables to capture in the APEX COPD registry.

Methods: A modified, Delphi process was used to reach consensus on which data to collect in the registry from electronic health records (EHRs), patient-reported information (PRI) and patient-reported outcomes (PRO), and by physicians during subsequent office visits. The Delphi panel comprised 14 primary care and specialty COPD experts from the U.S. and internationally. The process consisted of three iterative rounds. Responses were collected electronically.

Results: Of the initial 195 variables considered, consensus was reached to include up to 115 EHR variables, 34 PRI/PRO variables and five office-visit variables in the APEX COPD registry. These should include information on symptom burden, diagnosis, COPD exacerbations, lung function, quality-of-life, comorbidities, smoking status/history, treatment specifics (including side effects), inhaler management, and patient education/self-management.

Conclusions: COPD experts agreed upon the core variables to collect from EHR data and from patients to populate the APEX COPD registry. Data will eventually be integrated, standardized and stored in the APEX COPD database and used for approved COPD-related research.
Original languageEnglish
Pages (from-to)135-151
Number of pages17
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Issue number1
Publication statusPublished - Jan 2021


  • primary care
  • patient reported outcomes
  • research
  • clinically relevant data collection
  • registry
  • Patient-reported outcomes
  • Registry
  • Research
  • Primary care
  • Clinically relevant data collection
  • patient-reported outcomes


Dive into the research topics of 'Development of the Advancing the Patient Experience (APEX) in COPD Registry: A Modified Delphi Study'. Together they form a unique fingerprint.

Cite this