25 June 2020
Today’s announcement of a £1.3m programme funded by the Department of Health & Social Care and the Asthma UK & British Lung Foundation Partnership to develop a national research platform to rapidly evaluate new tests to diagnose COVID-19 infection (the CONDOR platform) is hugely important. As with many respiratory conditions, testing for Covid-19 is simply not quick enough or accurate enough, taking up to three days and involving swab samples being sent to a laboratory. Building the infrastructure to develop better tests quickly and efficiently is vital, not just for COVID-19 but for the future of the diagnostics industry in the UK.
For people with suspected respiratory disease getting a proper diagnosis can take weeks. Moreover, the limited accuracy and/or difficulty in performing diagnostic tests in primary care has led to widespread under- and over-diagnosis. As a platform that will trial new diagnostic tools for use in hospitals, general practices and care homes, CONDOR could pave the way towards a revolution in respiratory diagnostics.
The urgent need for better diagnosis of respiratory disease
Respiratory disease affects approximately 7.2 million people across the UK , significantly affecting people’s lives and causing an estimated 100,000 deaths a year. There are an estimated one million people living with undiagnosed COPD, and significant over- and under- diagnosis of asthma that highlight the problem of and over-reliance on a clinical assessment of symptoms rather than the use of objective tests. The reality is that people with suspected lung disease have to wait too long to be diagnosed, and a delayed or inaccurate diagnosis means people do not get the treatment they need and can end up in hospital unnecessarily. For people with aggressive lung disease a delayed diagnosis means they cannot make the most of the time they have left.
For major respiratory conditions there is an urgent need to improve the accuracy and speed of diagnosis, while also ensuring such tests are simple, inexpensive and easily performed by patients and their healthcare professionals. Experts have called for research into new objective diagnostic tests for COPD, particularly in primary care.
We now have the opportunity to test new technologies to move respiratory diagnosis into a new era, not only where specific types of respiratory illness (eg asthma, COPD) can be accurately diagnosed but also different sub-types of diseases. Through the analysis of vast quantities of data, we are moving closer to be able to identify different types of asthma, COPD and bronchiectasis, but vital research and development are needed to develop the new diagnostic tools that will be the basis of precision medicine in the future.
Developing better diagnostic tools requires major investment
Investment in research into respiratory conditions has historically not reflected the major impact that they have on people's lives. The most recent data shows that a mere £47m of the UK’s £2.56bn annual expenditure on health research was spent on respiratory conditions. We need to radically increase the investment into respiratory research and development nationally and internationally.
The UK Government has committed to increasing R&D spend to 2.4% by 2027, with diagnostics highlighted as a key focus. In 2017, the UK government’s Industrial Strategy set out an ambition through the £210m ‘Data to early diagnostics and precision medicine’ programme to enhance the power of health data to diagnose life-changing diseases at the earliest possible stage. Subsequent initiatives have seen a commitment of £100m to set up five centres of excellence for digital pathology that take advantage of artificial intelligence to analyse vast datasets.
It’s vital that more of these significant investments in the UK’s diagnostics capacity are directed to advancing the early and accurate diagnosis of respiratory conditions. The CONDOR platform could represent a major step forward in this process and ultimately lead to more personalised medicine for millions of people across the UK.