“I think it's very exciting because we're doing something that's never been done before,” says Dr. Shawn Aaron, winner of the Grimes Career Achievement Award. “We’re trying to catch and treat people with COPD and asthma early to see if we can improve the course of their disease.”It’s no exaggeration that Dr. Shawn Aaron’s research has transformed the diagnosis and care of chronic obstructive pulmonary disease (COPD), asthma and cystic fibrosis. And he’s not done yet.

COPD is a debilitating disease that makes people very short of breath. Flare-ups can be life-threatening and require an emergency department visit.

During his research training, Dr. Aaron led a clinical trial that showed patients with COPD flare-ups treated with the steroid prednisone had fewer relapses in the next month. These results were published in the New England Journal of Medicine, the world’s top medical journal, and prednisone is now a standard treatment.

That was just the beginning. Dr. Aaron also led the first clinical trial to use a combination of inhalers to treat COPD. This approach reduced hospitalizations and improved patients’ lung function and quality of life, and it has since been added to treatment guidelines.

But finding new treatments for COPD wasn’t enough. Now his research is focused on catching patients with COPD early, with the hopes of improving their outcomes.   

“The problem with COPD is that by the time a patient complains of shortness of breath, it's too late. They've already lost most of their lung capacity,” says Dr. Aaron, a senior scientist and respirologist at The Ottawa Hospital and professor at the University of Ottawa. “We don’t have any magic cures – we can only relieve the symptoms. Unfortunately, my patients with COPD are still quite disabled, and are still dying of their disease.”

How’s your breathing, caller #10?

The challenge with COPD is that most people don’t know they have it—an estimated 70% of cases go undiagnosed. So how can health-care providers find them?

Well, Dr. Aaron led the first-ever randomized controlled trial to systematically seek out and treat people with undiagnosed COPD as well as asthma, which has similar symptoms.

By calling random telephone numbers at 17 sites across the country, his team recruited 3,000 Canadians who complained of respiratory symptoms but had never been diagnosed with lung disease. After testing, it turns out 12% of these people had COPD and 8.4% had asthma.

 “Research is a team sport – I work with statisticians, research program managers, research coordinators, and collaborators across the country,” says Dr. Aaron. “Without that team, there's no way that I could ever have been successful."Based on their results, the team developed a 13-item questionnaire, the first to detect both asthma and COPD.  The questionnaire was found to be more sensitive at detecting undiagnosed cases than previous tools.

Patients in the trial diagnosed with early COPD or asthma have received either intensive treatment or usual care, to see if the intensive strategy can improve their outcomes. Results are expected in 2024.

“I think it's very exciting because we're doing something that's never been done before,” said Dr. Aaron, “We’re trying to catch and treat people with COPD and asthma early to see if we can improve the course of their disease.”

A research network that’s the envy of the world

Another of Dr. Aaron’s major achievements is being a founding director of the Canadian Respiratory Research Network. This extremely successful academic network was established in 2013 and funded by the Canadian Institutes of Health Research. With the goal of better understanding the origins and progression of chronic respiratory disease in Canada, this network has provided a strong vision for respiratory disease research in Canada.

The network includes more than 200 Canadian scientists, physicians and trainees, has published over 250 peer-reviewed papers and secured over $30 million in grant funding. It has helped launch the careers of many respirology researchers across Canada through its training and fellowship programs, early-career investigator funding and seed grants.

Dr. Aaron’s colleagues say in addition to being a visionary scientist and super-collaborator, he is also an encouraging mentor and team player.

“Research is a team sport – I work with statisticians, research program managers, research coordinators, and collaborators across the country,” says Dr. Aaron. “Without that team, there's no way that I could ever have been successful."

Check out this Q&A to learn more about Dr. Aaron and what inspires him.

The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa and supported by The Ottawa Hospital Foundation.