Luke Daines

Project: Deriving and validating a clinical prediction rule for the diagnosis of asthma

Asthma is common in the UK, causing considerable illness, healthcare usage, and public expense. Accurate diagnosis is essential for good asthma management. Yet, uncertainty about the best way to diagnose asthma can lead to missed diagnoses and under-treatment, or over-diagnosis leading to unnecessary treatment and healthcare costs.

This project aims to make it easier for doctors and nurses to identify and interpret the important information gathered from a patient suspected of having asthma.

Using an existing research database (Avon Longitudinal Study of Parents and Children (ALSPAC) http://www.bristol.ac.uk/alspac), we can identify which features predict who has asthma and use this information to develop an asthma clinical prediction rule. The rule will be tested using anonymous routine data from UK general practices (Optimum Patient Care Research Database (https://opcrd.co.uk) and a Netherlands-based asthma referral service (University of Groningen).

The prediction ‘rule’ will help doctors and nurses make sense of information in a standardised way, improving the accuracy with which asthma is diagnosed. Patients will benefit from being accurately diagnosed and receiving appropriate treatment.

About me

I graduated from the University of Edinburgh with MBChB in 2010. During my medical studies I completed an intercalated BSc in Anatomical Sciences at Bristol University.

Whilst training as a GP, I established links with the Asthma UK Centre for Applied Research (AUKCAR), at the University of Edinburgh, initially reviewing the evidence behind supported self-management for asthma.

Completing my GP training in 2015, I joined the University of Edinburgh as an Academic Clinical Fellow in General Practice. During my first year I contributed to the diagnosis chapter of the BTS/SIGN asthma guideline (2016) and completed a qualitative study exploring patient views on supported self-management for asthma, part of the IMP2ART programme of work.

I studied for a Master’s in Public Health during 2016/17. My interest in asthma diagnosis was further developed during a travel fellowship at the Technical University of Munich where I investigated the importance of alternative reference standards in evaluating diagnostic tests for asthma.

I am part of the BTS/SIGN asthma guideline development group, and a steering group member for the National Asthma Audit. I am an active member of the Primary Care Respiratory Society, contributing to their policy forum, conference committee and editorial board of their quarterly update.

I am glad to continue working as a GP at Craiglockhart Medical Group, Edinburgh.

Publications

Papers

Daines L, Lewis S, Schneider A, et al Defining high probability when making a diagnosis of asthma in primary care: mixed-methods consensus workshop BMJ Open 2020;10:e034559. doi: 10.1136/bmjopen-2019-034559

Daines L, Bonnett LJ, Boyd A et al. Protocol for the derivation and validation of a clinical prediction model to support the diagnosis of asthma in children and young people in primary care [version 1; peer review: awaiting peer review]. Wellcome Open Res 2020, 5:50 https://doi.org/10.12688/wellcomeopenres.15751.1

Vanfleteren, L.E.G.W., Blervaque, L., Franssen, F.M.E., Daines, L., Kocks, J.W.H., Honkoop, P.J., Poberezhets, V. ERS International Congress, Madrid, 2019: highlights from the General Pneumology Assembly ERJ Open Research 2020 6: 00323-2019; DOI: 10.1183/23120541.00323-2019

Akindele, A., Daines, L., Cavers, D. et al. Qualitative study of practices and challenges when making a diagnosis of asthma in primary care. npj Prim. Care Respir. Med. 29, 27 (2019). https://doi.org/10.1038/s41533-019-0140-z

Daines, L., McLean, S., Buelo, A. et al. Systematic review of clinical prediction models to support the diagnosis of asthma in primary care. npj Prim. Care Respir. Med. 29, 19 (2019). https://doi.org/10.1038/s41533-019-0132-z

Vanfleteren, L.E.G.W., Ojanguren, I., Nolan, C.M., Franssen, F.M.E., Andrianopoulos, V., Grgic, A., van Dijk, M., Slebos, D.J., Daines, L., Kocks, J.W.H., Kahn, N. European Respiratory Society International Congress, Paris, 2018: highlights from the Clinical Assembly. ERJ Open Research 2019 5: 00176-2018; DOI: 10.1183/23120541.00176-2018

Daines, L., McLean, S., Buelo, A. et al. Clinical prediction models to support the diagnosis of asthma in primary care: a systematic review protocol. npj Prim Care Resp Med 28, 15 (2018). https://doi.org/10.1038/s41533-018-0086-6

Kahn N, Mekov E, Fregonese L, Andrianopoulos V, Franssen FM, Grgic A, Coolen J, Bonta PI, Gompelmann D, Annema JT, Faverio P, Bonella F, Daines L, Pinnock H, Kocks J, Herth F. European Respiratory Society International Congress 2017: highlights from the Clinical Assembly. ERJ open research, 2018 4(1), pp.00134-2017.

Morrow S, Daines L, Wiener-Ogilvie S, Steed L, McKee L, Caress AL, Taylor SJ, Pinnock H. Exploring the perspectives of clinical professionals and support staff on implementing supported self-management for asthma in UK general practice: an IMP2ART qualitative study. Primary Care Respiratory Medicine. 2017; 27.

Hanlon P, Daines L, Campbell C, McKinstry B, Weller D, Pinnock H. Telehealth Interventions to Support Self-management of Long-term Conditions: A Systematic Overview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease and Cancer. J Med Internet Res 2017. 19 (5)

Pinnock H, Parke HL, Panagioti M, Daines L, Pearce G, Epiphanio E, Taylor SJC. Systematic meta-review and health economic meta-analysis of supported self-management for asthma: a healthcare perspective. BMC Medicine. 2017. 15: 64

Murray AD, Daines L, Archibald D, Hawkes R, Schiphorst C, Kelly P, Grant L, Mutrie N. The relationships between golf and health: a scoping review. Br J Sports Med 2017;51:12-19.

Daines L, McMurray A. Asthma in Children. InnovAiT. 10 (1) 5-14

Murray A, Daines L, Hawkes R, Archibald D, Grant E, Mutrie N. The relationship and effects of golf on physical and mental health: a scoping review protocol. Br J Sports Med. 2016 Apr 29. pii: bjsports-2015-095914. doi: 10.1136/bjsports-2015-095914.

uo J, Daines L, Charalambous AC, Annesly-Williams DJ, Adams MA, Dolan PD. Vertebroplasty: only small cement volumes are required to normalise stress distributions on the vertebral bodies. Spine 2009 Dec 15; 34(26): 2865-73

Best practice articles

Daines, L., Baxter, N., Gruffydd Jones, K., Holms, S., Keeley, D., Gerrard, V., Stonham, C. and Leese, D. Asthma Guidleines in Practice: a PCRS consensus. Primary Care Respiratory Update. 2019. Available from the PCRS website 

Daines L, Sheikh A. Chapter 1: Mapping the territory: descriptive studies. In: Critical Appraisal for Primary Care. 2018 Eds: Jones R. BJGP. Available from: http://bjgp.org/sites/default/files/PDFs/Critical%20Appraisal-2018.pdf

Letters

Daines L, Pinnock H, Paton JY. Netherlands asthma study: overdiagnosed or a variable and remitting condition? In response to: Looijmans-van den Akker I, van Luijn K, Verheij T. Overdiagnosis of asthma in children in primary care: a retrospective analysis. Br J Gen Pract. 2016 Mar 1;66(644):e152-7.

eLearning modules

Daines L, Thomas M. Guideline focus: Asthma diagnosis in adults and children. BMJ learning. January 2017. Available from: http://learning.bmj.com/learning/module-intro/.html?moduleId=10058403

Daines L, Pinnock H. Supported asthma self-management. Primary Care Respiratory Society / Pulse Cogora. August 2016. Accessible: www.respiratoryacademy.co.uk/cpd-modules/   

Acknowledgements

My PhD is affiliated with the Asthma UK Centre for Applied Research.