A80-2-32 The Temple Healthy Chest Initiative: A Contemporary, Diverse, and Digitally Integrated Chronic Obstructive Pulmonary Disease (COPD) Cohort Compared With Landmark Population Studies

Abstract Rationale Landmark COPD cohorts—including ECLIPSE, COPDGene, SPIROMICS, and CANCOLD—established understanding of COPD heterogeneity but were assembled more than a decade ago and underrepresented women, racial minorities, and individuals with multimorbidity. The Temple Healthy Chest Initiative (THCI) is a modern urban lung cancer screening (LCS) cohort designed to reflect the epidemiology of COPD and related chronic respiratory conditions. We compared baseline THCI characteristics with published data from these landmark cohorts to assess representativeness and complementarity. Methods Three hundred fifteen participants attending LCS at Temple Health consented to THCI. Electronic medical record data, post-bronchodilator spirometry, and chest CT imaging were collected, with quantitative analysis performed using AVIEW COPD, CORELINE. COPD was defined by a fixed FEV1/FVC ratio less than 0.70, and physiologic severity was graded by GOLD criteria using post-bronchodilator FEV1 percent predicted. Demographics, smoking exposure, body mass index (BMI), GOLD stage, and comorbidities were summarized and compared with baselines from ECLIPSE (Vestbo J et al., Eur Respir J 2008;31:869-873), COPDGene (Regan EA et al., COPD 2010;7:32-43), SPIROMICS (Couper D et al., Thorax 2014;69:491-494), and CANCOLD (Bourbeau J et al., Int J Chron Obstruct Pulmon Dis 2014;9:899-906). Continuous variables are reported as mean ± SD; categorical data as percentages. Results Among 315 THCI participants undergoing LCS, mean age was 63 ± 7 years; 60% were female; 75% Black or African American; and 14% Hispanic or Latino. Mean BMI was 31.2 ± 8.1 kg/m². Current smokers accounted for 61% with a mean exposure of 38 pack-years. Among those meeting obstruction criteria (n = 120), GOLD 1-4 distribution was 11%, 51%, 31%, and 8%, broadly similar to legacy cohorts. Compared with COPDGene (n = 10,198; mean age 59.8 years; 46% female; 33% Black), THCI included a higher proportion of women and Black participants and a slightly older age. Legacy cohorts reported BMI values in the high 20s and lower minority representation. Coronary artery calcium and metabolic comorbidities were frequent in THCI, though numeric comparison was limited because these measures were not uniformly reported. Quantitative CT analyses are ongoing. Conclusions THCI complements established COPD cohorts by capturing a more diverse and comorbid population while maintaining a comparable distribution of physiologic severity. Its integration of imaging, lung function, and behavioral data within a digital infrastructure supports investigation of phenotypes and implementation questions underrepresented in prior studies. These findings highlight the importance of updated cohort frameworks that better mirror present-day COPD populations and promote equitable translational research. This abstract is funded by: Supported by the Temple Lung Center and the Lewis Katz School of Medicine at Temple University, with additional support from an AstraZeneca research grant.