The CHEP Respiratory Physiology team

Assessing the impact of a Complex Asthma model of care to service all eligible Queensland children 

A significant driver of the huge healthcare burden of asthma is children with difficult-to-treat or severe asthma (5-10% of childhood asthma, termed collectively as “Complex Asthma”). A recent survey of Australian and New Zealand paediatric tertiary services has highlighted the lack of a standardised approach to services and issues adequately identifying these children affected to ensure access to recommended models of care. At Queensland Children’s hospital (QCH) we have established a unique multidisciplinary team (MDT) service, involving eight different medical and allied health teams: Respiratory, Allergy & Immunology, Psychology, Psychiatry, Adolescent Medicine, Speech Pathology, Physiotherapy and Social work. It was awarded a QCH Excellence award in August 2026. The research program will focus on evaluating the available evidence, developing effective screening questionnaires for co-morbidities, and evaluating the overall effectiveness of this MDT approach.  Read more.

Understanding early life trajectories in cystic fibrosis (CF) 

Increasing evidence suggests that irreversible, progressive lung disease begins in the very early years of life for patients with CF, however, the exact mechanism(s) that drive this damage, and who is at risk, are still largely unknown. A significant limitation to early disease detection has been the lack of feasible and sensitive measures available for use in very young patients. In 2020 we commenced the Early Life Origins of CF Disease (ELO) study; a 5-year longitudinal study aimed at improving clinical outcome measures across the lifespan and disease severity of CF.  Read more.

Improving detection of Pulmonary Graft-vs-Host Disease to facilitate earlier intervention

Chronic Graft-vs-Host Disease affects 60% of Haematopoeitic Stem Cell Transplant (HSCT) survivors by 6 years after their transplant, affecting multiple organs including skin, liver, gastrointestinal tract and lungs. Gold standard for pulmonary GVHD diagnosis is abnormal spirometry and subsequent CT-based imaging. Pulmonary GVHD is estimated to affect 10% of all subjects post HSCT yet this incidence is a gross underestimate due to the insensitivity of spirometry to detect peripheral lung changes where this process arises. This leads to late diagnosis, poor response to treatment, and poor prognosis (2-year and 5-year survival of 60% and 50%, respectively). Better tools to detect and monitor pulmonary GVHD are urgently required.  Read More. 

MOSAIC: MBW and OSC surveillance after stem cell transplant international collaboration

The MOSAIC study (Multiple Breath Washout and Oscillometry Surveillance After stem cell Transplant International Collaboration) is a retrospective individual participant data meta-analysis designed to evaluate lung function in patients who have undergone allogeneic haematopoietic stem cell transplantation (allo-HSCT). Read more. 

Remote monitoring of Paediatric Asthma to Improve Asthma Diagnosis and Control

Childhood asthma mortality remains substantial, and rates of hospitalisation are increasing globally in young children. This is driven by poor asthma control (which affects 50% of asthmatics) and ongoing exacerbations (which affects 25%). Of the 40,000 admissions each year, 80% are preventable! Current symptom-based management approaches fail – limited by poor perception/reporting by children and parents - and conventional spirometry/peak flow is insensitive or too challenging for this setting. 

This research program consists of a series of projects to analyse existing, and collect new, data to define the clinical utility of a unique remote home-based monitoring strategy focused on the day-to-day variability of a novel and sensitive lung function test. Studies will investigate its ability to correctly identify evolving asthma, detect loss of asthma control and provide an early signal of an impending asthma exacerbation to improve long term asthma outcomes. Read more.

Defining the natural history and trajectories of preschool children with current wheeze

The OBSTRUCT cohort commenced in 2019 and has recruited 126 wheezy children and 57 healthy children. Nearly 50% of preschool children worldwide experience an episode of asthma-like symptoms, but only 30% with recurrent wheeze go on to develop asthma past 6 years of age. In this study we want to better understand the complex link between early childhood wheezing and asthma. 

Defining early lung function and respiratory health trajectories in First Nations infants 

Disparities in health for indigenous communities are a global issue. The Strong Families Study is a First Nations peoples co-designed cohort to support improved perinatal and early childhood outcomes. It is the largest birth cohort study of its kind to date and the first inclusive of mothers, partners, and their children. This research program will focus on identifying important events happening within the first year of life that determine respiratory health and lung function trajectories in recruited infants. Read more.

Development of normative intra-breath oscillometry (IB-OSC) data 

IB-OSC is a new lung function modality that is easier for patients to use, quicker to achieve data in busy clinical settings, and has greater sensitivity to early disease progression. Normative data is urgently needed to aid in interpretation of this technique. Through collaborative research projects we have collated a dataset of over >1000 measurements, however, gaps across the age range are still present. Read more.

Classification of intra-breath oscillometry (IB-OSC) patterns for phenotyping paediatric respiratory disease 

Oscillometry (OSC) is a sensitive technique for measuring respiratory system mechanics and is performed by superimposing a pressure signal over tidal breathing. Conventional OSC is measured using a signal containing multiple frequences and averaged across multiple acceptable breaths. This does not account for flow or volume dependent changes apparent during breathing. Our novel adaptation, IB-OSC, allows for continuous tracking across the breathing cycle using a single frequency and offers a more mechanism-oriented and granular view of respiratory function. Read more.

The utility of respiratory surveillance in Childhood Neuromuscular disease 

Children with neuromuscular disease face a high burden of respiratory complications, from sleep-disordered breathing through to progressive ventilatory failure. Our team is pursuing several projects to improve how we detect and monitor this decline early, before it becomes clinically apparent. Read more.

Early Detection of Lung Disease to Improve Lifelong Trajectories

A significant global challenge is the escalating incidence of chronic lung diseases contributing to morbidity and

mortality at all stages of life. These diseases have their origins in childhood with the developing lung susceptible to a variety of environmental insults. Low lung function is a major risk factor for acute and chronic lung disease, cardiovascular disease, and premature death. Lung function trajectories are established early in life, with early deviations indicating disease onset, progression, and increased life-long disease risk. Read more. 

Bacterial mucosal immunotherapy for prevention of lower respiratory tract infections in preterm born

Infants born <30 weeks’ gestation often develop lung disease during the neonatal period, putting them at risk of significant lung disease throughout child- and adulthood, including asthma and the premature development of chronic obstructive pulmonary disease. After discharge from the neonatal unit, lung disease is exacerbated by frequent respiratory viral infections requiring far greater health utilisation than their term-born equivalents. Read more.