Recommended Research Topics for a Philippine Pulmonary Fellow

🔴 TIER 1 — Highest Impact + Most Feasible

• Rationale: The Philippines has one of the world's highest TB burdens. An enormous, underreported population lives with post-TB airflow obstruction, bronchiectasis, and restriction - yet no prospective Philippine data exists from private/academic centers. The Lancet highlighted barriers to TB care in the Philippines as a major gap.
• Design: Prospective cohort. Enroll newly declared TB treatment-complete patients, perform serial spirometry, 6MWT, and SGRQ at 0, 6, and 12 months.
• Policy impact: Would directly inform DOH National TB Program follow-up protocols and PhilHealth benefit packages for post-TB rehabilitation.
• Publishable in: Respirology, Int J Tuberc Lung Dis, BMC Pulm Med

• Rationale: A 2025 study (PMID 40816540) from the Philippines just published retrospective data on this. A prospective, academic center version with richer clinical detail (biomarkers, imaging phenotype, treatment response) would fill the evidence gap and be a meaningful extension.
• Design: Prospective observational. Compare outcomes (treatment response, hospitalization duration, mortality, readmission) between bacteriologically confirmed and clinical TB cases.
• Policy impact: Supports refining TB diagnostic and treatment algorithms in resource-limited settings.

• Rationale: COPD is projected to cost the Philippine economy over PHP 1.5 trillion from 2020-2025, yet a large portion of COPD cases remain undiagnosed. Spirometry access is limited outside tertiary centers.
• Design: Prospective cross-sectional/cohort. Screen all symptomatic patients with smoking or biomass exposure history using spirometry; characterize the undiagnosed pool.
• Policy impact: Strong evidence base for universal spirometry screening recommendations in Philippine primary care.
• Publishable in: NPJ Primary Care Respiratory Medicine, COPD Journal

🟡 TIER 2 — High Impact + Moderate Feasibility

• Rationale: Post-COVID pulmonary sequelae are still poorly characterized in Southeast Asian populations, where comorbidity profiles (high TB burden, diabetes, smoking) differ significantly from Western cohorts.
• Design: Prospective cohort. Enroll hospitalized severe COVID-19 survivors at discharge, follow up with PFTs, HRCT at 3 and 6 months, CAT/SGRQ quality of life scoring.
• Policy impact: Would directly inform PhilHealth post-COVID rehabilitation benefit coverage and hospital discharge planning protocols.

• Rationale: GOLD guideline adherence is suboptimal globally, and Southeast Asian data is sparse. A prospective study in your center can measure the gap between guideline recommendations and actual prescribing, then link it to outcomes.
• Design: Prospective observational cohort. Enroll new/follow-up COPD patients, assess GOLD-concordant therapy, and track exacerbation rates, ED visits, and hospitalizations over 12 months.
• Policy impact: Supports quality improvement initiatives and national COPD care pathway development.

• Rationale: OSA-related pulmonary hypertension is under-recognized in the Philippines, and sleep labs are concentrated in private academic centers - making your setting ideal. There is minimal published Philippine PH cohort data.
• Design: Prospective cross-sectional screening study. Enroll all newly diagnosed PH patients and perform overnight oximetry or full polysomnography; characterize the overlap.
• Policy impact: Would support integration of sleep screening into the Philippine PH diagnostic workup.

🟢 TIER 3 — Strategically Targeted (Niche, Policy-Driven)

• Rationale: LUS is increasingly replacing CXR in low-resource triage. A prospective accuracy study in a Philippine center with CT as reference standard would be highly publishable and clinically impactful.
• Design: Prospective diagnostic accuracy study. Enroll CAP patients in the ED; compare LUS findings and PSI/CURB-65 against CXR and HRCT outcomes.
• Publishable in: Chest, J Thorac Imaging, Ultrasound Med Biol

• Rationale: Pulmonary rehabilitation is evidence-based (Cochrane review, PMID 34559419) but adoption in the Philippines is near zero. A feasibility or outcomes study at your center would be among the first Philippine data.
• Design: Prospective pre-post cohort or small RCT. 8-week supervised program, measure 6MWT, MRC dyspnea, SGRQ before/after.
• Policy impact: Strong case for PhilHealth benefit coverage of pulmonary rehabilitation programs.

• Rationale: ILD is often diagnosed late in the Philippines due to low awareness and limited HRCT access. A prospective registry at an academic center would be the first structured Philippine ILD dataset.
• Design: Prospective registry cohort. Enroll newly diagnosed ILD, collect demographics, autoimmune workup, HRCT pattern, PFTs, treatment, and survival outcomes.
• Policy impact: Provides evidence for national ILD care guidelines and biosimilar/antifibrotic access advocacy.

• Rationale: Hospital readmission for COPD exacerbation is a major driver of healthcare costs. All current risk scores (PEARL, CODEX) were developed in Western populations. A Philippine-validated score would be directly usable in your institution's discharge planning protocols.
• Design: Prospective cohort. Enroll all admitted COPD exacerbations, collect clinical variables at discharge, follow up at 30 days for readmission.
• Timeline: Highly feasible in 6-12 months at an active academic center.
• Publishable in: COPD Journal, Respirology, BMC Pulm Med

Quick Comparison Table

My Top Recommendation for You

• Directly relevant to Philippine disease burden
• Novel (prospective academic-center data is essentially absent)
• Feasible in 12 months with a clearly defined exposure window (treatment completion)
• Highly publishable in indexed respiratory journals
• Has direct policy implications for DOH and PhilHealth