CAPO offers five types of research opportunities. The first option is for investigators interested in evaluating areas of management of hospitalized patients with CAP according to the data collected in the CAPO core study. As an example, several centers from Argentina recently analyzed data from the core study evaluating the current management of CAP in Argentina in relation to local national guidelines.
The second research option is for investigators to use the CAPO database to answer research questions other than the main ones for which the data were originally obtained. Performing clinical research using existing data, defined as secondary data analysis, has the advantage of reducing the time and cost necessary to answer a research question. Two recent CAPO publications, one evaluating outcomes in HIV patients with CAP and another evaluating the use of the pneumonia severity index as predictor for time to clinical stability, were performed using a secondary data analysis of the CAPO database.3,4
The third option is for investigators to propose a modification of the core cohort study protocol to collect new data that will help to answer a new research question. These types of studies, defined as ancillary studies, have the advantage of being efficient and inexpensive. Proposed ancillary studies that require the addition of a significant number of variables to the core study protocol are discussed during the annual CAPO investigators meeting. During the annual meeting on 21 May 2006 in San Diego, for example, the investigators agreed to add an ancillary study to evaluate criteria for clinical failure and the etiology of clinical failure during the first 7 days of hospitalization for all patients enrolled in the CAPO core study. A fourth research option is to combine data from CAPO with another database to generate a more powerful data set. Data from CAPO regarding antimicrobial use and outcomes were recently combined with an international database of atypical pathogens in CAP. The analysis of the combined databases culminated in a manuscript describing the incidence and outcomes of atypical pneumonias.5
A fifth research option is for investigators interested in implementing a new study protocol. Members of the Steering Committee will evaluate the feasibility of protocol implementation. The CAPO center manages a new study protocol that was recently implemented using investigators from the CAPO network. The CAPO center managed elements of study planning and logistics, training and communications, on-line subject enrollment and randomization, data collection, data management and data analysis for this international prospective randomized clinical trial of antimicrobial therapy in CAP.