PRECISE Cohort and Biobank

PRECISE is a long-term cohort following more than 600 children at risk of or diagnosed with muco-obstructive lung disease. By combining detailed health information, lung function testing, imaging, biological samples and information reported by children and their families, PRECISE aims to transform how chronic respiratory disease is understood, detected and treated in childhood.

Chronic lung diseases often begin in early childhood, long before symptoms become serious enough to lead to a diagnosis. Many adults living with chronic lung disease experienced breathing problems as children, yet a diagnosis may not be made until permanent changes to the lungs have already occurred.

Early childhood therefore provides a critical opportunity to identify children at risk, understand why lung disease develops, and intervene earlier.

The PRECISE cohort supports a strong portfolio of high-impact research projects, including multiple prestigious NHMRC- and MRFF-funded longitudinal studies including TIME-CF, ELITE,and BRIGHT.

Why is this research important?

Muco-obstructive lung diseases are conditions in which abnormal mucus and impaired airway clearance contribute to persistent inflammation, infection and progressive lung damage.

Children can experience symptoms such as chronic wet cough well before significant lung disease is recognised. Others may already have a diagnosed condition such as bronchiectasis, cystic fibrosis or primary ciliary dyskinesia.

PRECISE brings these children together within a single research cohort. Rather than studying each diagnosis only in isolation, we can investigate the clinical and biological characteristics children share and explore why their lung health follows different pathways over time.

This approach offers an opportunity to identify the earliest signs of declining lung health and develop more personalised approaches to prevention, monitoring and treatment.

The PRECISE Biobank

Biological samples collected through PRECISE form an important part of the study. When analysed alongside participants' clinical information, lung function, imaging and reported outcomes, these samples provide researchers with an opportunity to investigate the biological mechanisms underlying respiratory health and disease.

Crucially, PRECISE follows children over time. This means researchers can examine how biological and clinical characteristics relate to changes in lung health as children grow.

The biobank is designed as a long-term research resource, providing a foundation for future ethically approved research into childhood respiratory disease.

What are we hoping to discover?

PRECISE has three major aims:

Identify children at risk earlier

We want to identify children whose lung function is following an impaired trajectory so that those at greatest risk can be recognised earlier and receive appropriate specialist care and monitoring.

Understand why lung disease develops

By investigating early-life risk factors and the biological mechanisms underlying disease, we aim to better understand why muco-obstructive lung disease develops and progresses.

This knowledge could help identify new approaches to treatment that go beyond managing symptoms and have the potential to alter the course of disease.

Enable more personalised care

Children with different diagnoses can sometimes share similar clinical or biological characteristics.

PRECISE aims to identify groups of children with common patterns of disease, regardless of their diagnostic label. Understanding these patterns could ultimately help clinicians choose monitoring and treatment strategies tailored more closely to an individual child's needs.

By integrating clinical, physiological, biological, imaging and patient-reported information, PRECISE will build a more complete picture of how muco-obstructive lung diseases begin and progress during childhood.

Creating lasting benefits for children's lung health

PRECISE has the potential to deliver significant benefits for children, families and the Western Australian health system.

Earlier identification of airway abnormalities could enable children at greatest risk to receive more timely and targeted monitoring and intervention. In the longer term, improved risk assessment and prevention have the potential to reduce the burden associated with chronic respiratory disease, including emergency presentations, hospital admissions and other healthcare use.

Evidence generated through PRECISE can also help inform:

• more consistent approaches to respiratory care
• the use of sensitive diagnostic tools
• appropriate monitoring schedules
• risk-stratified clinical pathways
• precision-focused interventions
• health-economic evaluation and future health policy

The study also provides opportunities to strengthen expertise in Western Australia through training and experience in advanced respiratory diagnostics, imaging analysis and translational research.

Ultimately, PRECISE aims to become an enduring research resource for childhood lung health, enabling researchers to continue investigating how respiratory diseases begin, why they progress differently between children, and how we can intervene earlier.

By identifying risk sooner and understanding disease more precisely, we hope to help shift childhood respiratory care from managing established lung disease towards prevention, early detection and personalised treatment.