UNICORN (Unified Cohorts Research Network): Disaggregating asthma

The development of new methodologies for improving causal inference in epidemiological studies creates an opportunity for a step change in understanding mechanisms underlying asthma development. We propose that the best way to scale up research in asthma is to integrate unselected birth cohorts with patient cohorts and randomised controlled trials (RCTs) for joint analyses, as these different settings provide complementary windows on distinct aspects of understanding disease aetiology. UNICORN will form an alliance between the STELAR consortium of 5 birth cohorts aimed at studying asthma and allergies (in total >15000 participants), and patient cohorts with large numbers of carefully phenotyped patients with asthma (Breathing Together consortium, U-BIOPRED, RBH Severe Asthma cohort). In Workstream 1, we will build on earlier investments (eLab, tranSMART/eTRIX) to develop efficient scalable informatics solutions enabling integration, management, harmonisation and secure co-analysis of birth cohorts, patient cohorts, and RCTs. The development of an integrated data management and analysis platform at the heart of the UNICORN research engine will be a unique resource for the UK health science and will provide a template for implementation in other complex non-communicable disease areas where data integration provides the only realistic prospect of solving the complex and heterogeneous biology of these conditions. Workstream 2 will extend the detailed information collected from ante-natal period to adulthood in STELAR cohorts, with a routinely acquired data in primary care and hospital records, facilitating more sophisticated analyses. In Workstream 3, in an iterative discovery process, we will capitalise on a unique combination of expertise, well characterised birth and patient cohorts, and our novel research engine to promote the discovery of asthma endotypes, and identify and understand mechanisms underpinning such endotypes, thereby advancing stratified medicine.