My main interests are in the designing and conduct of clinical trials and other clinical investigations to evaluate new treatments and to investigate new biomarkers, or risk stratification variables, for people with respiratory disease. I led the first large-scale non-commercial multi-centre clinical trial in Idiopathic Pulmonary Fibrosis (IPF) in the UK which was one of the largest non-commercial IPF trials at the time. This created a network of research sites in the UK, which has allowed me to receive nearly continuous funding from the National Institute for Health Research (NIHR) to undertake IPF clinical trials since 2007. This work has convincingly shown that, despite clear theoretical reasons, prophylactic antibiotic therapy is not beneficial for people with moderate-severe IPF, and we are currently determining whether proton pump inhibitors have a role.

Other research in interstitial lung disease has shown that fatigue is an important component of the symptomatology in people with sarcoidosis, but is different in character from those with IPF, and a trial of methylphenidate, a stimulant used in other causes of fatigue, is feasible. We have also shown that accelerometers can be used to track the activity of people with interstitial lung disease, and they have more sedentary behaviour than healthy individuals. We are evaluating the utility of exhaled volatile organic compounds as a biomarker for sarcoidosis.