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Finland &#40;Foresight Unit&#41;&#44; and the United Kingdom &#40;Foresight Office&#41;&#44; to name just a few&#46; The future is not pre-determined&#44; but neither is it a vacuum where we can move freely&#46; Our very use of prospective methods clearly implies that the future we foresee is not neutral&#44; but instead reflect particular desires&#44; values&#44; cultural assumptions&#44; and worldviews&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">At the end of 2019&#44; the Committee on Quality and Innovation of the Spanish Society of Pulmonology and Thoracic Surgery &#40;SEPAR&#41; launched the Pneumology Project H2030&#44; that aimed to &#8220;forecast&#8221; the future of respiratory health in Spain&#46; We sought expert technical advice and began our collaboration with the Deusto Business School Health team at the Universidad de Deusto&#46; This partnership has resulted in the report entitled&#58; &#8220;Pneumology Project H2030&#58; A prospective overview of respiratory health in Spain&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Our goal was not only to predict the future&#44; but also to systematically analyze the available empirical evidence to identify potential challenges and opportunities in respiratory medicine&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The document was prepared primarily using the Delphi method&#44; with the participation of 70 qualified experts nominated by both partners&#46; The predictive capacity of Delphi is based on the systematization of the judgment of experts selected for their outstanding profiles and their key knowledge of the problem in question&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This method is effective for consulting expert groups on future developments in their respective fields&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A series of factors was proposed &#40;see <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; and we highlight the 9 that were awarded the highest impact scores &#40;9&#8211;10&#41; in 2030 by most experts &#40;&#62; 50&#37;&#41;&#46; These include&#44; in order of importance&#58; healthy lifestyle&#44; public policies on smoking&#44; the role of nursing&#44; air quality&#44; population aging&#44; Covid-19 and other pandemics&#44; ratio of specialist physicians&#44; new models of remote care&#44; and climate change&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">A more detailed analysis revealed that 6 of the 9 factors with the greatest impact are elements that transcend the health system&#44; and as such require measures and policies that go beyond the aegis of the health system alone&#46; However&#44; some factors do involve our own resources&#44; such as the role of nursing staff&#44; the ratio of specialist physicians&#44; and the enhancement of remote care models&#44; and these areas should serve as our waymarkers&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We have 10 years in which to exploit our strengths and correct our weaknesses&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Our strengths will improve as new technologies in respiratory health are developed and implemented&#46; For example&#44; by 2030&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> most people will have personal devices &#40;smartphones&#44; portable devices&#44; air quality sensors&#44; EEG monitors&#44; molecular test kits&#44; etc&#46;&#41; that will display signals&#44; similar to the dashboard of a current car&#44; with gauges and alarms&#44; and automatically transmit data that will assist us in our mission to promote healthy habits and prevent as far as possible the onset and exacerbation of diseases&#46; This capacity for self-diagnosis will develop along with the value of the tests endorsed by the scientific community and supported by patient associations who will act as decision-makers in health policies&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Our weaknesses&#44; on the other hand &#8211; characterized by the uncertain economic picture and the small number of specialists &#8211; will require the implementation of a specific cross-sectional plan with nursing and physiotherapy departments to adjust staffing to the recommendations for the year 2030&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To tackle threats ranging from political instability and climate change to population aging&#44; this report recommends promoting training in the management of multidisciplinary care teams involving primary care&#44; internal medicine&#44; geriatrics&#44; and respiratory home hospitalization to improve the management of chronicity&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The data extracted suggest that the situation we are currently experiencing is an opportunity to highlight the importance of respiratory health and to include respiratory health in the general culture&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In short&#44; favorable trends for respiratory health in 2030 have been detected&#44; including advances in therapeutic innovations&#44; the impact of prevention strategies and policies to promote healthy living habits&#44; and new management models&#46; Nevertheless&#44; we will have to face major challenges resulting from population aging&#44; air quality&#44; and future pandemics&#46;</p></span>"
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Editorial
Pneumology plan H2030: Our future
Proyecto neumología H2030: nuestro futuro
Carlos Javier Egea Santaolallaa,
Corresponding author
carlosegeasantaolalla@gmail.com

Corresponding author.
, Carlos Andrés Jimenez-Ruizb
a Unidad Funcional de Sueño, Hospital Universitario Araba, OSI Araba, Vitoria-Gasteiz, Spain()
b Unidad Especializada en Tabaquismo, Hospital Clínico San Carlos, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Since time immemorial&#44; humans have always desired to foretell the future&#46; In ancient days&#44; the prophets&#44; intermediaries between humans and gods&#44; became the ruling elite&#44; since they were best placed to make the right decisions based on their revelations&#46; This &#8220;prophetization&#8221; is what we now call prospective evaluation &#8211; a process that&#44; though not prophetic&#44; does have a common aim with the ancient prophetic traditions&#58; to know where the future will lead us and to make better decisions in the here-and-now&#46; Nowadays&#44; we depend on the opinions of experts articulated via systematized mechanisms of reflection&#46; For example&#44; many countries&#44; including Spain&#44; have set up &#8203;&#8220;foresight units&#8221; dedicated exclusively to forward planning&#58; Canada &#40;Policy Horizons&#41;&#44; France &#40;<span class="elsevierStyleItalic">Centre d&#39;Analyze Strategique</span>&#41;&#44; Finland &#40;Foresight Unit&#41;&#44; and the United Kingdom &#40;Foresight Office&#41;&#44; to name just a few&#46; The future is not pre-determined&#44; but neither is it a vacuum where we can move freely&#46; Our very use of prospective methods clearly implies that the future we foresee is not neutral&#44; but instead reflect particular desires&#44; values&#44; cultural assumptions&#44; and worldviews&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">At the end of 2019&#44; the Committee on Quality and Innovation of the Spanish Society of Pulmonology and Thoracic Surgery &#40;SEPAR&#41; launched the Pneumology Project H2030&#44; that aimed to &#8220;forecast&#8221; the future of respiratory health in Spain&#46; We sought expert technical advice and began our collaboration with the Deusto Business School Health team at the Universidad de Deusto&#46; This partnership has resulted in the report entitled&#58; &#8220;Pneumology Project H2030&#58; A prospective overview of respiratory health in Spain&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Our goal was not only to predict the future&#44; but also to systematically analyze the available empirical evidence to identify potential challenges and opportunities in respiratory medicine&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The document was prepared primarily using the Delphi method&#44; with the participation of 70 qualified experts nominated by both partners&#46; The predictive capacity of Delphi is based on the systematization of the judgment of experts selected for their outstanding profiles and their key knowledge of the problem in question&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This method is effective for consulting expert groups on future developments in their respective fields&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A series of factors was proposed &#40;see <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; and we highlight the 9 that were awarded the highest impact scores &#40;9&#8211;10&#41; in 2030 by most experts &#40;&#62; 50&#37;&#41;&#46; These include&#44; in order of importance&#58; healthy lifestyle&#44; public policies on smoking&#44; the role of nursing&#44; air quality&#44; population aging&#44; Covid-19 and other pandemics&#44; ratio of specialist physicians&#44; new models of remote care&#44; and climate change&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">A more detailed analysis revealed that 6 of the 9 factors with the greatest impact are elements that transcend the health system&#44; and as such require measures and policies that go beyond the aegis of the health system alone&#46; However&#44; some factors do involve our own resources&#44; such as the role of nursing staff&#44; the ratio of specialist physicians&#44; and the enhancement of remote care models&#44; and these areas should serve as our waymarkers&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We have 10 years in which to exploit our strengths and correct our weaknesses&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Our strengths will improve as new technologies in respiratory health are developed and implemented&#46; For example&#44; by 2030&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> most people will have personal devices &#40;smartphones&#44; portable devices&#44; air quality sensors&#44; EEG monitors&#44; molecular test kits&#44; etc&#46;&#41; that will display signals&#44; similar to the dashboard of a current car&#44; with gauges and alarms&#44; and automatically transmit data that will assist us in our mission to promote healthy habits and prevent as far as possible the onset and exacerbation of diseases&#46; This capacity for self-diagnosis will develop along with the value of the tests endorsed by the scientific community and supported by patient associations who will act as decision-makers in health policies&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Our weaknesses&#44; on the other hand &#8211; characterized by the uncertain economic picture and the small number of specialists &#8211; will require the implementation of a specific cross-sectional plan with nursing and physiotherapy departments to adjust staffing to the recommendations for the year 2030&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To tackle threats ranging from political instability and climate change to population aging&#44; this report recommends promoting training in the management of multidisciplinary care teams involving primary care&#44; internal medicine&#44; geriatrics&#44; and respiratory home hospitalization to improve the management of chronicity&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The data extracted suggest that the situation we are currently experiencing is an opportunity to highlight the importance of respiratory health and to include respiratory health in the general culture&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In short&#44; favorable trends for respiratory health in 2030 have been detected&#44; including advances in therapeutic innovations&#44; the impact of prevention strategies and policies to promote healthy living habits&#44; and new management models&#46; Nevertheless&#44; we will have to face major challenges resulting from population aging&#44; air quality&#44; and future pandemics&#46;</p></span>"
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