Chronic Obstructive Pulmonary Disease (COPD) is a respiratory disorder that affects about 300 million patients worldwide and 30 million patients in the US alone.  COPD carries a substantial burden in human suffering.  Dyspnea and other respiratory symptoms are common and can be disabling. Respiratory infections and exposure to environmental triggers lead to episodic deteriorations (acute exacerbations of COPD; AE-COPD) and result in over 700,000 hospitalizations and 100,000 deaths each year in the U.S. alone.    Deaths from COPD are increasing and are likely to become the 3rd leading cause of death, ahead of cerebrovascular accidents, in the U.S. by 2020.   In addition, the financial burden of COPD is enormous, with various estimates suggesting annual healthcare expenditures in the U.S. of $30 to $70 billion each year.  Moreover, the health and economic burden of COPD is growing despite the availability of an increasing evidence-base from randomized clinical trials that have established the efficacy of numerous therapies that reduce morbidity and mortality from COPD (i.e., smoking cessation, pharmacotherapy, lung volume reduction surgery, long-term oxygen therapy, and non-invasive positive pressure ventilation). 
 
There is increasing recognition that the availability of clinical trial data, collected from highly specialized research settings, do not necessarily translate into improved patient outcomes in real-world clinical settings.  Indeed, recent studies suggest that despite the existence of national and international treatment guidelines, the care and outcomes of patients with COPD vary substantially across the U.S. and many patients are not receiving recommended care. Explanations include differences between research and clinical settings in factors related to patients (e.g., presence of co-morbid conditions or poor self-management skills), clinicians (e.g., underuse, overuse, or misuse of interventions), or care environments (e.g., lack of adequate time, support staff, or other factors to implement interventions).  Also, patients with COPD often have multiple co-morbid conditions (e.g., heart failure) that complicate the evaluation and management of respiratory symptoms.   Further research is needed to identify and overcome barriers to implementing best practices, coordinating care between different clinicians (e.g., primary care physicians, pulmonologists, cardiologists ) and across different clinical settings (e.g., hospital to outpatient), as well as to improve patient and family support at the end-of-life. Effectiveness and translational research is defined as the investigative methodologies used to evaluate and understand the outcomes of care in clinical settings and the development and testing of care strategies to ensure that more patients benefit from advances in treatments in these settings.