In dry medical jargon, it's called an exacerbation. For the patients, it's a frightening, wrenching assault on the body that some liken to drowning. It happens to people with chronic obstructive pulmonary disease, or COPD, and consists of a rapid or sudden worsening of the condition's symptoms: shortness of breath, cough, and mucus buildup. Gerard Criner, professor of medicine of Temple University School of Medicine, has an idea to ease the burden - not through any new treatments as such, but by means of handheld computers or cell phones.

An exacerbation is "the equivalent of a heart attack for people who have COPD," Criner says. Most patients, however, fail to call their doctors as signs and symptoms leading to the crisis worsen. "If you get a doctor sooner than later, you can get better if the therapy's right," while possibly saving the healthcare system money, he adds.

That's where the electronic gadgetry comes in. Patients use it to update nurses on their condition daily, including breathing capacity, temperature, and ability to get through daily routines. "We have prescripted algorithms that trigger treatment based on threshold scores," Criner explains. The goal: to head off flare-ups. A four-year, state-funded clinical trial is underway at Temple, along with Lancaster General Hospital in Lancaster, Pa., and Western Pennsylvania Hospital in Pittsburgh.

COPD really refers to two lung diseases marked by airway obstruction: chronic bronchitis and emphysema, which are classified together because they often coexist. Other obstructive diseases such as asthma aren't considered COPD. The condition is the fourth leading cause of death in the United States, according to the American Lung Association; it's estimated to claim more than 120,000 lives nationwide annually. So it's perhaps unsurprising that fear stalks many patients, especially when an exacerbation arises, as typically occurs around four or five times yearly.

In a recently started trial, known as the Pennsylvania Study of COPD Exacerbations (PA-SCOPE), patients communicate with doctors' offices using handheld computers called portable digital assistants. Early results suggest that these patients show 20% better average readings than controls on peak flow meters, which measure how quickly a patient can push air out of the lungs, says Criner.

Scheduled to last through June 2008, the trial involves 53 patients divided between a control and a treatment arm. The devices now in use may later be replaced by cell phones, which would probably be more practical, says Criner, the principal investigator. The effort could lead to similar projects for other chronic diseases, he adds. "Any chronic diseases where you can measure something - blood pressure, severe chronic asthma," for instance - "all of those lend themselves to simple monitoring on a daily basis." The desired result is fewer nasty health surprises, whatever name you use for them.