Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease GOLD executive summary

Chronic obstructive pulmonary disease (COPD) is a global health problem, and since 2001, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published its strategy document for the diagnosis and management of COPD. This executive summary presents themaincontents of thesecond5-year revision of theGOLD document that has implemented some of the vast knowledge about COPD accumulated over the last years. Today, GOLD recommends that spirometry isrequired for the clinical diagnosis ofCOPDto avoid misdiagnosis and to ensure proper evaluation of severity of airflowlimitation. Thedocumenthighlights that theassessment of thepatientwith COPDshould always includeassessment of (1)symptoms,(2)severityof airflow limitation, (3) history of exacerbations, and (4) comorbidities. Thefirst threepointscanbeusedtoevaluatelevelof symptomsandrisk of futureexacerbations, andthis isdoneinawaythatsplitspatientswith COPD into four categories-A, B, C, and D. Nonpharmacologic and pharmacologic management of COPD match this assessment in an evidence-based attempt to relieve symptoms and reduce risk of exacerbations. Identification and treatment of comorbidities must have high priority, and a separate section in the document addresses management of comorbidities aswell asCOPDin the presence of comorbidities. The revised document also contains a newsection on exacerbations of COPD. TheGOLDinitiative will continue tobringCOPDto the attention of all relevant shareholdersandwillhopefullyinspire futurenationaland local guidelines on the management of COPD.