Investigating the natural history of lung function: facts, pitfalls, and opportunities.
COPD is currently defined as a progressive, preventable, and treatable disease that is characterized by an accelerated decline of lung function. However, contrary to other common chronic conditions like cardiovascular disease or cancer, there are no lifelong population-based studies describing the natural history of lung function and COPD. In this review, we describe the methodology used in population-based studies, both American and European, that have formed the basis of our current understanding of the "natural history" of COPD, including studies with serial pulmonary function testing, which hold potential for further investigations. We highlight the methodological limitations of longitudinal studies and suggest possible solutions. Finally, some characteristics of an "ideal" study on the natural history of lung function decline are recommended, both in health and disease.
Program of Epidemiology and Clinical Research, Fundación Caubet-International Centre for Advanced Respiratory Medicine (CIMERA) Illes Balears, Bunyola, Illes Balears, Spain; Department of Pulmonary and Critical Care Medicine and Ludwig Boltzmann Institute for COPD, Otto Wagner Hospital, Vienna, Austria. Electronic address: r.kohansal@gmx.at.
Robab
R
Kohansal
Program of Epidemiology and Clinical Research, Fundación Caubet-International Centre for Advanced Respiratory Medicine (CIMERA) Illes Balears, Bunyola, Illes Balears, Spain; Centro de Investigacíon Biomedica en Red de Enfermedades Respiratorias, Illes Balears, Mallorca, Spain.
Joan B
JB
Soriano
Servei Pneumologia, Hospital Universitari Son Dureta, Illes Balears, Mallorca, Spain; Centro de Investigacíon Biomedica en Red de Enfermedades Respiratorias, Illes Balears, Mallorca, Spain; Program of Epidemiology and Clinical Research, Fundación Caubet-International Centre for Advanced Respiratory Medicine (CIMERA) Illes Balears, Bunyola, Illes Balears, Spain.
Alvar
A
Agusti
D018450:Disease Progression; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012129:Respiratory Function Tests