title: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.
abstract: 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 the main contents of the second 5-year revision of the GOLD document that has implemented some of the vast knowledge about COPD accumulated over the last years. Today, GOLD recommends that spirometry is required for the clinical diagnosis of COPD to avoid misdiagnosis and to ensure proper evaluation of severity of airflow limitation. The document highlights that the assessment of the patient with COPD should always include assessment of (1) symptoms, (2) severity of airflow limitation, (3) history of exacerbations, and (4) comorbidities. The first three points can be used to evaluate level of symptoms and risk of future exacerbations, and this is done in a way that splits patients with 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 as well as COPD in the presence of comorbidities. The revised document also contains a new section on exacerbations of COPD. The GOLD initiative will continue to bring COPD to the attention of all relevant shareholders and will hopefully inspire future national and local guidelines on the management of COPD.
authors.affiliation: Manchester Academic Sciences Health Centre, Respiratory Research Group, University of Manchester, University Hospital South Manchester, Southmoor Road, Manchester M23 9LT, UK. jorgen.vestbo@manchester.ac.uk
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vestbo
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Hurd
authors.forename: Alvar G
authors.initials: AG
authors.lastname: Agustí
authors.forename: Paul W
authors.initials: PW
authors.lastname: Jones
authors.forename: Claus
authors.initials: C
authors.lastname: Vogelmeier
authors.forename: Antonio
authors.initials: A
authors.lastname: Anzueto
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Barnes
authors.forename: Leonardo M
authors.initials: LM
authors.lastname: Fabbri
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Martinez
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
authors.forename: Robert A
authors.initials: RA
authors.lastname: Stockley
authors.forename: Don D
authors.initials: DD
authors.lastname: Sin
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodriguez-Roisin
mesh_terms: D014943:Global Health; D006801:Humans; D038622:Internationality; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D012307:Risk Factors; D012720:Severity of Illness Index; D013147:Spirometry