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Global Initiative for Chronic Obstructive Lung Disease

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) works with health care professionals and public health officials around the world to raise awareness of Chronic Obstructive Pulmonary Disease (COPD) and to improve prevention and treatment of this lung disease.

The GOLD initiative gives out guidelines for COPD Diagnosis, Management, and Prevention.

GOLD guidelines indicate that spirometry is of the utmost importance in diagnosing COPD.  

GOLD Classification for COPD

The GOLD expert panel classified COPD into 5 stages, ranging from 0 to 4:

 Stage

 Characteristics

0: At risk

Normal Spirometry
Chronic Symptoms (cough, sputum production)

1: Mild COPD

FEV1/FVC < 70%
FEV1 > or equal to 80% predicted
With or without chronic symptoms (cough, sputum production)

2: Moderate COPD

FEV1/FVC < 70%
FEV1 between 50 and 80% predicted
With or without chronic symptoms (cough, sputum production)

3: Severe COPD

FEV1/FVC < 70%
FEV1 between 30 and 50% predicted
With or without chronic symptoms (cough, sputum production)

4: Very Severe COPD

FEV1/FVC < 70%
FEV1 < or equal to 30% predicted or FEV1 < 50% predicted plus chronic respiratory failure

GOLD Therapy Guidelines

gold therapy

 

The official guidelines can be downloaded from the GOLD website. 

Fletcher Graph

Many patients believe that once damage has been done, smoking cessation isn't necessary anymore.
The Fletcher-Peto graph clearly shows the importance of quiting smoking, even if serious damage is already present.

fletcher-peto graph
Fletcher's graph clearly shows the importance of smoking cessation, even in late stage COPD