The 2011 revision of the global strategy for the diagnosis, management and prevention of COPD (GOLD) – why and what?

Authors

  • Jørgen Vestbo,

    Corresponding author
    1. Clinical Institute, University of Southern Denmark, Odense, Denmark
    2. Respiratory Research Group, Manchester Academic Health Sciences Centre, University Hospital South Manchester NHS Foundation Trust, University of Manchester, Manchester, UK
    • Department of Respiratory Medicine J, Odense University Hospital, Odense, Denmark
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  • Suzanne S. Hurd,

    1. Global Initiative for Chronic Obstructive Lung Disease, Vancouver, WA, USA
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  • Roberto Rodriguez-Roisin

    1. Servei de Pneumologia, Thorax Institute, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
    2. Ciber Enfermedades Respiratorias (CIBERES), Barcelona, Spain
    3. Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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  • Authorship and contributorship

    JV drafted the manuscript; All authors contributed and approved the final manuscript.

  • Conflict of interest

    JV and RRR have received honoraria from the pharmaceutical industry. A full list can be found on http://www.goldcopd.org. SSH is an employee of GOLD.

Correspondence

Jørgen Vestbo, DMSc, Department of Respiratory Medicine J, Odense University Hospital, Sdr Boulevard 29, 5000 Odense, Denmark.

Tel: +45 6541 2740

email: jvestbo@dadlnet.dk

Abstract

Introduction

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published a strategy for diagnosis and for management of chronic obstructive pulmonary disease (COPD) since 2001 and this has formed the basis for numerous national and regional guidelines.

Objectives

We describe the background for the 2011 revision of the GOLD document.

Methods

The GOLD document is updated annually and revised every 5 years based on published research as well as an evaluation by an expert panel of how to best formulate and disseminate knowledge on COPD.

Results

The GOLD 2011 revision states that spirometry is required for making a clinical diagnosis of COPD. At the same time, the document has less emphasis on spirometric evaluation of disease severity and launches a combined assessment taking symptoms, spirometry and history of exacerbations into account. This is matched with initial treatment for COPD where smoking cessation, pulmonary rehabilitation and physical activity in general are given high priority followed by pharmacologic treatment guided by the novel assessment scheme. Comorbidities are often present in COPD and the GOLD 2011 revision gives some guidance in how to manage these as well as how to manage COPD in the presence of comorbidities.

Conclusion

A more clinically oriented GOLD document will hopefully improve assessment and management of COPD.

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