A Clinical Practice Guideline Update on the Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease
Authors: Robert P. Young, Raewyn J. Hopkins
Journal: Annals of Internal Medicine (2012)

Letters3 January 2012A Clinical Practice Guideline Update on the Diagnosis and Management of Stable Chronic Obstructive Pulmonary DiseaseRobert P. Young, MD, PhD and Raewyn J. Hopkins, MPHRobert P. Young, MD, PhDFrom University of Auckland, Auckland 1344, New Zealand.Search for more papers by this author and Raewyn J. Hopkins, MPHFrom University of Auckland, Auckland 1344, New Zealand.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-1-201201030-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with disappointment the first recommendation of recently published guidelines (1) on the diagnosis and management of stable chronic obstructive pulmonary disease (COPD). This recommendation states, “Spirometry should not be used to screen for airflow obstruction in individuals without respiratory symptoms” (1). In our opinion, this would be like recommending that fasting blood glucose not be measured in obese patients until angina develops. Even if spirometry does not in itself modify the underlying risk (smoking cessation) or warrant immediate treatment (use of bronchodilators), airflow limitation is a marker of premature death from all causes—in particular, heart ...References1. Qaseem A, Wilt TJ, Weinberger SE, Hanania , Criner G, van der Molen T, et al; American College of Physicians. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med. 2011;155:179-91. [PMID: 21810710] LinkGoogle Scholar2. Young RP, Hopkins R, Eaton TE. Forced expiratory volume in one second: not just a lung function test but a marker of premature death from all causes. Eur Respir J. 2007;30:616-22. [PMID: 17906084] CrossrefMedlineGoogle Scholar3. Young R, Hopkins R. Lung function predicts lung cancer [Letter]. Eur Respir J. 2010;35:1421-2. [PMID: 20513918] CrossrefMedlineGoogle Scholar4. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al; National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395-409. [PMID: 21714641] CrossrefMedlineGoogle Scholar5. Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD. COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J. 2009;34:380-6. [PMID: 19196816] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Auckland, Auckland 1344, New Zealand.Disclosures: Dr. Young and the funding of his research have been supported by grants from the University of Auckland, Health Research Council of New Zealand, and Synergenz BioSciences Ltd. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society Amir Qaseem , Timothy J. Wilt , Steven E. Weinberger , Nicola A. Hanania , Gerard Criner , Thys van der Molen , Darcy D. Marciniuk , Tom Denberg , Holger Schünemann , Wisia Wedzicha , Roderick MacDonald , Paul Shekelle , and A Clinical Practice Guideline Update on the Diagnosis and Management of Stable COPD Amir Qaseem , Timothy J. Wilt , and Paul Shekelle Metrics Cited ByAirflow limitation and survival after surgery for non-small cell lung cancer: Results from a systematic review and lung cancer screening trial (NLST-ACRIN sub-study)Reduced Expiratory Flow Rate among Heavy Smokers Increases Lung Cancer Risk. Results from the National Lung Screening Trial–American College of Radiology Imaging Network CohortThe Gut–Liver–Lung Axis. Modulation of the Innate Immune Response and Its Possible Role in Chronic Obstructive Pulmonary DiseaseAirflow Limitation and Histology Shift in the National Lung Screening Trial. The NLST-ACRIN Cohort SubstudyAdefovir- or Lamivudine-Induced Renal Tubular Dysfunction after Liver TransplantationPersonalizing annual lung cancer screening for patients with chronic obstructive pulmonary disease: A decision analysisDRUGS System Enhancing Adherence of Chinese Surgeons to Antibiotic Use Guidelines during Perioperative PeriodCT screening in COPD: Impact on lung cancer mortalityUpdate on the potential role of statins in chronic obstructive pulmonary disease and its co-morbidities 3 January 2012Volume 156, Issue 1_Part_1Page: 68-69KeywordsChronic obstructive pulmonary diseaseLung and intrathoracic tumorsLungsMyocardial infarctionResearch fundingRespiratory system proceduresSpirometryTreatment guidelines ePublished: 3 January 2012 Issue Published: 3 January 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...