The Global Initiative for Chronic Obstructive Lung Disease (GOLD) and the Global Lung Function Initiative (GLI) have published a joint statement on the use and interpretation of spirometry for the diagnosis of COPD.
480 million people live with COPD, and 3.7 million die each year. COPD is the third commonest cause of death globally. It also creates massive economic costs and a recent study estimated that the global economic burden from COPD will amount to $US40 trillion by 2050.
Many patients remain undiagnosed and spirometry is essential to confirm the diagnosis. However, for more than 30 years there has been an unproductive debate about how the results of spirometry should be interpreted to confirm the diagnosis in symptomatic patients.
The divergent recommendations about spirometry interpretation have confused primary and secondary care clinicians, as well as lung specialists, leading to the perception that spirometry is a difficult test to perform and interpret, and underuse of the test.
GOLD and GLI have now agreed how spirometry should be interpreted to confirm the diagnosis resolving the confusion. They also agree that performing spirometry is not difficult and more tests need to be done.
Professor David Halpin , a member of the GOLD Board & Science Committee, commented:
Working with GLI to agree how spirometry should be interpreted to confirm the diagnosis is an important step forward in addressing the huge levels of underdiagnosis of COPD globally. Both organisations are clear that more spirometry tests need to be performed and we hope that making its interpretation simple will help with this.
European Respiratory Journal
Commentary/editorial
Not applicable
Joint statement from GOLD/GLI regarding the use of spirometry to define airflow obstruction and diagnose COPD
Conflict of interest: D. M. G. Halpin reports payment or honoraria for lectures, presentations, educational events or participation on data safety monitoring board or advisory boards from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Inogen, Novartis, Sanofi, Berlin Chemie, Synairgen and Menarini and a leadership role with the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Conflict of interest: S. Stanojevic reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Vyaire Medicine and GOLD, participation on an advisory board with Ndd Technologiest, leadership roles with the Global Lung Function Initiative and the American Thoracic Society Pulmonary Function Testing Committee, is a Statistical Editor for Thorax and is an Associate Editor of the European Respiratory Journal. Conflict of interest: M. C. McCormack reports payment or honoraria for lectures, presentations, manuscript writing or educational events from Up To Date, and participation on a data safety monitoring board or advisory board with ndd Medical Technologies, consultancy fees from GSK and MCG Diagnostics and a leadership role with the Global Lung Function Initiative. Conflict of interest: D. Singh reports consultancy fees from Adovate, Almirall, Anaveon, Apogee, Arcutis Biotherapeutics, Arrowhead, AstraZeneca, Belenos Biosciences, Bial, Celldex, Chiesi, Cipla, CONNECT Biopharm, Covis, DevPro Biopharma LCC, Elpen, Empirico, EpiEndo, Generate Biomedicines, GlaxoSmithKline, Glenmark, Jasper, Kinaset Therapeutics, KOLON, Kymera, Lupin, Melodia, Menarini, MicroA, OM Pharma, OrientEuroPharma, Recipharm, Revolo, RIGImmune Inc, Roche, Roivant Sciences, Sanofi, Sitryx, Synairgen, Tetherex, UCB, Upstream, Verona Pharma, Winward, Zura Bio and Zymeworks and is an Associate Editor of the European Respiratory Journal. Conflict of interest: D. Kaminsky reports royalties from UptoDate and Elsevier, honoraria for presentations from MGC Diagnostics receipt of equipment, material or drugs for research purposes from MGC Diagnostics, Inc. Conflict of interest: C.F. Vogelmeier reports grants from the German Ministry of Education and Science (BMBF), AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKline and Grifols, consultancy fees from Aerogen, AstraZeneca, Boehringer Ingelheim, CSL Behring, Chiesi, GlaxoSmithKline, Insmed, Menarini, Roche and Sanofi and payment or honoraria for lectures, presentations, manuscript writing or educational events from Aerogen, AstraZeneca, Boehringer Ingelheim, CSL Behring, Chiesi, GlaxoSmithKline, Insmed, Menarini, Roche and Sanofi. Conflict of interest: L. Gochicoa-Rangel reports payment for lectures from Chiesi, Vyaire, Sunvou and Thorasys, support for attending meetings from Chiesi and leadership roles with the Sociedad Mexicana de Neumología y Cirugía de Tórax and the Asociación Latinoamericana de Tórax Education committee. Conflict of interest: A. Agusti reports consultancy fees from GSK, AstraZeneca, Chiesi, Roche and Menarini, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from GSK, AstraZeneca, Chiesi, Roche, Menarini, Zambon and Glenmark, support for attending meetings from Roche and a leadership role with the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Conflict of interest: B. Cooper received support for attending meetings from the Japanese Respiratory Society.