by admin | Jan 14, 2018
While research has made large strides in the assessment and treatment of patients with COPD in recent years, a number of important questions remain to be answered. The American Thoracic Society and European Respiratory Society have teamed up to publish a joint statement that describes current evidence on the diagnosis, assessment, and management of COPD; identifies gaps in knowledge; and makes recommendations for future research. Current Needs Perhaps the biggest need that spans all areas of COPD research is to determine which outcomes matter most to patients and then to ensure that research studies measure these outcomes. “Understanding what patients care about is the basis of patient-centered care,” says Kevin C. Wilson, MD, co-author of the statement, which was published in the American Journal of Respiratory and Critical Care Medicine. Physiological and/or anatomical outcomes are used frequently in studies because they tend to be easier to measure. Such surrogate outcomes, however, should strongly correlate with patient-centered outcomes if they are used in clinical research. Examples of patient-centered outcomes include quality of life, dyspnea, and frequency and severity of exacerbations. Determining the optimal method for diagnosing COPD based on spirometry is another important research need according to Dr. Wilson. It is undetermined whether the diagnosis of COPD should be based upon a fixed threshold or the lower limit of normal for the FEV1/FVC ratio. A post-bronchodilator FEV1/FVC ratio of less than 0.7 has traditionally been the criterion for airflow limitation. However, this threshold may result in more frequent identification of airflow limitation among the elderly and less frequent diagnoses among patients younger than 45 when compared with a threshold based...
