TY - JOUR
T1 - Diagnosis and management of stable chronic obstructive pulmonary disease
T2 - A clinical practice guideline from the American College of Physicians
AU - Qaseem, Amir
AU - Snow, Vincenza
AU - Shekelle, Paul
AU - Sherif, Katherine
AU - Wilt, Timothy J.
AU - Weinberger, Steven
AU - Owens, Douglas K.
PY - 2007/11/6
Y1 - 2007/11/6
N2 - Recommendation 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.) Recommendation 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.) Recommendation 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled β-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.) Recommendation 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.) Recommendation 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (PaO2 ≤55 mm Hg). (Grade: strong recommendation, moderate-quality evidence.) Recommendation 6: Clinicians should consider prescribing pulmonary rehabilitation in symptomatic individuals with COPD who have an FEV1 less than 50% predicted. (Grade: weak recommendation, moderate-quality evidence.)
AB - Recommendation 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.) Recommendation 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.) Recommendation 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled β-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.) Recommendation 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.) Recommendation 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (PaO2 ≤55 mm Hg). (Grade: strong recommendation, moderate-quality evidence.) Recommendation 6: Clinicians should consider prescribing pulmonary rehabilitation in symptomatic individuals with COPD who have an FEV1 less than 50% predicted. (Grade: weak recommendation, moderate-quality evidence.)
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U2 - 10.7326/0003-4819-147-9-200711060-00008
DO - 10.7326/0003-4819-147-9-200711060-00008
M3 - Review article
C2 - 17975186
AN - SCOPUS:38449115415
SN - 0003-4819
VL - 147
SP - 633
EP - 638
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 9
ER -