Opinion
Video
GOLD 2025 Report: Prebronchodilator Spirometry and Diagnosis of COPD
Panelists discuss the initial thought that postbronchodilator spirometry would help differentiate chronic obstructive pulmonary disease (COPD) from asthma. However, postbronchodilator spirometry adds time and effort, as well as exposing a patient to short-term medication that may have adverse effects. Guidelines favor a fixed ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC; < 0.7) because of the ratio’s simplicity and is independent of other reference values.
Video content above is prompted by the following:
- Why is postbronchodilator spirometry no longer recommended in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2025 Report as the first step in confirming a diagnosis of COPD?
- How do the results of prebronchodilator spirometry further guide a COPD diagnosis?
- Why do the guidelines favor a fixed FEV1/FVC ratio (<0.7) over a lower limit of normal as a diagnostic criterion for COPD?
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