GOLD 2025 Report: Prebronchodilator Spirometry and Diagnosis of COPD

Author(s):

M. Bradley Drummond, MD, MHS,MeiLan K. Han, MD, MS

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.

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?

GOLD 2025 Report: Prebronchodilator Spirometry and Diagnosis of COPD

EP: 1.Overview and Diagnosis of COPD

EP: 2.Risk Factors for COPD

EP: 3.Mortality and Comorbidities with COPD

EP: 4.Health and Economic Burden of COPD

EP: 5.Treatment of COPD Based on Symptoms

EP: 6.GOLD 2025 Report: Prebronchodilator Spirometry and Diagnosis of COPD