Global Initiative for Obstructive Lung Disease (GOLD) Criteria ...

Global Initiative for Obstructive Lung Disease (GOLD) Criteria for COPD · Symptom burden Lower (mMRC <2 or CAT Score <10). Higher (mMRC ≥2 or CAT Score ≥10). CalcFunctionCalcsthathelppredictprobabilityofadiseaseDiagnosisSubcategoryof'Diagnosis'designedtobeverysensitiveRuleOutDiseaseisdiagnosed:prognosticatetoguidetreatmentPrognosisNumericalinputsandoutputsFormulaMedtreatmentandmoreTreatmentSuggestedprotocolsAlgorithmDiseaseSelect...SpecialtySelect...ChiefComplaintSelect...OrganSystemSelect...PatentPendingLogInEmailAddressPasswordShowForgotyourpassword?LogInOrcreateanewaccount(it'sfree)ForgotPassword?EmailAddressEnteryouremailaddressandwe'llsendyoualinktoresetyourpassword.GetNewPasswordSignInRequiredTosavefavorites,youmustlogin.Creatinganaccountisfree,easy,andtakesabout60seconds.LogInCreateAccountAlreadyhaveanMDCalcaccount?LogintolinkyourfavoritesandrecentlyusedcalcsEmailAddressPasswordShowForgotyourpassword?LogInOrcontinuetoNuanceAttentionCOACHSTUDYparticipants:Theprincipalinvestigatorsofthestudyrequestthatyouusetheofficialversionofthemodifiedscorehere.GlobalInitiativeforObstructiveLungDisease(GOLD)CriteriaforCOPDAssessesdifferentstagesofCOPDandprovidestreatmentrecommendations.INSTRUCTIONSUseinpatients>18yearsofagewithalready-diagnosedCOPDbyspirometry(FEV₁/FVC<0.7)withbaselinesymptomsandlungfunction.DonotusetodiagnoseCOPDanddonotuseinpatientswithacuteexacerbation.WhentoUsePearls/PitfallsWhyUsePatientswithCOPDwithrecentspirometryresultsavailableintheambulatorysettingwhoareattheirbaselinewithregardtosymptomsandlungfunction.Donotuseinpatientssufferinganacuteexacerbationorworseningofrespiratorysymptoms.TheGOLDCriteriaweredevelopedandprimarilyvalidatedforpatients>18yearsofage.TheGOLDCriteriaareusedclinicallytodeterminetheseverityofexpiratoryairflowobstructionforpatientswithCOPD.ShouldnotbeusedtodiagnoseCOPD,butrathertocategorizeclinicalseveritytoinformprognosisandtoguidetherapeuticinterventions.Determiningapatient’sGOLDstatusrequiresamultidimensionalassessmentofapatient’sspirometry,symptomburden,andfrequencyofCOPDexacerbations.Spirometryismeasuredbyformalpulmonaryfunctiontesting,andthepercentpredictedoftheforcedexpiratoryvolumein1second(FEV₁)isthevalueusedincalculatingapatient’sGOLDstatus.SymptomburdenisquantifiedbyeitherthemodifiedMedicalResearchCouncil(mMRC)DyspneaScaleorCOPDassessmenttest(CAT)score.ExacerbationfrequencyencompassesthenumberofacutesymptomaticdeteriorationsofCOPDoverthepast12monthsrequiringeitherincreasedmedicalmanagementorhospitalization.GOLDstatus(A-D)explicitlyguidestherapeuticinterventionsformanagementofstable,baselineCOPD,withGOLDApatientsrequiringlessmedicalmanagementthanGOLDDpatients.The2017GOLDCriteriapredictmortalityriskforpatientswithCOPD,butnotmoreaccuratelythantheearlierGOLDscores(LeivsethandSoriano).StageBmaypredicthighermortalitythanstageCCOPD,asdeterminedbythe2011GOLDCriteria(Lange).GOLDstatusinthe2011criteriadoespredictriskofexacerbationbetterthantheolder,spirometrically-basedGOLDCriteria(LangeandSoriano).GOLDstagesB,C,andDdonotaccuratelyreflectpatient’sfunctionalstatusasmeasuredby6minutewalktesting,LondonChestActivitiesofDailyLivingScale,ordailylifeactivitymonitoring(Moreira).ThetherapeuticguidancecoupledtoGOLDstagesisprimarilybasedonexpertconsensusratherthandirectevidencesupportingspecifictherapeuticrecommendationsforagivenGOLDstage;however,theindividualmedicationsandclinicalinterventionsaresupportedbyrelativelystronglevelofevidence.PredictsriskoffutureCOPDexacerbations(LangeandSoriano)andmortality(Lange,Leivseth,andSoriano).CanserveasaframeworktodiscussdiseasemanagementandriskreductionforpatientswithCOPD.GOLDstagesarelinkedtospecifictherapeuticrecommendationsformedicalmanagementforbothchronicCOPD,aswellassuggestionsforacuteexacerbations.Derivedfromanddescribedinaglobalpatientpopulation,implyingrelevancyforuseinawidevarietyofclinicalandgeographicsettings.SymptomburdenmMRC2=Walksslowerthanpeopleofthesameagebecauseofdyspneaorhastostopforbreathwhenwalkingatownpace;CAT10=COPDsymptomshavelow-mediumimpactonpatient'slifeLower(mMRC<2orCATScore<10)Higher(mMRC≥2orCATScore≥10)Exacerbationhistory0exacerbations1exacerbationwithouthospitaladmission≥1exacerbationwithhospitaladmission≥2exacerbationsFEV₁%ofpredicted≥8050–7930–49<30Result:Pleasefilloutrequiredfields.NextStepsEvidenceCreatorInsightsDr.EdwardPetsonkAbouttheCreatorEdwardPetsonk,MD,isaprofessorofmedicineatWestVirginiaUniversity.Heisapracticingpulmonologistandcriticalcarephysicianandhasbeenpublishedintheliteratureonoccupationaldeficitsduetolungdisease.Dr.PetsonkisalsoaretiredcaptainintheUSPublicHealthService.ToviewDr.EdwardPetsonk'spublications,visitPubMedAreyouDr.EdwardPetsonk?Sendusamessagetoreviewyourphotoandbio,andfindouthowtosubmitCreatorInsights!MDCalclovescalculatorcreators–researcherswho,throughintelligentandoftencomplexmethods,discovertoolsthatdescribescientificfactsthatcanthenbeappliedinpractice.Thesearerealscientificdiscoveriesaboutthenatureofthehumanbody,whichcanbeinvaluabletophysicianstakingcareofpatients.ContentContributorsJeremyB.Richards,MDRelatedCalcsCOPDAssessmentTest(CAT)BODEIndexEstimatedPeakFlowHavefeedbackaboutthiscalculator?AbouttheCreatorDr.EdwardPetsonkAreyouDr.EdwardPetsonk?AlsofromMDCalc...RelatedCalcsCOPDAssessmentTest(CAT)BODEIndexEstimatedPeakFlowContentContributorsJeremyB.Richards,MD