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In 2001 the US National Heart, Lung and Blood Institute (NHLBI) and the World Health Organization announced guidelines for the diagnosis, management, and treatment of COPD (Global Initiative for Chronic Obstructive Lung Disease, GOLD).1 One key aspect of these guidelines is that COPD is classified by severity into five stages which constitute the basis of treatment recommendations. However, to date there has been little evidence for the usefulness of these severity stages.
We retrospectively reviewed 1000 patients with COPD diagnosed clinically in 2001; 500 patients originated from a pulmonary rehabilitation hospital. Patients’ symptoms (based on a standardised interview), findings of a standardised lung examination, lung function data, and chest radiographic findings are routinely documented in a …