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  1. Nicole M Probst-Hensch1,2,
  2. Ivan Curjuric1,2,
  3. Pierre-Olivier Bridevaux3,
  4. Nino Künzli1,2,
  5. Christian Schindler1,2,
  6. Thierry Rochat3
  1. 1Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
  2. 2University of Basel, Basel, Switzerland
  3. 3Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland
  1. Correspondence to Professor Dr Nicole M Probst-Hensch, Unit of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P O Box, 4002 Basel, Switzerland; nicole.probst{at}

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We appreciate the issues raised by Dr Hoesein regarding our paper1 and respond as follows.

First, the NELSON study is a randomised screening trial for lung cancer and therefore targets subjects at high risk. The focus of our paper is different. We evaluated the prognostic meaning of a change in prebronchodilation spirometry—a common outcome in environmental epidemiology—in terms of respiratory health, not specifically bound to chronic obstructive pulmonary disease (COPD). We showed that this outcome has value in epidemiological research, but that understanding of the early stages of airflow obstruction, where non-persistence …

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  • Linked articles 139410.

  • Competing interests None.

  • Ethics approval Ethics approval for the original study was obtained from the respective Swiss and Cantonal Ethics Boards.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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