Clinical and functional assessment in COPD: From case finding to follow-up

A spirometry with bronchodilator test is needed for the diagnosis of COPD. It is recommended to detect COPD only in subjects with symptoms (dyspnoea and/or chronic cough and/or chronic sputum production) and a history of exposure to risk factors for the disease (tobacco smoking and/or occupational exposure). Measurement of peak expiratory flow to detect COPD, although simpler than conventional spirometry, allows only detection of the most severe cases of COPD. Specialist referral is often useful in the diagnosis of COPD, to establish the presence of incompletely reversible airflow obstruction, assess severity (using clinical questionnaires, plethysmography, exercise testing and arterial blood gases when indicated) and define future management. The level of FEV1 is associated with individualized assessment of symptoms and evaluation of exacerbation risk in the management strategy of stable COPD.