Statement on Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease (COPD) and Asthma

TLDR

COPD and asthma are the leading causes of pulmonary disability in the United States, affecting more than 10 million people and up to 5 % of the population, yet despite advances over the past two decades substantial gaps in understanding remain. This statement was produced by a Task Group of the American Thoracic Society to provide a timely, comprehensive review of COPD and asthma diagnosis and care. The authors focused on clinically relevant topics, offering concise guidance and selected references, with the first two chapters defining the diseases and outlining diagnostic and admission/discharge recommendations, and the remaining four chapters critically reviewing therapeutic options. The committee identified several controversial areas where conclusive experimental data are still lacking.

Abstract

Chronic obstructive pulmonary disease (COPD) and asthma are the major causes of pulmonary disability in the United States, with at least 10 million Americans suffering form COPD and up to 5% of the population afflicted with asthma. Over the past 20 years, major strides have been made in our understanding of the pathophysiology of these disorders, although there are still large gaps in our knowledge. While a number of position papers and statements have been promulgated by the American Thoracic Society concerning various aspects of the diagnosis and treatment of COPD and asthma, it was felt that a review of the overall topic was timely. This statement represents the combined efforts of a Task Group appointed by the Scientific Assemble of Clinical Problems of the American Thoracic Society to accomplish this task. Clearly, we could not cover every aspect of this broad topic nor even provide a detailed review of those areas addressed. We elected instead to concentrate on clinically relevant topics and to provide sufficient data to be useful as a guide as well as to include selected, but in no was exhaustive, references. The first two chapters define the entities and set forth recommendations for diagnosis, hospital admission, and discharge. The remaining four chapters critically review the various facets of therapy. We have noted controversial areas and those were conclusive experimental data are not yet available. In these situations, the committee often decided to take a position on one side or the other based upon the best available information.