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

 The Global Initiative for Chronic Obstructive Pulmonary Lung Disease (GOLD) Criteria were first published in 2001 to assist clinicians in assessing and characterizing the severity of Chronic Obstructive Pulmonary Disease (COPD). Once COPD is diagnosed by spirometry (FEV1/FVC <0.7), the GOLD Criteria can be used to predict the risk of future COPD exacerbations and classify patients into therapeutic treatment groups (A,B & E). The Global ABE Assessment Process includes assessment of airflow obstruction by stage (GOLD 1-4) based on FEV1. The final step involves two dyspnea scales called the COPD Assessment Test (CAT) or the Modified Medical Research Council (mMRC) Dyspnea Scale in conjunction with the patient's exacerbation history to guide therapeutic interventions for management of stable, baseline COPD. In addition, the Global ABE Assessment includes the use of blood eosinophils to assist in identifying high risk patients that may benefit from additional Inhaled Corticosteroid (ICS) therapy.

Of note, the Global ABE Assessment Process:

• Intended for patients > 18 years old with a current COPD diagnosis by spirometry (FEV2/FVC <0.7) and history.
• Do not use the GOLD criteria to diagnose COPD.
• Do not use in patients with acute exacerbation. Refer to the GOLD guidelines for management of acute exacerbations.

FORMULA

RECOMMENDATIONS

GLOBAL RECOMMENDATIONS

Goals for Treatment of Stable COPD:

1. Reduce Symptoms
   1. Relieve Symptoms
   2. Improve Exercise Tolerance
   3. Improve Health Status
2. Reduce Risk
   1. Prevent Disease Progression
   2. Prevent & Treat Exacerbations
   3. Reduce Mortality

Review:

1. Risk factor management
   1. ∝1-antitrypsin
   2. blood eosinophil count
   3. exposures/irritants
2. Inhaler technique & adherence
3. Self management skills
   1. breathlessness
   2. written action plan
4. Need for oxygen, NIV, lung volume reduction, palliative approaches
5. Management of comorbidities
6. Spirometry (at least annually)

Refer to the 2024 guidelines for more information.

• Intended for patients > 18 years old with a current COPD diagnosis by spirometry (FEV2/FVC <0.7) and history.
• Do not use the GOLD criteria to diagnose COPD.
• Do not use in patients with acute exacerbation.