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KMID : 1141720180060010001
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폐쇄성폐질환
2018 Volume.6 No. 1 p.1 ~ p.6
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Um Soo-Jung
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Abstract
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In totally revised version of Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 document, the degree of airflow limitation was excluded from patient assessment ABCD system. The claimed reasons for this change were because FEV1 by itself lacks sufficient precision to be used clinically as a predictor and exacerbation history is the most powerful predictor of COPD exacerbation. Though GOLD ABCD classification had been introduced to reflect heterogeneity of COPD, considering air flow obstruction and exacerbations at the same time as a risk predictor made the classification heterogeneous, difficult to apply. The revised GOLD ABCD 2017 is simpler and more accessible to various levels of health care system than FEV1 based version. However, there are concerns that the new ABCD is expected to shift significant proportion of patients from grades C and D to A and B. Initial treatment choice of Patients with severe air flow limitation and without frequent previous exacerbations will be LAMA or LABA alone instead of LABA/LAMA. Although the new step-up system is expected to complement the reduction, the impact of this change need more research.
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KEYWORD
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Chronic obstructive pulmonary disease, Assessment, Stratification, FEV1
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FullTexts / Linksout information
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Listed journal information
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