ABSTRACT
The main aspects of chronic obstructive pulmonary disease (COPD) diagnosis,
evaluation, and treatment are covered in detail in the preceding chapters. One difficult
task for clinicians is to translate the corresponding scientific evidence into clinical
practice; guidelines aim at helping them to do so, through a critical appraisal of
available data by a multi-professional group of experts. The most recent and widely
disseminated guidelines on COPD are the global initiative on obstructive lung
diseases (GOLD) guidelines (1), which have been regularly updated following the
initial report (2) and mention the level of scientific evidence supporting each
recommendation. A few years before the last GOLD update, the American Thoracic
Society and European Respiratory Society also issued international guidelines, which
share most of their conclusions with the GOLD document (3). In many countries,
adaptations of international guidelines have been developed, taking into account
national specificity and constraints; the impact of these guidelines on quality of care
and patients’ outcomes has been seldom assessed, with variable but frequently
disappointing results (4-20).
