Abstract
This review article describes the development of the evaluation of chronic obstructive pulmonary disease (COPD). From simple evaluation (weight, degree of COPD treatment) as forced expiratory volume in the first second of air through the extended classification of shortness of breath and / or symptoms and acute exacerbations in the previous year (since 2011) to phenotypic differentiation of patients.
Phenotype is the one feature or combination of features of the disease, which describe the differences between individuals with COPD and its influence clinically significant consequences, such as symptoms, exacerbations, response to treatment, the rate of disease progression or mortality. There is no unity in how many phenotypes of COPD can be regarded as proven, eg.
In Spanish recommendations out four phenotypes, our recommendation from 2013, six of them can be found in the recommendations of the 2014 GOLD phenotype is not even mentioned. Methods for identification is not uniform (i multifactorial cluster analysis), their examination in prospective trials are necessary.
However, phenotyping of patients with COPD, also provides an opportunity to deploy targeted therapy at present knowledge, which differs from the treatment lump. Differences in the treatment of the individual in our established phenotypes are also the subject of communication.