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lüll Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians Qaseem A; Snow V; Shekelle P; Sherif K; Wilt TJ; Weinberger S; Owens DKAnn Intern Med 2007[Nov]; 147 (9): 633-8RECOMMENDATION 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled beta-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.) RECOMMENDATION 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.) RECOMMENDATION 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (Pao2 < or =55 mm Hg). (Grade: strong recommendation, moderate-quality evidence.) RECOMMENDATION 6: Clinicians should consider prescribing pulmonary rehabilitation in symptomatic individuals with COPD who have an FEV1 less than 50% predicted. (Grade: weak recommendation, moderate-quality evidence.).|Administration, Inhalation[MESH]|Adrenal Cortex Hormones/adverse effects/therapeutic use[MESH]|Adrenergic beta-2 Receptor Agonists[MESH]|Cholinergic Antagonists/adverse effects/therapeutic use[MESH]|Forced Expiratory Volume[MESH]|Hospitalization[MESH]|Humans[MESH]|Oxygen Inhalation Therapy[MESH]|Prognosis[MESH]|Pulmonary Disease, Chronic Obstructive/*diagnosis/*drug therapy/mortality/physiopathology[MESH]|Receptors, Adrenergic, beta-2/therapeutic use[MESH]|Spirometry[MESH] |