[GOLD guideline and recommendation for role of spirometry in COPD]

COPD is currently the fourth leading cause of death in the world, and further increase in its prevalence and mortality have been predicted for the coming decades. To decrease the morbidity and mortality due to COPD, better recognition of the risk of COPD and improvement in prevention and management of COPD is required. Many national and international societies of respiratory diseases have developed guidelines for COPD. In the GOLD report, COPD is a disease status characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Airflow limitation in COPD is best measured through spirometry, which is a key to the diagnosis and management of the disease. It is the most standardized, reproducible, and objective measurement of airflow limitation available. A decrease in the ratio of FEV1 to FVC is often the first sign of developing airflow limitation. In Japan, a major problem is the lack of guidelines for standardization of spirometry. To achieve consistently accurate test results, not only standardization of spirometry but also propagation of proper procedure and evaluation of spirometry are required.