Recommendations for the early diagnosis of COPD: the AIMAR view.
Chronic obstructive pulmonary disease (COPD) has the dubious distinction of being one of the few major causes of death that continues to rise in the United States and the world. In that sense, its prevention, early diagnosis when clinically present, and finally its appropriate treatment should constitute a priority item in today’s health care agenda. In this sense, the recently published AIMAR’s recommendation for the early diagnosis of COPD constitutes a valuable contribution to this concerted effort . Professor Nardini and colleagues are to be commended for the comprehensive effort that has made this publication possible.
Perhaps the title is a little misguided as it only describes the document as a “recommendation for diagnosis”, when in reality the content is extremely comprehensive covering not just diagnostic issues of relevance, but it also develops, in rich detail, primary and secondary prevention as well as treatment. Furthermore, it extends its recommendations to the often forgotten area of end-of-life and palliative care so important in our ageing population. Perhaps the title should have included the fact that it recommends prevention and treatment as well as diagnosis. In their modesty, the authors do not pretend this to be an evidence based document, primarily due to the fact that no evidence methodology was used, but its recommendations are very much in line with those existing in the international guidelines.
The document begins with a layout of the landscape. It attempts to relate what is known about prevalence and the burden of COPD around the world to the situation in Italy itself. Overall, it would appear that there is room to improve and in a more precise manner determine the Italian situation. It follows with a section on prevention and then with an excellent discussion on the issue of secondary screening ...