The Global Initiative for Chronic Obstructive Lung
Disease (GOLD) Report 20116
over-rides its 2006 Report1
in some important aspects. The staging of severity of
COPD on the basis of forced expiratory volume in the
first second (FEV1
) is replaced by grading of disease
based upon symptom burden, activity limitation, risk of
exacerbations, co-morbidities and health-related quality
of life (HRQoL) including social isolation and
depression. The FEV1
alone is no longer considered a
reliable marker of the severity of the disease.6