GOLD v LLN    Page 6


Conclusions

   The GOLD criteria were set up in 1997 in an attempt to standardise the future research into COPD so that all workers in the field could work to a common standard. There was insufficient evidence at the time to substantiate the rules that were presented. In the light of current evidence it is clear that the main crux of diagnosis of COPD by the GOLD criteria are flawed.

   This will lead to more older subjects being diagnosed with COPD than is justified since the inclusion criteria as shown above will include a significant number of normal subjects who do not have disease. These false positives will then possibly receive treatment they do not require and bear the burden of the label of disease they do not warrant.

   It is clear that the scientific community in Respiratory Medicine must act to correct this anomaly so that research into COPD is not contaminated by the rules being wrong at the start.