Evidence-Based Answers

Evidence Central™ is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research.

Browse

Evidence Central for Mobile Devices

Evidence Central iOS iPhone iPad Android

Evidence Central from Unbound Medicine, available for iOS® and Android™, is optimized for each platform and features superior navigation, so answers are easy to find at the bedside or anywhere they’re needed. Learn More

Word of the Day

Guidelines for the management of COPD

Clinical Question:
What are useful rules for the treatment of patients with stable chronic obstructive pulmonary disease?

Bottom Line:
The current guidelines, which are outlined in the synopsis, are an update of guidelines from 2007. They reaffirm previous recommendations regarding when to use spirometry, and add recommendations regarding when to consider pharmacotherapy. (LOE = 5)

Reference:
Qaseem A, Wilt TJ, Weinberger SE, et al, for the American College of Physicians, the American College of Chest Physicians, the American Thoracic Society, and the European Respiratory Society. Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med 2011;155(3):179-191.  [PMID:21810710]

Study Design:
Practice guideline

Funding:
Foundation

Setting:
Various (guideline)

Synopsis:
These guidelines are based on 3 literature searches that were used to update the guidelines originally developed in 2007 by the American College of Physicians. The guidelines for the treatment of patients with stable chronic obstructive pulmonary disease, in brief, are: (1) Spirometry should continue to be used for diagnosis in patients with symptoms but not for screening in patients without symptoms. (2) Inhaled bronchodilator may be used in patients with an FEV1 between 60% and 80% of predicted and should be used when the FEV1 is less than 60%. (3) Either a long-acting beta-agonist or anticholinergic should be used as monotherapy or combined with a corticosteroid for patients with an FEV1 of less than 60%. (4) Pulmonary rehabilitation may be prescribed for patients with an FEV1 of greater than 50% and should be prescribed when the FEV1 is less than 50% (5) Continuous oxygen therapy should be prescribed for patients with severe resting hypoxemia.

RSS FEED

Site Licenses

Site license

Site Licenses are available for schools, universities, hospitals, government agencies, and companies. For more information, contact us.