A group of researchers is questioning the potential effect of a new algorithm proposed for the management of patients with COPD.

Writing in Lancet Respiratory Medicine, researchers argue that the algorithm, which was first proposed by researchers Christopher Cooper and Igor Barjaktarevic and published in the journal’s April 2015 issue, is “is too restricted to improve future management of individual patients with COPD.”

From the article:

In the algorithm, clinical phenotyping is only suggested in patients with “uncontrolled disease”.1 However, patients with mild airflow limitation and bronchial hyper-responsiveness might respond well to inhaled corticosteroids. 

Respiratory failure is recognized in the description of the clinical phenotypes of severe COPD. However, the potential of noninvasive ventilation in such patients is completely ignored. The proposed algorithm is also too simple to cover the complex, non-pulmonary features and common comorbidities of COPD.

We strongly believe that Cooper and Barjaktarevic’s proposed algorithm is too restricted to improve future management of individual patients with COPD. Because the degree of airflow limitation is moderately associated with daily symptoms, comorbidities, exercise intolerance, and impaired health status in patients with COPD, and non-pharmacological therapy based on early clinical phenotyping, need to be emphasized in the management of COPD.