|
|
 | |||
|
|
|
|
| |||
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
A 60-year-old white man presents for evaluation of progressive dyspnea. He is a former smoker with a 20-pack-year smoking history and a 10-year history of diagnosed chronic obstructive pulmonary disease (COPD). There is no family history of COPD. Severe airflow obstruction is seen on spirometry, with a forced expiratory volume in 1 second (FEV1) that is 40% of the predicted value.
The Clinical Problem
Strategies and Evidence
Diagnosis
Evaluation and Follow-up
Treatment
Lung Disease
Liver Disease
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Channing Laboratory and Pulmonary and Critical Care Division, Brigham and Women's Hospital, and Harvard Medical School, Boston (E.K.S.); and the Pulmonary Division, National Jewish Health, Denver (R.A.S.).
An audio version of this article is available at NEJM.org.
Address reprint requests to Dr. Silverman at Channing Laboratory and Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, MA 02115, or at ed.silverman@channing.harvard.edu.
HOME | SUBSCRIBE | SEARCH | CURRENT ISSUE | PAST ISSUES | COLLECTIONS | PRIVACY | TERMS OF USE | HELP | beta.nejm.org Comments and questions? Please contact us. The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved. |
Previous
