Diagnosing chronic obstructive pulmonary disease. The importance of differentiating asthma, emphysema, and chronic bronchitis.

In patients with chronic obstructive pulmonary disease (COPD), a thorough understanding on the clinician's part of the pathophysiologic basis of airflow limitation greatly enhances decisions regarding care. Differences in prognosis among the major types of COPD have become clear, and identification of airway inflammation has dramatically altered medical therapy. Dr Martinez, who coordinated this symposium, here explains the importance of judiciously applying findings from history taking, physical examination, laboratory studies (particularly pulmonary function testing), and radiographic studies to all aspects of disease management. The remaining four symposium articles address specific avenues for treatment of emphysema and chronic bronchitis.