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Special Feature |

Investigating the Natural History of Lung Function: Facts, Pitfalls, and Opportunities

Robab Kohansal, MD; Joan B. Soriano, MD, PhD; Alvar Agusti, MD, PhD
Author and Funding Information

*From the Program of Epidemiology and Clinical Research (Drs. Kohansal, Soriano, and Agusti), Fundación Caubet-International Centre for Advanced Respiratory Medicine (CIMERA) Illes Balears, Bunyola, Illes Balears, Spain; the Department of Pulmonary and Critical Care Medicine and Ludwig Boltzmann Institute for COPD (Dr. Kohansal), Otto Wagner Hospital, Vienna, Austria; Centro de Investigacíon Biomedica en Red de Enfermedades Respiratorias (Drs. Soriano and Agusti), Illes Balears, Mallorca, Spain; and Servei Pneumologia (Dr. Agusti), Hospital Universitari Son Dureta, Illes Balears, Mallorca, Spain www.caubet-cimera.es.

Correspondence to: Robab Kohansal, MD, Program of Epidemiology & Clinical Research, Fundación Caubet-CIMERA Illes Balears, Recinte Hospital Joan March, Carretera Soller Km 12, 07110 Bunyola, Illes Balears, Spain; e-mail: r.kohansal@gmx.at


Dr. Kohansal was the recipient of a 2007 European Respiratory Society/Spanish Society of Pulmonology and Thoracic Surgery Long-Term Fellowship No. 123 at Fundación Caubet-International Centre for Advanced Respiratory Medicine (CIMERA) Illes Balears, Bunyola, Illes Balears, Spain (www.caubet-cimera.es).

The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;135(5):1330-1341. doi:10.1378/chest.08-1750
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COPD is currently defined as a progressive, preventable, and treatable disease that is characterized by an accelerated decline of lung function. However, contrary to other common chronic conditions like cardiovascular disease or cancer, there are no lifelong population-based studies describing the natural history of lung function and COPD. In this review, we describe the methodology used in population-based studies, both American and European, that have formed the basis of our current understanding of the “natural history” of COPD, including studies with serial pulmonary function testing, which hold potential for further investigations. We highlight the methodological limitations of longitudinal studies and suggest possible solutions. Finally, some characteristics of an “ideal” study on the natural history of lung function decline are recommended, both in health and disease.

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