COPD, comorbidity, and disease-specific clinical practice guidelines

Many recent studies suggest that individuals with chronic obstructive pulmonary disease (COPD) are predisposed to comorbidity. Data on the prevalence of individual comorbidities among patients with COPD are highly variable. This may partly be due to differences in the methods of data acquisition, which range from self-reported survey data to administrative database analysis. There is also variability in comorbidity selection and the patient demographics among studies. When trying to determine the best diagnostic or treatment modality for a given patient, physicians often look to disease-specific clinical guidelines for recommendations to guide clinical decisions. These guidelines evaluate the body of evidence behind clinical questions and formulate recommendations, with the intent to influence clinical decision making. The strength of a recommendation is partially based on the quality of evidence from which it is derived. Even the strongest recommendations, however, are meant to be interpreted within the context of individual patient preferences and goals of care. A physician must use his or her clinical judgment when applying these guidelines to medical practice. One important question that must always be asked is whether or not these recommendations apply to the patient in question who may be elderly or have multiple comorbidities.