# Comparison of Diagnostic and Therapeutic Protocols for Chronic Obstructive Pulmonary Disease (COPD): Global Initiative for Chronic Obstructive Lung Disease (GOLD) vs. American Thoracic Society/European Respiratory Society (ATS/ERS) Guidelines

## TL;DR

This paper compares two major COPD guidelines, GOLD and ATS/ERS, focusing on their differences in diagnosis and treatment approaches.

## Contribution

The paper provides a detailed comparison of the 2025 GOLD and ATS/ERS guidelines for COPD, emphasizing their distinct clinical strategies.

## Key findings

- GOLD prioritizes clinical simplicity, while ATS/ERS emphasizes physiological precision.
- Divergences include diagnostic thresholds and treatment classification systems.
- Biomarker usage, such as blood eosinophils, is highlighted as a key difference.

## Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality. International clinical practice guidelines, specifically the 2025 Global Initiative for Chronic Obstructive Lung Disease (GOLD) and the joint American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines, provide standardized frameworks for its diagnosis and management. This narrative review compares these two frameworks, highlighting the trade-off between GOLD’s clinical simplicity and the ATS/ERS emphasis on physiological precision. Key areas of divergence include diagnostic thresholds (fixed ratio vs. lower limit of normal), treatment classification systems (GOLD’s ABE tool vs. ATS/ERS phenotype-driven care), and the use of biomarkers like blood eosinophils. Understanding these nuances is critical for clinicians to optimize diagnostic labeling and long-term therapeutic outcomes.