Evidence mapPaperPMID 41813011Full record

SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2026

Definitions of early COPD and predictors for disease progression: a systematic review.

Alastair Watson, Ross Davidson, Fu Chuen Kon, Arnav Sharma, Gbenga Adesoye, Bryan Chang, Kane Alexander, Mosea Song, Isobel Soper, Akhilesh Jha and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Alastair WatsonSchool of Clinical Medicine, University of Cambridge, Cambridge, UK Alastair.watson7@nhs.net.ORCID https://orcid.org/0000-0002-6735-2567
Ross DavidsonSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Fu Chuen KonRoyal Free London NHS Foundation Trust, London, UK.
Arnav SharmaSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Gbenga AdesoyeCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID https://orcid.org/0009-0008-2843-7649
Bryan ChangCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Kane AlexanderChelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Mosea SongCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Isobel SoperCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Akhilesh JhaSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.ORCID https://orcid.org/0000-0002-8413-7738
Marie FiskSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEarly chronic obstructive pulmonary disease (COPD) is considered to represent the initial phase of the disease. However, inconsistent terminology and lack of standardised definitions hinders research and clinical application. This systematic review examined clinical research on early COPD, analysed terms and definitions used, and evaluated predictors of disease progression. This serves as a platform to reach consensus and direct future research to target early disease states and improve patient outcomes.

methodsUtilising a standardised protocol, we systematically screened all clinical studies on early COPD. Titles and abstracts were reviewed and compared against inclusion and exclusion criteria. Stage 1 assessed terminology and definitions and stage 2 evaluated predictors of progression. Two independent people reviewed studies at each stage. Study quality was appraised using a modified Downs and Black checklist.

resultsWe identified 4871 articles, 1759 were screened after duplicate removal. The terms used included PRISm (preserved ratio impaired spirometry) (104 articles), GOLD 0 (Global Initiative for Chronic Obstructive Lung Disease stage 0) (63), early COPD (37), at-risk COPD (35) and pre-COPD (30). Definitions were heterogeneous and proposed early COPD definitions were not routinely used. Stage 2 included 43 full-text articles from cohort studies, of which 93% were of good quality. Predictors of progression included age (n=13 articles), smoking history (12), symptoms (12), exacerbations (one), lung function measures (20), computed tomography metrics (14), risk tools (three) and machine learning approaches (three).

conclusionWe demonstrate an urgent need for consensus on clinically applicable definitions of the early disease course of COPD, prior to diagnosis. We highlight predictors of progression; these need validation to enable stratification of individuals early in their disease trajectory for targeted management to halt or modify progression.

Indexed as

LungPulmonary Disease, Chronic ObstructiveTerminology as TopicAgedDisease ProgressionEarly DiagnosisFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisRisk AssessmentRisk FactorsSeverity of Illness IndexTime Factors

Identifiers

PMID41813011
PMCPMC12976884

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.