The new GOLD document (Global Initiative for Chronic Obstructive Lung Disease) 2017 [1] recommends guiding the treatment of chronic obstructive pulmonary disease (COPD) predominantly based on the degree of dyspnea and the occurrence of exacerbations, excluding FEV1 from the decision-making process. Although we are fully aware that this document is oriented to the management of COPD and not to an individual patient with COPD, the fact of excluding said parameter from the therapeutic algorithm further widens the gap between the purpose of the GOLD guidelines and the reality we have to face daily.
