Gold criteria
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GOLD 2026 COPD diagnosis spirometry FEV1 FVC classification ABE official report
GOLD criteria for COPD
1. Diagnosis
COPD is confirmed by post-bronchodilator spirometry showing:
[
\boxed{\text{FEV}_1/\text{FVC} < 0.70}
]
This should be interpreted in a person with compatible symptoms or exposures, such as chronic dyspnea, cough/sputum, smoking, biomass-fuel exposure, occupational dust/fumes, or recurrent respiratory infections. The GOLD 2026 report retains the fixed post-bronchodilator ratio of <0.70 for diagnosis.
2. Spirometric severity of airflow obstruction
Use post-bronchodilator FEV₁ % predicted once COPD is confirmed:
| GOLD grade | FEV₁ % predicted | Severity |
|---|---|---|
| GOLD 1 | ≥80% | Mild |
| GOLD 2 | 50-79% | Moderate |
| GOLD 3 | 30-49% | Severe |
| GOLD 4 | <30% | Very severe |
3. Initial clinical assessment: GOLD ABE groups
GOLD now uses A, B, and E groups to guide initial treatment, based on symptoms plus prior exacerbations.
| Group | Symptoms | Exacerbation history in previous year |
|---|---|---|
| A | Low: CAT <10 or mMRC 0-1 | 0-1 moderate exacerbation, with no hospitalization |
| B | More: CAT ≥10 or mMRC ≥2 | 0-1 moderate exacerbation, with no hospitalization |
| E | Any symptom level | ≥2 moderate exacerbations or ≥1 exacerbation requiring hospitalization |
Definitions
- CAT: COPD Assessment Test, score 0-40
- mMRC: Modified Medical Research Council dyspnea scale
- A moderate exacerbation generally requires oral corticosteroids and/or antibiotics; a severe one requires emergency care or hospitalization.
So a complete GOLD description might read:
“COPD confirmed by post-bronchodilator FEV₁/FVC <0.70; spirometric grade GOLD 3; Group E due to prior hospitalized exacerbation.”
The older ABCD grouping has been replaced by ABE, because high exacerbation risk is now grouped as E irrespective of symptom burden. See the official GOLD 2026 pocket guide.
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