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Chronic obstructive pulmonary disease — master index¶
Last curated: 2026-10-27 · status: sweep pending audit
The condition in five sentences. COPD is a heterogeneous lung condition characterized by persistent respiratory symptoms and airflow obstruction from airway and/or alveolar abnormalities, confirmed by post-bronchodilator spirometry (Christenson 2022, PMID 35533707). Modeling estimated 391.9 million people aged 30–79 had COPD in 2019, with tobacco, household/ambient pollution and occupational exposures producing major regional differences (Adeloye 2022, PMID 35279265). Small-airway disease, emphysema, mucus, inflammation, vascular change and systemic comorbidity combine differently across individuals, including many never-smokers (Yang 2022, PMID 35427530). Smoking cessation, vaccination, inhaled bronchodilators, pulmonary rehabilitation and exacerbation prevention anchor care; inhaled corticosteroids benefit selected exacerbation-prone/eosinophilic patients but increase pneumonia risk (McCarthy 2015, PMID 25705944; Lipson 2018, PMID 29668352; Zhang 2020, PMID 32643439). The frontier is earlier detection and phenotype-specific therapy, illustrated by dupilumab benefit in eosinophilic COPD, while access to spirometry and rehabilitation remains a larger global constraint (Bhatt 2023, PMID 37272521; Ho 2019, PMID 30838057).
Start here: overview.md. Frontier: OPEN-QUESTIONS.md. Growth history: LOG.md.
Pages¶
| File | Scope | Status |
|---|---|---|
| overview.md | Definition, burden, heterogeneity and treatment map | curated |
| diagnosis-spirometry-and-case-finding.md | Persistent obstruction, testing quality, under/overdiagnosis and mimics | draft |
| epidemiology-and-global-burden.md | Prevalence, mortality, exposures, inequalities and trends | curated |
| small-airway-disease-and-emphysema.md | Airway remodeling, parenchymal destruction and gas exchange | curated |
| inflammation-and-endotypes.md | Neutrophilic, eosinophilic/type-2, infectious and systemic biology | curated |
| genetics-and-alpha-1-antitrypsin.md | SERPINA1, COPDGene, genetic susceptibility and testing | draft |
| smoking-pollution-and-occupational-risk.md | Tobacco, biomass, ambient pollution and work exposures | curated |
| stable-inhaled-therapy.md | LABA/LAMA/ICS, inhaler selection and de-escalation | curated |
| exacerbations-and-acute-care.md | Definitions, triggers, antibiotics, steroids, NIV and recovery | draft |
| pulmonary-rehabilitation-and-self-management.md | Exercise, education, nutrition and action plans | curated |
| oxygen-and-ventilatory-support.md | LTOT, moderate desaturation, home NIV and palliative support | draft |
| emphysema-procedures-and-transplant.md | Valves, volume reduction, bullectomy and transplant | draft |
| comorbidity-and-systemic-effects.md | Cardiovascular, muscle, bone, mood, cancer and multimorbidity | draft |
| guidelines.md | GOLD and regional recommendations and disagreements | draft |
| biomarkers-and-imaging-phenotypes.md | Eosinophils, CT, MRI, physiology and treatable traits | draft |
| clinical-trials-landscape.md | Inhaled drugs, biologics, regeneration and device trials | draft |
| patient-experience-and-advocacy.md | Breathlessness, stigma, work, oxygen and access | draft |
| red-flags-and-safety-concerns.md | Acute respiratory failure, pneumothorax, hemoptysis and oxygen/medication safety | curated |
Literature layer¶
| Artifact | Scope | Status |
|---|---|---|
| BIBLIOGRAPHY.md | Topic-grouped master bibliography | draft; 2026-10-20 and 2026-10-27 sweep additions pending audit |
| notes/ | Five landmark-paper notes | audited |
| guidelines/REGISTRY.md | Global guideline catalogue and disagreement | draft; 2026-10-20 and 2026-10-27 sweep additions pending audit |
| statistics/STATISTICS.md | Sourced quantitative quick reference | draft; 2026-10-20 and 2026-10-27 sweep additions pending audit |
| patient-voice/ | Ethical public-source experience layer | 2026-10-27 additions pending audit |
Curation state¶
2026-10-27 periodic sweep (author: Codex; independent audit pending). Five papers survived triage: comparative biologics, CONQUEST-ADVANCE implementation, German palliative-care needs, a menthol crossover trial and the RARICO pilot. Three wiki pages were changed (clinical trials, guidelines and patient experience); all remain draft. Updated registry currency/candidate checks, official burden statistics with an explicit WHO discrepancy, public awareness sources and OQ-33/-43. Added a registry-only synthesis of AERIFY-1/2 primary outcomes: the itepekimab benefit was not replicated in the AERIFY-2 former-smoker cohort. All 54 NCT IDs in condition Markdown were fetched live; no status or results-availability change was found against the prior snapshot, with one administrative record update. See LOG.md and the search manifest.
2026-10-20 periodic sweep (author: Claude; independent audit pending). Nine pages were edited and demoted to draft: genetics/AATD, comorbidity, procedures, clinical trials, diagnosis, biomarkers, oxygen, exacerbations and guidelines. Twenty-two new PubMed records were added (18 cited in wiki prose, 2 in statistics only, 2 bibliography only); see LOG.md. The breadth figures below describe the 2026-09-02 audited state and were not recomputed.
This condition was independently re-audited on 2026-09-02 (auditor: Claude; author of the preceding widening pass: codex). At that audit, all 18 canonical pages were curated.
Citation breadth, measured on citations that actually appear in page prose. Each page's ## References list now mirrors its body citations exactly. The wiki cites 295 distinct PubMed records — 16.4 per canonical page, with 18–44 records per individual page (mean 25.6) across 163–199 lines. Before the audit, the pages carried 302 records in their files but only 288 in body prose (16.0 per page): 127 reference-list entries named papers the page never cited, 110 of them papers already carried by other pages. Those entries were removed; the records remain in BIBLIOGRAPHY.md. The audit added 7 records while replacing stale absence statements with positively-stated evidence.
All 313 PMIDs and all 38 NCT identifiers appearing anywhere under the condition were re-resolved live during the audit; none failed.