Respiratory Strong — GOLD 2024

FEV₁/FVC Ratio (Airflow Obstruction)

Interprets spirometry FEV₁/FVC ratio to classify airflow obstruction severity per GOLD criteria.

Used in: COPD

Score interpretation

No Obstruction 0

FEV₁/FVC ≥ 0.70: No airflow obstruction. Pattern may be normal or restrictive.

→ If restrictive pattern (reduced FVC, normal ratio): consider ILD, chest wall disease. Refer for full lung function tests (TLC/DLCO).

GOLD 1 — Mild 1

Obstruction with FEV₁ ≥ 80%: GOLD 1 (Mild). Post-bronchodilator ratio < 0.70 required for COPD diagnosis.

→ SABA (as needed). Smoking cessation. Vaccinations.

GOLD 2 — Moderate 2

Obstruction with FEV₁ 50–79%: GOLD 2 (Moderate).

→ LABA or LAMA. Consider combination. Pulmonary rehabilitation referral.

GOLD 3 — Severe 3

Obstruction with FEV₁ 30–49%: GOLD 3 (Severe).

→ Dual bronchodilation (LABA+LAMA). ICS if frequent exacerbations or eosinophils ≥300. Specialist review.

GOLD 4 — Very Severe 4

Obstruction with FEV₁ < 30%: GOLD 4 (Very Severe).

→ Triple therapy. Consider LTOT if PaO₂ < 7.3 kPa. Evaluate for lung transplant. Palliative care.

Interpretation bands for the FEV₁/FVC. Apply clinical judgement and local guidance.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.