TABLE 1.

Stratification of chronic obstructive pulmonary disease (COPD) severity/future risk

	Severity of airflow limitation	Symptom severity	Exacerbation risk
Czech Republic	GOLD stages 1, 2, 3 and 4	mMRC or CAT	Low risk: 0–1 exacerbations
			High risk: ≥2 exacerbations
England and Wales#	FEV1/FVC <70% pred and Mild: FEV1 ≥80% pred; moderate: FEV1 50–79% pred; severe: FEV1 30–49% pred; very severe: FEV1 <30% pred	Presence of systemic symptoms BMI Health status: measure not specified (CAT in NICE quality standard) Exercise capacity (e.g. 6-min walking distance) PaO2	Not specified
Finland	Low risk: FEV1 ≥50% pred High risk: FEV1 <50% pred¶	CAT score <10 or ≥10	High risk: ≥2 exacerbations or one leading to hospitalisation in the past year
France	GOLD stages 1, 2, 3 and 4	mMRC Episodic versus daily occurrence of dyspnoea on exercise	History of exacerbations (≥2)
Germany	GOLD stages 1, 2, 3 and 4	Not graded or used for assessment	Not graded or used for assessment
Italy	Mild: FEV1 ≥80% pred; moderate: FEV1 <80% pred and ≥50% pred; severe: FEV1 <50% pred	None stated	None stated
Poland	Mild: FEV1 ≥80% pred; moderate: FEV1 <80% pred and ≥50% pred; severe: FEV1 ≥30% pred and <50% pred; very severe: FEV1 <30% pred	mMRC or CAT	High risk: FEV1 <50% pred, or ≥2 exacerbations treated with antibiotics or 1 hospitalisation due to exacerbation within past 12 months
Portugal	GOLD stages 1, 2, 3 and 4 Overall: GOLD A, B, C and D classification used	mMRC or CAT	Low risk: 0–1 moderate exacerbations High risk: ≥2 moderate or ≥1 severe exacerbation
Russia	Mild: FEV1 ≥80% pred; moderate: FEV1 <80% pred and ≥50% pred; severe: FEV1 ≥30% pred and <50% pred; very severe: FEV1 <30% pred	mMRC, CAT or CCQ	High risk: according to GOLD 2011 classification (high risk ≥2 exacerbations or ≥1 hospitalisation per year)
Spain	GOLD stages 1, 2, 3 and 4	CAT	Low risk: 0–1 exacerbations High risk: ≥2 exacerbations
Sweden	FEV1	CAT, CCQ or mMRC	Number per year

GOLD: Global Initiative for Chronic Obstructive Lung Disease; mMRC: modified Medical Research Council; CAT: COPD assessment test; FEV₁: forced expiratory volume in 1 s; FVC: forced vital capacity; BMI: body mass index; NICE: National Institute for Health and Care Excellence; P_aO2: arterial oxygen tension; CCQ: clinical COPD questionnaire. ^#: the guidelines for England and Wales also assess P_aO2; ^¶: provides a separate tool for assessing severity of obstruction according to GOLD strategy as well as assessing the severity of full clinical presentation.