. 2019 Nov 13;28(154):190049. doi: 10.1183/16000617.0049-2019

TABLE 3.

EWGSOP2 algorithm for case finding, making a diagnosis and quantifying severity of sarcopenia in clinical practice with clinical and research considerations for COPD patients

Steps	Components	Response	Considerations for COPD patients
Step 1: Case finding	SARC-F or clinical suspicion	+: Go to step 2	SARC-F in all COPD patients
Step 1: Case finding	SARC-F or clinical suspicion	−: No sarcopenia, rescreen later	SARC-F in all COPD patients
Step 2: Assess	Muscle strength (grip strength or chair stand test)	+: Go to step 3 plus start intervention: “probable sarcopenia”	Call for research directed to define accurate cut-off points for low muscle strength in COPD patients
Step 2: Assess	Muscle strength (grip strength or chair stand test)	−: No sarcopenia, rescreen later
Step 3: Confirm	Muscle quantity or quality (DXA, BIA, CT, MRI)	+: Go to step 4 plus intervention: “sarcopenia”	Call for research directed to define accurate cut-off points for low muscle mass in COPD patients
Step 3: Confirm	Muscle quantity or quality (DXA, BIA, CT, MRI)	−: Intervention for “probable sarcopenia”
Step 4: Severity	Physical performance (gait speed, SPPB, TUG, 400 m walk)	+: “Severe sarcopenia”	Call for research directed to define optimal physical performance tests and accurate cut-off points for COPD patients
Step 4: Severity	Physical performance (gait speed, SPPB, TUG, 400 m walk)	−: Intervention for “sarcopenia”

EWGSOP2: 2018 European Working Group Older People; SARC-F: questionnaire with the five components of strength, assistance with walking, rise from a chair, climb stairs and falls; DXA: dual-energy X-ray absorptiometry; BIA: bioelectrical impedance analysis; CT: computed tomography; MRI: magnetic resonance imaging; SPPB: Short Physical Performance Battery; TUG: timed up and go test.