Chronic obstructive pulmonary disease (COPD) is a large and increasing global health problem.1 Although cigarette smoking is the most common preventable cause of COPD, not all cases of COPD are associated with smoking.2,3 Most of the clinical limitations stem from the accelerated loss of lung function that characterizes COPD, but few data speak to the factors that cause, aggravate, and determine this loss.
The Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study4 was undertaken to fill some of the gaps in our knowledge of these factors. The study recruited patients with what the Global Initiative on . . .
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