GOLD stage

When doctors want a shared shorthand for 'how blocked are these airways?', they often use the GOLD stage — a simple ladder of severity based on a breathing test. It puts a number on COPD airflow limitation so clinicians worldwide can speak the same language.

GOLD stages come from the Global Initiative for Chronic Obstructive Lung Disease. After confirming obstruction (a post-bronchodilator FEV1/FVC below 0.70), the FEV1 measured as a percentage of the predicted normal value is graded GOLD 1 (mild, FEV1 at least 80% predicted), GOLD 2 (moderate, 50–79%), GOLD 3 (severe, 30–49%), and GOLD 4 (very severe, below 30%).

Importantly, airflow grade is only part of the picture. Modern GOLD assessment also weighs symptoms (using questionnaires) and exacerbation history into separate ABE groups that guide treatment. So the spirometric stage describes how narrowed the airways are, but it does not, on its own, predict how a particular person feels or which inhaler they need.