{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:16:57Z","timestamp":1777933017878,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>COPD is a heterogeneous disorder. We developed a multidisciplinary evaluation scheme to identify patients with COPD who may benefit from phenotype-specific therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Our team of general and interventional pulmonologists, thoracic surgeons, radiologists, respiratory therapists, and advanced practice nurses meets monthly to discuss patients with advanced COPD. For each patient, pulmonary function tests, imaging, and other pertinent data are reviewed. Emphysema is assessed visually and by quantitative computed tomography modalities. A consensus is sought for medical, bronchoscopic, and\/or surgical treatments and recommendations are relayed to the referring physician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The multidisciplinary team reviewed 510 cases between November 2015 and December 2022. Eighty-five of 510 subjects were found to be appropriate candidates for lung-volume-reduction surgery and 36 underwent the procedure. Subjects in the post-multidisciplinary evaluation cohort experienced improvement in mean\u2009\u00b1\u2009SD FEV\n                      <jats:sub>1<\/jats:sub>\n                      of 0.23\u2009\u00b1\u20090.38 L (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.52) and mean\u2009\u00b1\u2009SD reduction in residual volume by 0.78\u2009\u00b1\u20090.98 L (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.09) 6 months after surgery, which was similar to the improvements in pre-multidisciplinary evaluation subjects (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.52 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.09, respectively). Of the 202 subjects referred for bronchoscopic lung volume reduction, 28 underwent the procedure. Mean\u2009\u00b1\u2009SD improvement in FEV\n                      <jats:sub>1<\/jats:sub>\n                      was 0.14\u2009\u00b1\u20090.18 L and mean\u2009\u00b1\u2009SD reduction in residual volume was 0.68\u2009\u00b1\u20090.80 L (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001, respectively) at 6 months after the procedure. Most subjects were not suitable candidates for lung volume reduction due to anatomical, physiologic, or phenotypical exclusions. Management was found to be optimal in the majority of subjects who were not candidates for lung volume reduction (53.7%). A survey of meeting attendees indicated high confidence in managing these patients with a high likelihood of changing management decisions after multidisciplinary discussion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Most symptomatic subjects with advanced COPD were not candidates for lung-volume-reduction interventions. There is an unmet need for novel therapeutic options in this population. The multidisciplinary evaluation consensus recommendations provided assurance and guidance to clinicians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/respcare.12345","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T20:35:41Z","timestamp":1738355741000},"page":"810-820","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Multidisciplinary Evaluation for COPD Management"],"prefix":"10.1177","volume":"70","author":[{"given":"Avantika","family":"Nathani","sequence":"first","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelrahman","family":"Nanah","sequence":"additional","affiliation":[{"name":"Dr. Nanah is affiliated with the Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed J.","family":"Al-Jaghbeer","sequence":"additional","affiliation":[{"name":"Dr. Al-Jaghbeer is affiliated with the King Hussein Cancer Foundation and Center, Amman, Jordan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne M.","family":"Meli","sequence":"additional","affiliation":[{"name":"Mses Meli and Marsili are affiliated with the Nursing Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Wisen","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lenee","family":"Marsili","sequence":"additional","affiliation":[{"name":"Dr. Murthy is affiliated with the Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Marlow","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Connolly","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Machuzak","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas R.","family":"Gildea","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudish","family":"Murthy","sequence":"additional","affiliation":[{"name":"Dr. Murthy is affiliated with the Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usman","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Dr. Ahmad is affiliated with the Heart, Vascular and Thoracic Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atul C.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loutfi S.","family":"Aboussouan","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruchi","family":"Yadav","sequence":"additional","affiliation":[{"name":"Dr. Yadav is affiliated with the Imaging Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Attaway","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vickram","family":"Tejwani","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James K.","family":"Stoller","sequence":"additional","affiliation":[{"name":"Dr. Stoller is affiliated with the Education Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Wang","sequence":"additional","affiliation":[{"name":"Ms. Y. Wang and Dr. X. Wang are affiliated with the Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Ms. Y. Wang and Dr. X. Wang are affiliated with the Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umur","family":"Hatipo\u011flu","sequence":"additional","affiliation":[{"name":"Dr. Nathani, Ms. Wisen, Mr. Marlow, Ms. Connolly, Machuzak, Gildea, Gillespie, Mehta, Aboussouan, Attaway, Tejwani, and Hatipo\u011flu are affiliated with the Department of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.165.2.ats01"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2019.00246"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1017501"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202204-0671PP"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.2103\/7\/jtd.2018.07.36"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1179548419852063"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu129"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S434011"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.02.005"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-040942"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030287"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201803-0590OC"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000517034"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00219111"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1081\/copd-200053377"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201209-1596OC"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2015.1007930"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00217-6"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjp.2008.362"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S175706"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.07.016"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-019-00303-7"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2023.05.001"},{"key":"e_1_3_4_26_2","unstructured":"2024 GOLD Report. 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