{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:39:21Z","timestamp":1793191161477,"version":"4.5.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008184","name":"COPD Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008184","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL151751"],"award-info":[{"award-number":["K23HL151751"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K24HL138188"],"award-info":[{"award-number":["K24HL138188"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL122438"],"award-info":[{"award-number":["R01HL122438"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01HL089856"],"award-info":[{"award-number":["U01HL089856"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01HL089897"],"award-info":[{"award-number":["U01HL089897"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008184","name":"COPD Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008184","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008184","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL151751"],"award-info":[{"award-number":["K23HL151751"]}],"id":[{"id":"10.13039\/100008184","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008184","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K24HL138188"],"award-info":[{"award-number":["K24HL138188"]}],"id":[{"id":"10.13039\/100008184","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008184","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL122438"],"award-info":[{"award-number":["R01HL122438"]}],"id":[{"id":"10.13039\/100008184","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008184","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01HL089856"],"award-info":[{"award-number":["U01HL089856"]}],"id":[{"id":"10.13039\/100008184","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008184","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01HL089897"],"award-info":[{"award-number":["U01HL089897"]}],"id":[{"id":"10.13039\/100008184","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Cigarette smoking contributes to the risk of death through different mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine how causes of and clinical features associated with death vary in tobacco cigarette users by lung function impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We stratified current and former tobacco cigarette users enrolled in Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) into normal spirometry, PRISm (Preserved Ratio Impaired Spirometry), Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1\u20132 COPD, and GOLD 3\u20134 COPD. Deaths were identified via longitudinal follow-up and Social Security Death Index search. Causes of death were adjudicated after a review of death certificates, medical records, and next-of-kin interviews. We tested associations between baseline clinical variables and all-cause mortality using multivariable Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Over a 10.1-year median follow-up, 2,200 deaths occurred among 10,132 participants (age 59.5\u2009\u00b1\u20099.0\u2009yr; 46.6% women). Death from cardiovascular disease was most frequent in PRISm (31% of deaths). Lung cancer deaths were most frequent in GOLD 1\u20132 (18% of deaths vs. 9\u201311% in other groups). Respiratory deaths outpaced competing causes of death in GOLD 3\u20134, particularly when BODE index \u22657. St. George\u2019s Respiratory Questionnaire score \u226525 was associated with higher mortality in all groups: Hazard ratio (HR), 1.48 (1.20\u20131.84) normal spirometry; HR, 1.40 (1.05\u20131.87) PRISm; HR, 1.80 (1.49\u20132.17) GOLD 1\u20132; HR, 1.65 (1.26\u20132.17) GOLD 3\u20134. History of respiratory exacerbations was associated with higher mortality in GOLD 1\u20132 and GOLD 3\u20134, quantitative emphysema in GOLD 1\u20132, and airway wall thickness in PRISm and GOLD 3\u20134.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Leading causes of death vary by lung function impairment in tobacco cigarette users. Worse respiratory-related quality of life is associated with all-cause mortality regardless of lung function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202210-1887oc","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T16:17:15Z","timestamp":1683649035000},"page":"451-460","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":46,"title":["Causes of and Clinical Features Associated with Death in Tobacco Cigarette Users by Lung Function Impairment"],"prefix":"10.1093","volume":"208","author":[{"given":"Wassim W.","family":"Labaki","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, T.H. Chan School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine"},{"name":"Medical Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9612-5454","authenticated-orcid":false,"given":"J. Michael","family":"Wells","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surya P.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4336-3835","authenticated-orcid":false,"given":"Jessica","family":"Bon","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"Medical Service, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5037-2919","authenticated-orcid":false,"given":"Alejandro A.","family":"Diaz","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1342-4334","authenticated-orcid":false,"given":"Craig P.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, and"},{"name":"Channing Division of Network Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Wan","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts"},{"name":"Veterans Affairs Boston Healthcare System, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri H.","family":"Beaty","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Hokanson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4651-363X","authenticated-orcid":false,"given":"Russell P.","family":"Bowler","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas A.","family":"Arenberg","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella A.","family":"Kazerooni","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine"},{"name":"Department of Radiology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando J.","family":"Martinez","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin K.","family":"Silverman","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, and"},{"name":"Channing Division of Network Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Crapo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry J.","family":"Make","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Regan","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, National Jewish Health, Denver, Colorado; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MeiLan K.","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,15]]},"reference":[{"key":"2026012204424167600_bib1","volume-title":"The health consequences of smoking\u201350 years of progress: a report of the surgeon general","year":"2014"},{"key":"2026012204424167600_bib2","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1056\/NEJMsa1407211","article-title":"Smoking and mortality\u2014beyond established causes","volume":"372","author":"Carter","year":"2015","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib3","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1056\/NEJM199906243402503","article-title":"Long-term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking","volume":"340","author":"Pauwels","year":"1999","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib4","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1056\/NEJMoa063070","article-title":"Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease","volume":"356","author":"Calverley","year":"2007","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib5","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1056\/NEJMoa0805800","article-title":"A 4-year trial of tiotropium in chronic obstructive pulmonary disease","volume":"359","author":"Tashkin","year":"2008","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib6","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1136\/thx.2006.072348","article-title":"Ascertainment of cause-specific mortality in COPD: operations of the TORCH clinical endpoint committee","volume":"62","author":"McGarvey","year":"2007","journal-title":"Thorax"},{"key":"2026012204424167600_bib7","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1164\/rccm.200906-0876OC","article-title":"Mortality in the 4-year trial of tiotropium (UPLIFT) in patients with chronic obstructive pulmonary disease","volume":"180","author":"Celli","year":"2009","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012204424167600_bib8","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/1465-9921-11-122","article-title":"Characterisation of COPD heterogeneity in the ECLIPSE cohort","volume":"11","author":"Agusti","year":"2010","journal-title":"Respir Res"},{"key":"2026012204424167600_bib9","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1056\/NEJMoa1505971","article-title":"Clinical significance of symptoms in smokers with preserved pulmonary function","volume":"374","author":"Woodruff","year":"2016","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib10","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1001\/jamainternmed.2015.2735","article-title":"Clinical and radiologic disease in smokers with normal spirometry","volume":"175","author":"Regan","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2026012204424167600_bib11","first-page":"384","article-title":"COPDGene 2019: redefining the diagnosis of chronic obstructive pulmonary disease","volume":"6","author":"Lowe","year":"2019","journal-title":"Chronic Obstr Pulm Dis (Miami)"},{"key":"2026012204424167600_bib12","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1164\/rccm.201703-0451PP","article-title":"The role of chest computed tomography in the evaluation and management of the patient with chronic obstructive pulmonary disease","volume":"196","author":"Labaki","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012204424167600_bib13","first-page":"A3995","article-title":"Causes and predictors of death in smokers with and without COPD: an analysis of the COPDGene cohort","volume":"199","author":"Labaki","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012204424167600_bib14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3109\/15412550903499522","article-title":"Genetic epidemiology of COPD (COPDGene) study design","volume":"7","author":"Regan","year":"2010","journal-title":"COPD"},{"key":"2026012204424167600_bib15","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1164\/ajrccm\/145.6.1321","article-title":"A self-complete measure of health status for chronic airflow limitation. The St. George\u2019s Respiratory Questionnaire","volume":"145","author":"Jones","year":"1992","journal-title":"Am Rev Respir Dis"},{"key":"2026012204424167600_bib16","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1056\/NEJMoa021322","article-title":"The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease","volume":"350","author":"Celli","year":"2004","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib17","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1164\/rccm.200407-874OC","article-title":"The prediction of small airway dimensions using computed tomography","volume":"171","author":"Nakano","year":"2005","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012204424167600_bib18","doi-asserted-by":"crossref","first-page":"466","DOI":"10.3109\/15412555.2012.690010","article-title":"Automated telecommunication to obtain longitudinal follow-up in a multicenter cross-sectional COPD study","volume":"9","author":"Stewart","year":"2012","journal-title":"COPD"},{"key":"2026012204424167600_bib19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s12931-014-0089-y","article-title":"Epidemiology, genetics, and subtyping of preserved ratio impaired spirometry (PRISm) in COPDGene","volume":"15","author":"Wan","year":"2014","journal-title":"Respir Res"},{"key":"2026012204424167600_bib20","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1164\/rccm.201701-0218PP","article-title":"Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary","volume":"195","author":"Vogelmeier","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012204424167600_bib21","doi-asserted-by":"crossref","first-page":"1901217","DOI":"10.1183\/13993003.01217-2019","article-title":"Trajectory and mortality of preserved ratio impaired spirometry: the Rotterdam study","volume":"55","author":"Wijnant","year":"2020","journal-title":"Eur Respir J"},{"key":"2026012204424167600_bib22","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1001\/jama.2021.20939","article-title":"Association between preserved ratio impaired spirometry and clinical outcomes in US adults","volume":"326","author":"Wan","year":"2021","journal-title":"JAMA"},{"key":"2026012204424167600_bib23","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S2213-2600(21)00369-6","article-title":"Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK Biobank cohort analysis","volume":"10","author":"Higbee","year":"2022","journal-title":"Lancet Respir Med"},{"key":"2026012204424167600_bib24","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1056\/NEJMoa1102873","article-title":"Reduced lung-cancer mortality with low-dose computed tomographic screening","volume":"365","author":"Aberle","year":"2011","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib25","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa1911793","article-title":"Reduced lung-cancer mortality with volume CT screening in a randomized trial","volume":"382","author":"de Koning","year":"2020","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib26","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1001\/jamaoncol.2016.6416","article-title":"Lung cancer screening with low-dose computed tomography in the United States-2010 to 2015","volume":"3","author":"Jemal","year":"2017","journal-title":"JAMA Oncol"},{"key":"2026012204424167600_bib27","doi-asserted-by":"crossref","first-page":"347","DOI":"10.21037\/tlcr.2018.05.04","article-title":"Chronic obstructive pulmonary disease (COPD) and lung cancer screening","volume":"7","author":"Young","year":"2018","journal-title":"Transl Lung Cancer Res"},{"key":"2026012204424167600_bib28","doi-asserted-by":"crossref","first-page":"391","DOI":"10.7326\/0003-4819-93-3-391","article-title":"Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial","volume":"93","author":"Nocturnal Oxygen Therapy Trial Group","year":"1980","journal-title":"Ann Intern Med"},{"key":"2026012204424167600_bib29","first-page":"681","article-title":"Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Report of the Medical Research Council Working Party","volume":"1","year":"1981","journal-title":"Lancet"},{"key":"2026012204424167600_bib30","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1056\/NEJMoa030287","article-title":"A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema","volume":"348","author":"Fishman","year":"2003","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib31","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/S2213-2600(14)70153-5","article-title":"Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial","volume":"2","author":"K\u00f6hnlein","year":"2014","journal-title":"Lancet Respir Med"},{"key":"2026012204424167600_bib32","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1001\/jama.2017.4451","article-title":"Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation: a randomized clinical trial","volume":"317","author":"Murphy","year":"2017","journal-title":"JAMA"},{"key":"2026012204424167600_bib33","article-title":"Pharmacotherapy and mortality in COPD","author":"Halpin","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012204424167600_bib34","doi-asserted-by":"crossref","first-page":"2098","DOI":"10.1177\/15353702211019697","article-title":"Role of sex hormones in lung cancer","volume":"246","author":"Fuentes","year":"2021","journal-title":"Exp Biol Med (Maywood)"},{"key":"2026012204424167600_bib35","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1001\/jama.2021.1117","article-title":"Screening for lung cancer: US Preventive Services Task Force recommendation statement","volume":"325","author":"Krist","year":"2021","journal-title":"JAMA"},{"key":"2026012204424167600_bib36","doi-asserted-by":"crossref","first-page":"1900734","DOI":"10.1183\/13993003.00734-2019","article-title":"Prognostic significance of chronic respiratory symptoms in individuals with normal spirometry","volume":"54","author":"\u00c7olak","year":"2019","journal-title":"Eur Respir J"},{"key":"2026012204424167600_bib37","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1001\/jamainternmed.2020.0104","article-title":"Association of nonobstructive chronic bronchitis with respiratory health outcomes in adults","volume":"180","author":"Balte","year":"2020","journal-title":"JAMA Intern Med"},{"key":"2026012204424167600_bib38","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S2213-2600(12)70044-9","article-title":"GOLD 2011 disease severity classification in COPDGene: a prospective cohort study","volume":"1","author":"Han","year":"2013","journal-title":"Lancet Respir Med"},{"key":"2026012204424167600_bib39","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1056\/NEJMoa1701632","article-title":"Airway mucin concentration as a marker of chronic bronchitis","volume":"377","author":"Kesimer","year":"2017","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib40","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1056\/NEJMoa2204752","article-title":"Bronchodilators in tobacco-exposed persons with symptoms and preserved lung function","volume":"387","author":"Han","year":"2022","journal-title":"N Engl J Med"},{"key":"2026012204424167600_bib41","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1136\/thoraxjnl-2016-209544","article-title":"Biomechanical CT metrics are associated with patient outcomes in COPD","volume":"72","author":"Bodduluri","year":"2017","journal-title":"Thorax"},{"key":"2026012204424167600_bib42","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/S2213-2600(17)30207-2","article-title":"Frequency of exacerbations in patients with chronic obstructive pulmonary disease: an analysis of the SPIROMICS cohort","volume":"5","author":"Han","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2026012204424167600_bib43","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/aje\/kws412","article-title":"The table 2 fallacy: presenting and interpreting confounder and modifier coefficients","volume":"177","author":"Westreich","year":"2013","journal-title":"Am J Epidemiol"},{"key":"2026012204424167600_bib44","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1164\/rccm.201810-1909PP","article-title":"Chronic obstructive pulmonary disease in America\u2019s Black population","volume":"200","author":"Ejike","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2026012204424167600_bib45","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1164\/rccm.201801-0168WS","article-title":"Female sex and gender in lung\/sleep health and disease. Increased understanding of basic biological, pathophysiological, and behavioral mechanisms leading to better health for female patients with lung disease","volume":"198","author":"Han","year":"2018","journal-title":"Am J Respir Crit Care Med"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/208\/4\/451\/66436935\/ajrccm_208_4_451.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/208\/4\/451\/66436935\/ajrccm_208_4_451.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T09:42:56Z","timestamp":1769074976000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/208\/4\/451\/8427909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":45,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,8,15]]},"published-print":{"date-parts":[[2023,8,15]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.202210-1887oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"2022-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}