Consistent with strategies across many traditionally defined diseases and syndromes, research efforts in chronic obstructive pulmonary disease (COPD) have attempted to identify meaningful subclasses of disease that categorize and help identify patients who may be uniquely responsive to specific interventions. In the current context of increased interest in “precision medicine,” achieving this classification would require developing a better understanding of genetic variation and the resulting uniquely expressed cellular targets amenable to specific molecular therapeutic intervention. However, better classification of patients based on unique clinical, physiologic, and radiographic factors, rather than genetic variation, has been more effective in achieving increasingly precise clinical application of therapeutics in the context of surgical and bronchoscopic device lung volume reduction strategies.
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