array:24 [
  "pii" => "S1579212921002287"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2021.06.007"
  "estado" => "S300"
  "fechaPublicacion" => "2021-09-01"
  "aid" => "2726"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2021"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2021;57:596-9"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289621000235"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2020.12.037"
      "estado" => "S300"
      "fechaPublicacion" => "2021-09-01"
      "aid" => "2726"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2021;57:596-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
        "titulo" => "Consenso sobre el diagn&#243;stico&#44; tratamiento y seguimiento de la EPOC&#58; Grupo de trabajo EPOC Forum"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "596"
            "paginaFinal" => "599"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Forum COPD Working Group Consensus on the Diagnosis&#44; Treatment and Follow-Up of COPD"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jos&#233; Luis L&#243;pez-Campos, Myriam Calle Rubio, Jos&#233; Luis Izquierdo Alonso, Alberto Fern&#225;ndez-Villar, Beatriz Abascal-Bolado, Bernardino Alc&#225;zar, Francisco Garc&#237;a-R&#237;o, Germ&#225;n Peces-Barba, Joan Serra Batlles, Jos&#233; Javier Mart&#237;nez Garcer&#225;n, Juan Antonio Riesco Miranda, Juan Marco Figueira-Gon&#231;alves, Juan Jos&#233; Soler-Catalu&#241;a, Mikel Temprano, Francisco Ortega Ruiz, Salud Santos P&#233;rez, Carlos Jos&#233; &#193;lvarez Mart&#237;nez"
            "autores" => array:17 [
              0 => array:2 [
                "nombre" => "Jos&#233; Luis"
                "apellidos" => "L&#243;pez-Campos"
              ]
              1 => array:2 [
                "nombre" => "Myriam"
                "apellidos" => "Calle Rubio"
              ]
              2 => array:2 [
                "nombre" => "Jos&#233; Luis"
                "apellidos" => "Izquierdo Alonso"
              ]
              3 => array:2 [
                "nombre" => "Alberto"
                "apellidos" => "Fern&#225;ndez-Villar"
              ]
              4 => array:2 [
                "nombre" => "Beatriz"
                "apellidos" => "Abascal-Bolado"
              ]
              5 => array:2 [
                "nombre" => "Bernardino"
                "apellidos" => "Alc&#225;zar"
              ]
              6 => array:2 [
                "nombre" => "Francisco"
                "apellidos" => "Garc&#237;a-R&#237;o"
              ]
              7 => array:2 [
                "nombre" => "Germ&#225;n"
                "apellidos" => "Peces-Barba"
              ]
              8 => array:2 [
                "nombre" => "Joan"
                "apellidos" => "Serra Batlles"
              ]
              9 => array:2 [
                "nombre" => "Jos&#233; Javier"
                "apellidos" => "Mart&#237;nez Garcer&#225;n"
              ]
              10 => array:2 [
                "nombre" => "Juan Antonio"
                "apellidos" => "Riesco Miranda"
              ]
              11 => array:2 [
                "nombre" => "Juan Marco"
                "apellidos" => "Figueira-Gon&#231;alves"
              ]
              12 => array:2 [
                "nombre" => "Juan Jos&#233;"
                "apellidos" => "Soler-Catalu&#241;a"
              ]
              13 => array:2 [
                "nombre" => "Mikel"
                "apellidos" => "Temprano"
              ]
              14 => array:2 [
                "nombre" => "Francisco"
                "apellidos" => "Ortega Ruiz"
              ]
              15 => array:2 [
                "nombre" => "Salud"
                "apellidos" => "Santos P&#233;rez"
              ]
              16 => array:2 [
                "nombre" => "Carlos Jos&#233;"
                "apellidos" => "&#193;lvarez Mart&#237;nez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212921002287"
          "doi" => "10.1016/j.arbr.2021.06.007"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002287?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621000235?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005700000009/v1_202109020750/S0300289621000235/v1_202109020750/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212921002317"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2021.06.010"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "2734"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2021;57:599-600"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Pneumatocele following lung cryobiopsy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "599"
          "paginaFinal" => "600"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Neumatocele posterior a criobiopsia pulmonar"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2081
              "Ancho" => 2500
              "Tamanyo" => 461464
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">High-resolution chest tomography&#46; &#40;A&#41; before TBCB&#58; bilateral consolidations with peripheral and peribronchovascular air bronchogram&#46; &#40;B&#41; 1 month after TBCB&#58; lesion with air-fluid level in right upper lobe&#46; &#40;C&#41; and &#40;D&#41; 3 months after TBCB&#58; decrease in the size of the lesion with disappearance or reabsorption of the air content and persistence of the bloody content &#40;hematocele&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Horacio Mat&#237;as Castro, Esteban Javier Wainstein, Rodrigo Castro Azcurra, Alberto Seehaus"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Horacio Mat&#237;as"
              "apellidos" => "Castro"
            ]
            1 => array:2 [
              "nombre" => "Esteban Javier"
              "apellidos" => "Wainstein"
            ]
            2 => array:2 [
              "nombre" => "Rodrigo"
              "apellidos" => "Castro Azcurra"
            ]
            3 => array:2 [
              "nombre" => "Alberto"
              "apellidos" => "Seehaus"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289621000326"
        "doi" => "10.1016/j.arbres.2021.01.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621000326?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002317?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005700000009/v1_202109020614/S1579212921002317/v1_202109020614/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212921002263"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2021.06.005"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "2690"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2021;57:594-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Lung infection caused by <span class="elsevierStyleItalic">Lophomonas blattarum</span>"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "594"
          "paginaFinal" => "596"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Infecci&#243;n pulmonar por <span class="elsevierStyleItalic">Lophomonas blattarum</span>"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1572
              "Ancho" => 1207
              "Tamanyo" => 198430
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A microscopic view of <span class="elsevierStyleItalic">Lophomonas blattarum</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nathalie Pinos V&#233;lez, Ricardo Ordo&#241;ez Vintimilla, Solmayra Agreda Orellana"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Nathalie"
              "apellidos" => "Pinos V&#233;lez"
            ]
            1 => array:2 [
              "nombre" => "Ricardo"
              "apellidos" => "Ordo&#241;ez Vintimilla"
            ]
            2 => array:2 [
              "nombre" => "Solmayra"
              "apellidos" => "Agreda Orellana"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289620305445"
        "doi" => "10.1016/j.arbres.2020.12.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620305445?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002263?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005700000009/v1_202109020614/S1579212921002263/v1_202109020614/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Forum COPD working group consensus on the diagnosis&#44; treatment and follow-up of COPD"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "596"
        "paginaFinal" => "599"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Jos&#233; Luis L&#243;pez-Campos, Myriam Calle Rubio, Jos&#233; Luis Izquierdo Alonso, Alberto Fern&#225;ndez-Villar, Beatriz Abascal-Bolado, Bernardino Alc&#225;zar, Francisco Garc&#237;a-R&#237;o, Germ&#225;n Peces-Barba, Joan Serra Batlles, Jos&#233; Javier Mart&#237;nez Garcer&#225;n, Juan Antonio Riesco Miranda, Juan Marco Figueira-Gon&#231;alves, Juan Jos&#233; Soler-Catalu&#241;a, Mikel Temprano, Francisco Ortega Ruiz, Salud Santos P&#233;rez, Carlos Jos&#233; &#193;lvarez Mart&#237;nez"
        "autores" => array:17 [
          0 => array:4 [
            "nombre" => "Jos&#233; Luis"
            "apellidos" => "L&#243;pez-Campos"
            "email" => array:1 [
              0 => "lcampos@separ.es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Myriam"
            "apellidos" => "Calle Rubio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Jos&#233; Luis"
            "apellidos" => "Izquierdo Alonso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Alberto"
            "apellidos" => "Fern&#225;ndez-Villar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Beatriz"
            "apellidos" => "Abascal-Bolado"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Bernardino"
            "apellidos" => "Alc&#225;zar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Francisco"
            "apellidos" => "Garc&#237;a-R&#237;o"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff0035"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Germ&#225;n"
            "apellidos" => "Peces-Barba"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Joan"
            "apellidos" => "Serra Batlles"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">i</span>"
                "identificador" => "aff0045"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Jos&#233; Javier"
            "apellidos" => "Mart&#237;nez Garcer&#225;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff0050"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "Juan Antonio"
            "apellidos" => "Riesco Miranda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">k</span>"
                "identificador" => "aff0055"
              ]
            ]
          ]
          11 => array:3 [
            "nombre" => "Juan Marco"
            "apellidos" => "Figueira-Gon&#231;alves"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">l</span>"
                "identificador" => "aff0060"
              ]
            ]
          ]
          12 => array:3 [
            "nombre" => "Juan Jos&#233;"
            "apellidos" => "Soler-Catalu&#241;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">m</span>"
                "identificador" => "aff0065"
              ]
            ]
          ]
          13 => array:3 [
            "nombre" => "Mikel"
            "apellidos" => "Temprano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">n</span>"
                "identificador" => "aff0070"
              ]
            ]
          ]
          14 => array:3 [
            "nombre" => "Francisco"
            "apellidos" => "Ortega Ruiz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">o</span>"
                "identificador" => "aff0075"
              ]
            ]
          ]
          15 => array:3 [
            "nombre" => "Salud"
            "apellidos" => "Santos P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">p</span>"
                "identificador" => "aff0080"
              ]
            ]
          ]
          16 => array:3 [
            "nombre" => "Carlos Jos&#233;"
            "apellidos" => "&#193;lvarez Mart&#237;nez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">q</span>"
                "identificador" => "aff0085"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:17 [
          0 => array:3 [
            "entidad" => "Unidad M&#233;dico-Quir&#250;rgica de Enfermedades Respiratorias&#44; Instituto de Biomedicina de Sevilla &#40;IBiS&#41;&#44; Hospital Universitario Virgen del Roc&#237;o&#47;Universidad de Sevilla&#44; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Medicina&#44; Universidad Complutense de Madrid&#44; Hospital Cl&#237;nico de San Carlos&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Medicina y Especialidades&#44; Universidad de Alcal&#225;&#44; Hospital Universitario de Guadalajara&#44; Guadalajara&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Hospital &#193;lvaro Cunqueiro&#44; Instituto de Investigaci&#243;n Sanitaria Galicia Sur &#40;IISGS&#41;&#44; Vigo&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; AIG de Medicina&#44; Hospital de Alta Resoluci&#243;n de Loja&#44; Granada&#44; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Hospital Universitario Fundaci&#243;n Jim&#233;nez D&#237;az&#44; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
          8 => array:3 [
            "entidad" => "Hospital Universitari de Vic&#44; Barcelona&#44; Spain"
            "etiqueta" => "i"
            "identificador" => "aff0045"
          ]
          9 => array:3 [
            "entidad" => "Hospital General Universitario Santa Luc&#237;a&#44; Cartagena&#44; Spain"
            "etiqueta" => "j"
            "identificador" => "aff0050"
          ]
          10 => array:3 [
            "entidad" => "Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#44; Spain"
            "etiqueta" => "k"
            "identificador" => "aff0055"
          ]
          11 => array:3 [
            "entidad" => "Hospital Universitario Nuestra Se&#241;ora de Candelaria&#44; Tenerife&#44; Spain"
            "etiqueta" => "l"
            "identificador" => "aff0060"
          ]
          12 => array:3 [
            "entidad" => "Hospital Universitario Arnau de Vilanova&#44; Valencia&#44; Spain"
            "etiqueta" => "m"
            "identificador" => "aff0065"
          ]
          13 => array:3 [
            "entidad" => "Hospital San Eloy&#44; Bizkaia&#44; Spain"
            "etiqueta" => "n"
            "identificador" => "aff0070"
          ]
          14 => array:3 [
            "entidad" => "Unidad M&#233;dico-Quir&#250;rgica de Enfermedades Respiratorias&#44; Instituto de Biomedicina de Sevilla &#40;IBiS&#41;&#44; Hospital Universitario Virgen del Roc&#237;o&#47;Universidad de Sevilla&#59; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "o"
            "identificador" => "aff0075"
          ]
          15 => array:3 [
            "entidad" => "Hospital Universitario de Bellvitge-IDIBELL&#44; Hospitalet de Llobregat&#44; Barcelona&#44; Spain"
            "etiqueta" => "p"
            "identificador" => "aff0080"
          ]
          16 => array:3 [
            "entidad" => "Complejo Hospitalario Ruber Juan Bravo&#44; Madrid&#44; Spain"
            "etiqueta" => "q"
            "identificador" => "aff0085"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Consenso sobre el diagn&#243;stico&#44; tratamiento y seguimiento de la EPOC&#58; Grupo de trabajo EPOC Forum"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Despite the numerous strategic plans for the prevention and management of chronic obstructive pulmonary disease &#40;COPD&#41; that have been implemented to date&#44; high prevalence&#44; underdiagnosis&#44; and burden of care all remain a challenge in clinical practice<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a>&#46; Some of the main difficulties in COPD management include the prioritization and degree of control of treatable traits&#44; and problems with inhaled therapy&#44; such as device selection and patient adherence to prescribed maintenance treatment<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5&#8211;8</span></a>&#46; Moreover&#44; new care strategies and&#44; above all&#44; new therapeutic strategies are scene-changers in the clinical management of COPD&#46; The aim of this study was to reach a consensus among COPD experts on controversial issues in the evaluation and treatment of the disease&#44; using Delphi methodology<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A scientific committee of 17 COPD experts participated in the project&#46; The project coordinators selected a committee of SEPAR members whose profile demonstrated a consolidated background in COPD supported by publications&#44; while ensuring that the whole of Spain was represented by regions&#46; The committee analyzed the scientific evidence in four areas&#58; therapeutic adherence&#44; COPD control&#44; COPD treatable traits&#44; and inhalation devices&#46; This evidence was then examined in 15 discussion sessions&#44; to which 5 attending pulmonologists from each area were invited&#44; selected by the expert committee&#46; Using the information obtained at these meetings&#44; a questionnaire of 43 statements &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; was developed and sent to a panel of 95 experienced COPD pulmonologists who were asked to grade them on a Likert scale of 1&#8211;9&#46; Statements that were scored 1&#8211;3 &#40;disagreement&#44; median &#8804;3&#41; or 7&#8211;9 &#40;agreement&#44; median &#8805;7&#41; by more than two-thirds of the panelists&#44; were considered to have achieved consensus&#46; When more than two-thirds scored a statement in the range of 4&#8211;6&#44; it was considered inconclusive&#46; After two consecutive rounds&#44; consensus was reached on 37 statements&#58; 36 in agreement &#40;83&#46;7&#37;&#41; and one in disagreement &#40;2&#46;3&#37;&#41;&#46; Only six statements &#40;14&#37;&#41; failed to achieve consensus&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the scores and the degree of agreement for each statement&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Seven of the nine statements on therapeutic adherence reached a consensus of agreement&#46; The panelists believed that trust between the physician and the patient was important but noted that the information provided by the latter is not always reliable&#46; Although there was no consensus on whether adherence to 12- and 24-h regimens differed significantly&#44; panelists agreed &#40;68&#46;82&#37;&#41; that the 12-h regimen is preferable in patients with more symptomatic COPD&#46; It was agreed that in order to increase adherence&#44; the number of inhalers should be reduced and the patient&#8217;s preferences must be taken into account&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Consensus agreement was achieved in 12 of the 14 statements on COPD control&#46; A high percentage &#40;&#62;72&#37;&#41; agreed that control targets should be established on the basis of severity&#44; symptoms&#44; exacerbations&#44; lung function&#44; and smoking habit&#46; Only 36&#46;57&#37; considered that disease impact and stability were sufficient to assess COPD control&#46; However&#44; there was broad agreement &#40;93&#46;76&#37;&#41; that a patient with controlled COPD shows few symptoms and no exacerbations and remains stable over time&#46; This suggests that&#44; in the participants&#8217; view&#44; a patient with a persistent absence of symptoms or exacerbations over time would probably be well controlled&#44; but it is unclear whether&#44; as a general rule&#44; control can be established solely on the basis of these 2 variables&#46; This becomes clear in statement 18&#44; in which panelists value the importance of lung function in disease control&#46; According to the agreement reached &#40;69&#46;8&#37;&#41;&#44; a low-risk patient must be clinically stable for 1&#8239;year to be considered controlled&#46; However&#44; in high-risk patients&#44; agreement was not reached &#40;27&#46;96&#37;&#41; on the statement that stability should be maintained for 3 months for a patient to be considered controlled&#46; Most panelists &#40;&#62;92&#37;&#41; indicated their agreement with the following criteria for adjusting treatment&#58; adherence&#44; physical activity&#44; comorbidities&#44; and patient preferences&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">All statements on COPD treatable traits achieved consensus agreement&#46; Those with the greatest degree of agreement &#40;&#62;91&#37;&#41; were those that stated that these traits should be prioritized because of their impact on prognosis&#44; symptoms and exacerbations&#46; It was also agreed &#40;&#62;75&#37;&#41; that the definition of treatable traits should include individual&#44; quantifiable&#44; and prognostic traits&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally&#44; of the 14 statements on inhalation devices&#44; 11 achieved consensus agreement and 1 consensus disagreement&#46; Nearly 74&#37; of panelists agreed that if the inhaler is being used properly in stable COPD&#44; treatment outcomes depend on the lung deposition achieved by the device&#46; However&#44; there was consensus disagreement that if the inhalation device is used properly&#44; there are no differences in clinical outcomes&#44; regardless of the type of device used&#46; Nonetheless&#44; panelists agreed that outcomes depend on the type of inhaler&#44; lung deposition&#44; and the characteristics of the drug&#46; The criterion that achieved the highest degree of consensus regarding inhaler choice was inspiratory flow &#40;92&#46;70&#37;&#41;&#46; There was no consensus with the statement that there are no differences in the outcomes obtained with nebulizers or inhalers with spacers in the management of exacerbations&#44; regardless of their severity&#46; It was argued that there was insufficient evidence to claim that both devices are the same in this clinical context&#46; In fact&#44; 67&#46;74&#37; agreed that nebulizers are preferable in severe exacerbations&#46; In the absence of therapeutic response&#44; and before escalating treatment&#44; the main consensus &#40;98&#46;96&#37;&#41; was to check the correct use of the device&#46; No consensus was reached for the statement that the physician should be responsible for educating patients in inhaler use&#46; Panelists considered that the nursing staff would be more appropriate for this task&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">This Delphi study highlights the concerns of panelists surrounding the challenges faced by clinicians in the care of the COPD patient&#46; Although controversial issues still persist&#44; the high degree of agreement reached by the panelists identifies some key messages that should be taken into account in recommendations on the management of these patients&#46; These include the importance of therapeutic adherence&#44; the need to define COPD control&#44; a more personalized approach based on treatable traits&#44; verification of proper use of inhalers before escalating treatment&#44; and consideration of inspiratory flow as a significant criterion in the choice of inhalation device&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">This study was funded by <span class="elsevierStyleGrantSponsor" id="gs0005">Chiesi</span> Espa&#241;a&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">Jos&#233; Luis L&#243;pez-Campos has received honoraria in the past 3 years for lectures&#44; scientific consultancy&#44; clinical trial participation&#44; and preparation of publications from &#40;in alphabetical order&#41;&#58; AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; CSL Behring&#44; Esteve&#44; Ferrer&#44; Gebro&#44; GlaxoSmithKline&#44; Grifols&#44; Megalabs&#44; Menarini&#44; Novartis&#44; and Rovi&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Myriam Calle Rubio has received honoraria for lectures from AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; GlaxoSmithKline&#44; and&#46;Grifols&#46; Jos&#233; Luis Izquierdo has received honoraria for consultancy&#44; projects&#44; and lectures from AstraZeneca&#44; Bayer&#44; Boehringer Ingelheim&#44; Chiesi&#44; GlaxoSmithKline&#44; Grifols&#44; Menarini&#44; Novartis&#44; Orion&#44; Pfizer&#44; Sandoz&#44; and Teva&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Alberto Fern&#225;ndez-Villar has received in the last three years grants for research or training activities and payment for lectures or consultancy from AstraZeneca&#44; Bial&#44; Boehringer Ingelheim&#44; Chiesi&#44; Esteve&#44; Grifols&#44; GlaxoSmithKline&#44; Menarini&#44; Novartis&#44; Roche&#44; and Rovi&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Beatriz Abascal has given lectures and scientific consultancy sponsored by Teva&#44; GlaxoSmithKline&#44; Ferrer&#44; AstraZeneca&#44; and FAES Farma&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Bernardino Alc&#225;zar has received honoraria and&#47;or payments in the last five years from AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; FAES&#44; GlaxoSmithKline&#44; Menarini&#44; and Novartis&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Francisco Garc&#237;a-R&#237;o has been a speaker at activities organized by Boehringer Ingelheim&#44; Pfizer&#44; Chiesi&#44; GlaxoSmithKline&#44; Menarini&#44; Novartis and Rovi&#59; he has received grants for research projects from Chiesi&#44; GlaxoSmithKline&#44; AstraZeneca&#44; Menarini&#44; and Esteve&#59; and he has provided scientific consultancy to Boehringer Ingelheim&#44; Pfizer&#44; GlaxoSmithKline&#44; and Novartis&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Germ&#225;n Peces-Barba has received institutional research grants from GlaxoSmithKline&#44; Boehringer Ingelheim&#44; Chiesi&#44; and Menarini&#44; and has provided scientific consultancy to GlaxoSmithKline and Orion Pharma&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Joan Serra Batlles has no conflict of interest&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Jos&#233; Javier Mart&#237;nez Garcer&#225;n has given talks sponsored by Chiesi&#44; GlaxoSmithKline&#44; Novartis&#44; Pfizer&#44; Almirall&#44; AstraZeneca&#44; Menarini&#44; and Boehringer Ingelheim&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Juan Antonio Riesco Miranda has no conflict of interest&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Juan Marco Figueira-Gon&#231;alves has received speaker fees and funding for conference attendance from Esteve Laboratories&#44; MundiPharma&#44; AstraZeneca&#44; Boehringer Ingelheim&#44; Ferrer&#44; Pfizer&#44; FAES&#44; Menarini&#44; Rovi&#44; GlaxoSmithKline&#44; Chiesi&#44; Novartis&#44; and Gebro Pharma&#44; and he has received research project grants from Boehringer Ingelheim&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Juan Jos&#233; Soler-Catalu&#241;a has received speaker fees from AstraZeneca&#44; Boehringer Ingelheim&#44; Bial&#44; Chiesi&#44; Ferrer&#44; Laboratorio Esteve&#44; Menarini&#44; Mundipharma&#44; Novartis&#44; Rovi and Teva&#59; consultancy fees from Air Liquide&#44; AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; Ferrer&#44; GlaxoSmithKline&#44; Laboratorios Esteve&#44; Mundipharma&#44; and Novartis&#44; and research grants from GlaxoSmithKline and Boehringer Ingelheim&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Mikel Temprano has received honoraria for scientific sessions from Boehringer Ingelheim&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Francisco Ortega Ruiz has no conflict of interest&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Salud Santos P&#233;rez has received honoraria for lectures from Almirall&#44; Boehringer Ingelheim&#44; AstraZeneca&#44; Chiesi&#44; Pfizer&#44; GlaxoSmithKline&#44; Menarini&#44; and Novartis&#59; and for consultancy from Almirall&#44; Gebro Pharma&#44; AstraZeneca&#44; Novartis&#44; FAES&#44; Grifols&#44; and Menarini&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Carlos Jos&#233; &#193;lvarez Mart&#237;nez has no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Funding"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Conflict of interest"
        ]
        2 => array:2 [
          "identificador" => "xack552799"
          "titulo" => "Acknowledgements"
        ]
        3 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; L&#243;pez-Campos JL&#44; Calle Rubio M&#44; Izquierdo Alonso JL&#44; Fern&#225;ndez-Villar A&#44; Abascal-Bolado B&#44; Alc&#225;zar B&#44; et al&#46; Consenso sobre el diagn&#243;stico&#44; tratamiento y seguimiento de la EPOC&#58; Grupo de trabajo EPOC Forum&#46; Arch Bronconeumol&#46; 2021&#59;57&#58;596&#8211;599&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">DPI&#58; dry powder inhalers&#59; COPD&#58; chronic obstructive pulmonary disease&#59; IQI&#58; interquartile interval&#59; MDI&#58; metered dose inhalers&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">White&#58; agreement consensus&#59; dark gray&#58; disagreement consensus&#59; light gray&#58; no consensus&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Median &#40;IQI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37; agreement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Therapeutic adherence</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46; Questionnaires are of limited use in clinical practice because of the time required for their completion&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46; A climate of trust between the physician and patient does not guarantee that the patient will reliably report therapeutic adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46; Calculating adherence on the basis of prescriptions filled in pharmacies is useful&#44; but does not confirm that the medication was taken&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46; To improve adherence&#44; pharmacies should participate in programs for training COPD patients on the use of devices&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46; Devices that are easy to use improve adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46; According to the existing evidence&#44; there are no significant differences in adherence if the drug is administered every 12 or 24&#8239;h&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46; In patients with more symptomatic COPD&#44; dosing every 12&#8239;h is preferable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46; Reducing the number of inhalers in the same patient is important to improve adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46; Taking account of patient preferences improves therapeutic adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">COPD control</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46; Disease impact and stability are sufficient to assess COPD control&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46; COPD control targets should be established according to severity&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46; In low-risk patients&#44; COPD control targets should be established according to symptoms&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46; In high-risk patients&#44; COPD control targets should be established according to symptoms and exacerbations&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46; COPD control targets should be defined on the basis of the patient&#8217;s situation at the time of implementing a new therapeutic plan&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46; A patient with controlled COPD is one with mild symptoms and no exacerbations&#44; maintained over time&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46; A patient with low-risk COPD is considered controlled when they have been stable for 1&#8239;year&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46; A patient with high-risk COPD is considered controlled when they have been stable for 3 months&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46; Decrease in lung function should be a criterion for poor COPD control&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46; Active smoking should be a factor associated with poor COPD control&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46; Criteria for treatment adjustment should include therapeutic adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46; Criteria for treatment adjustment should include the patient&#8217;s physical activity&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46; Criteria for treatment adjustment should include comorbidities&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46; Criteria for treatment adjustment should include the patient&#8217;s preferences&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">COPD treatable traits</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46; The definition of COPD treatable traits should state that they are individual characteristics of each patient&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46; The definition of COPD treatable traits should state that they are quantifiable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46; The definition of COPD treatable traits should state that they are prognostic&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46; COPD treatable traits should be prioritized because of their impact on the prognosis of the disease&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46; COPD treatable traits should be prioritized because of their impact on symptoms&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46; COPD treatable traits should be prioritized because of their impact on exacerbations&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Inhalation devices</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46; In stable COPD&#44; when the inhaler is used correctly&#44; treatment outcomes depend on the lung deposition achieved by the device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46; In stable COPD&#44; when the inhaler is used correctly&#44; there are no differences in treatment outcomes&#44; regardless of the type of device used&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46; The main critical errors in the use of MDI inhalation devices are associated with coordination between activation and inhalation&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46; The main critical errors in the use of DPI inhalation devices are associated with an insufficient inspiratory flow&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46; The use of nebulizers is preferred during severe COPD exacerbations&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46; In COPD exacerbations&#44; regardless of severity&#44; there are no differences in the results obtained with nebulizers and inhalers with spacers&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46; The use of DPI devices should be avoided in exacerbations due to insufficient inspiratory flow in many patients&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46; In COPD patients who do not respond to treatment&#44; a drug switch should be considered before escalating treatment&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46; In COPD patients who do not respond to treatment&#44; the correct use of the device must always be verified before escalating treatment&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46; Patient age is an important criterion in the choice of inhalation device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46; Inspiratory flow is an important criterion in the choice of inhalation device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46; Patient preference must always be taken into account when choosing the inhalation device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46; The physician should be responsible for educating patients on the use of inhalation devices&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46; Nursing staff should be responsible for educating patients on the use of inhalation devices&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2684898.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Results obtained by the panel of experts after 2 rounds of consultations&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:9 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atenci&#243;n a la EPOC en el abordaje al paciente cr&#243;nico en atenci&#243;n primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Llauger Rosell&#243;"
                            1 => "M&#46;A&#46; Pou"
                            2 => "L&#46; Dom&#237;nguez"
                            3 => "M&#46; Freixas"
                            4 => "P&#46; Valverde"
                            5 => "C&#46; Valero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2011.10.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol&#46;"
                        "fecha" => "2011"
                        "volumen" => "47"
                        "paginaInicial" => "561"
                        "paginaFinal" => "570"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22036593"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global strategy for the diagnosis&#44; management&#44; and prevention of chronic obstructive lung disease 2017 report&#58; GOLD executive summary"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;F&#46; Vogelmeier"
                            1 => "G&#46;J&#46; Criner"
                            2 => "F&#46;J&#46; Martinez"
                            3 => "A&#46; Anzueto"
                            4 => "P&#46;J&#46; Barnes"
                            5 => "J&#46; Bourbeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2017.02.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol&#46;"
                        "fecha" => "2017"
                        "volumen" => "53"
                        "paginaInicial" => "128"
                        "paginaFinal" => "149"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28274597"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic obstructive pulmonary disease &#40;COPD&#41; in Spain and the different aspects of its social impact&#58; a multidisciplinary opinion document"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Bouza"
                            1 => "A&#46; Alvar"
                            2 => "P&#46; Almagro"
                            3 => "T&#46; Alonso"
                            4 => "J&#46; Ancochea"
                            5 => "F&#46; Barb&#233;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Quimioter&#46;"
                        "fecha" => "2020"
                        "volumen" => "33"
                        "paginaInicial" => "49"
                        "paginaFinal" => "67"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and determinants of COPD in Spain&#58; EPISCAN II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;B&#46; Soriano"
                            1 => "I&#46; Alfageme"
                            2 => "M&#46; Miravitlles"
                            3 => "P&#46; de Lucas"
                            4 => "J&#46;J&#46; Soler-Catalu&#241;a"
                            5 => "F&#46; Garc&#237;a-R&#237;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2020.07.024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol&#46;"
                        "fecha" => "2020"
                        "volumen" => "57"
                        "paginaInicial" => "61"
                        "paginaFinal" => "69"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32950310"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of COPD&#58; relationships between daily dosing frequency&#44; adherence&#44; resource use&#44; and costs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;L&#46; Toy"
                            1 => "N&#46;U&#46; Beaulieu"
                            2 => "J&#46;M&#46; McHale"
                            3 => "T&#46;R&#46; Welland"
                            4 => "C&#46;A&#46; Plauschinat"
                            5 => "A&#46; Swensen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Respir Med&#46;"
                        "fecha" => "2011"
                        "volumen" => "105"
                        "paginaInicial" => "435"
                        "paginaFinal" => "441"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medication adherence and persistence in chronic obstructive pulmonary disease patients receiving triple therapy in a USA commercially insured population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Bogart"
                            1 => "R&#46;H&#46; Stanford"
                            2 => "F&#46; Laliberte"
                            3 => "G&#46; Germain"
                            4 => "J&#46;W&#46; Wu"
                            5 => "M&#46;S&#46; Duh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/COPD.S184653"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Chron Obstruct Pulmon Dis&#46;"
                        "fecha" => "2019"
                        "volumen" => "14"
                        "paginaInicial" => "343"
                        "paginaFinal" => "352"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30863037"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Status of and strategies for improving adherence to COPD treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; L&#243;pez-Campos"
                            1 => "E&#46; Quintana Gallego"
                            2 => "L&#46; Carrasco Hern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/COPD.S170848"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Chron Obstruct Pulmon Dis&#46;"
                        "fecha" => "2019"
                        "volumen" => "14"
                        "paginaInicial" => "1503"
                        "paginaFinal" => "1515"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31371936"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatable traits&#58; toward precision medicine of chronic airway diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Agusti"
                            1 => "E&#46; Bel"
                            2 => "M&#46; Thomas"
                            3 => "C&#46; Vogelmeier"
                            4 => "G&#46; Brusselle"
                            5 => "S&#46; Holgate"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/13993003.01359-2015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2016"
                        "volumen" => "47"
                        "paginaInicial" => "410"
                        "paginaFinal" => "419"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26828055"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Research guidelines for the Delphi survey technique"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Hasson"
                            1 => "S&#46; Keeney"
                            2 => "H&#46; McKenna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Adv Nurs&#46;"
                        "fecha" => "2000"
                        "volumen" => "32"
                        "paginaInicial" => "1008"
                        "paginaFinal" => "1015"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11095242"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack552799"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0125" class="elsevierStylePara elsevierViewall">The authors would like to thank Fernando S&#225;nchez Barbero PhD and Luz&#225;n 5 Health Consulting for their help in preparing the manuscript&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005700000009/v1_202109020614/S1579212921002287/v1_202109020614/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "49861"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Scientific letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000009/v1_202109020614/S1579212921002287/v1_202109020614/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002287?idApp=UINPBA00003Z"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Scientific Letter
Forum COPD working group consensus on the diagnosis, treatment and follow-up of COPD
Consenso sobre el diagnóstico, tratamiento y seguimiento de la EPOC: Grupo de trabajo EPOC Forum
José Luis López-Camposa,
Corresponding author
lcampos@separ.es

Corresponding author.
, Myriam Calle Rubiob, José Luis Izquierdo Alonsoc, Alberto Fernández-Villard, Beatriz Abascal-Boladoe, Bernardino Alcázarf, Francisco García-Ríog, Germán Peces-Barbah, Joan Serra Batllesi, José Javier Martínez Garceránj, Juan Antonio Riesco Mirandak, Juan Marco Figueira-Gonçalvesl, Juan José Soler-Cataluñam, Mikel Tempranon, Francisco Ortega Ruizo, Salud Santos Pérezp, Carlos José Álvarez Martínezq
a Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
b Departamento de Medicina, Universidad Complutense de Madrid, Hospital Clínico de San Carlos, Madrid, Spain
c Departamento de Medicina y Especialidades, Universidad de Alcalá, Hospital Universitario de Guadalajara, Guadalajara, Spain
d Hospital Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Spain
e Hospital Universitario Marqués de Valdecilla, Santander, Spain
f Servicio de Neumología, AIG de Medicina, Hospital de Alta Resolución de Loja, Granada, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
g Hospital Universitario La Paz, Madrid, Spain
h Hospital Universitario Fundación Jiménez Díaz, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
i Hospital Universitari de Vic, Barcelona, Spain
j Hospital General Universitario Santa Lucía, Cartagena, Spain
k Hospital San Pedro de Alcántara, Cáceres, Spain
l Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
m Hospital Universitario Arnau de Vilanova, Valencia, Spain
n Hospital San Eloy, Bizkaia, Spain
o Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
p Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
q Complejo Hospitalario Ruber Juan Bravo, Madrid, Spain
Ver más
Read
3614
Times
was read the article
1271
Total PDF
2343
Total HTML
Share statistics
 array:24 [
  "pii" => "S1579212921002287"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2021.06.007"
  "estado" => "S300"
  "fechaPublicacion" => "2021-09-01"
  "aid" => "2726"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2021"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2021;57:596-9"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289621000235"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2020.12.037"
      "estado" => "S300"
      "fechaPublicacion" => "2021-09-01"
      "aid" => "2726"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2021;57:596-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
        "titulo" => "Consenso sobre el diagn&#243;stico&#44; tratamiento y seguimiento de la EPOC&#58; Grupo de trabajo EPOC Forum"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "596"
            "paginaFinal" => "599"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Forum COPD Working Group Consensus on the Diagnosis&#44; Treatment and Follow-Up of COPD"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jos&#233; Luis L&#243;pez-Campos, Myriam Calle Rubio, Jos&#233; Luis Izquierdo Alonso, Alberto Fern&#225;ndez-Villar, Beatriz Abascal-Bolado, Bernardino Alc&#225;zar, Francisco Garc&#237;a-R&#237;o, Germ&#225;n Peces-Barba, Joan Serra Batlles, Jos&#233; Javier Mart&#237;nez Garcer&#225;n, Juan Antonio Riesco Miranda, Juan Marco Figueira-Gon&#231;alves, Juan Jos&#233; Soler-Catalu&#241;a, Mikel Temprano, Francisco Ortega Ruiz, Salud Santos P&#233;rez, Carlos Jos&#233; &#193;lvarez Mart&#237;nez"
            "autores" => array:17 [
              0 => array:2 [
                "nombre" => "Jos&#233; Luis"
                "apellidos" => "L&#243;pez-Campos"
              ]
              1 => array:2 [
                "nombre" => "Myriam"
                "apellidos" => "Calle Rubio"
              ]
              2 => array:2 [
                "nombre" => "Jos&#233; Luis"
                "apellidos" => "Izquierdo Alonso"
              ]
              3 => array:2 [
                "nombre" => "Alberto"
                "apellidos" => "Fern&#225;ndez-Villar"
              ]
              4 => array:2 [
                "nombre" => "Beatriz"
                "apellidos" => "Abascal-Bolado"
              ]
              5 => array:2 [
                "nombre" => "Bernardino"
                "apellidos" => "Alc&#225;zar"
              ]
              6 => array:2 [
                "nombre" => "Francisco"
                "apellidos" => "Garc&#237;a-R&#237;o"
              ]
              7 => array:2 [
                "nombre" => "Germ&#225;n"
                "apellidos" => "Peces-Barba"
              ]
              8 => array:2 [
                "nombre" => "Joan"
                "apellidos" => "Serra Batlles"
              ]
              9 => array:2 [
                "nombre" => "Jos&#233; Javier"
                "apellidos" => "Mart&#237;nez Garcer&#225;n"
              ]
              10 => array:2 [
                "nombre" => "Juan Antonio"
                "apellidos" => "Riesco Miranda"
              ]
              11 => array:2 [
                "nombre" => "Juan Marco"
                "apellidos" => "Figueira-Gon&#231;alves"
              ]
              12 => array:2 [
                "nombre" => "Juan Jos&#233;"
                "apellidos" => "Soler-Catalu&#241;a"
              ]
              13 => array:2 [
                "nombre" => "Mikel"
                "apellidos" => "Temprano"
              ]
              14 => array:2 [
                "nombre" => "Francisco"
                "apellidos" => "Ortega Ruiz"
              ]
              15 => array:2 [
                "nombre" => "Salud"
                "apellidos" => "Santos P&#233;rez"
              ]
              16 => array:2 [
                "nombre" => "Carlos Jos&#233;"
                "apellidos" => "&#193;lvarez Mart&#237;nez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212921002287"
          "doi" => "10.1016/j.arbr.2021.06.007"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002287?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621000235?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005700000009/v1_202109020750/S0300289621000235/v1_202109020750/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212921002317"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2021.06.010"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "2734"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2021;57:599-600"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Pneumatocele following lung cryobiopsy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "599"
          "paginaFinal" => "600"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Neumatocele posterior a criobiopsia pulmonar"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2081
              "Ancho" => 2500
              "Tamanyo" => 461464
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">High-resolution chest tomography&#46; &#40;A&#41; before TBCB&#58; bilateral consolidations with peripheral and peribronchovascular air bronchogram&#46; &#40;B&#41; 1 month after TBCB&#58; lesion with air-fluid level in right upper lobe&#46; &#40;C&#41; and &#40;D&#41; 3 months after TBCB&#58; decrease in the size of the lesion with disappearance or reabsorption of the air content and persistence of the bloody content &#40;hematocele&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Horacio Mat&#237;as Castro, Esteban Javier Wainstein, Rodrigo Castro Azcurra, Alberto Seehaus"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Horacio Mat&#237;as"
              "apellidos" => "Castro"
            ]
            1 => array:2 [
              "nombre" => "Esteban Javier"
              "apellidos" => "Wainstein"
            ]
            2 => array:2 [
              "nombre" => "Rodrigo"
              "apellidos" => "Castro Azcurra"
            ]
            3 => array:2 [
              "nombre" => "Alberto"
              "apellidos" => "Seehaus"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289621000326"
        "doi" => "10.1016/j.arbres.2021.01.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289621000326?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002317?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005700000009/v1_202109020614/S1579212921002317/v1_202109020614/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212921002263"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2021.06.005"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "2690"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2021;57:594-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Lung infection caused by <span class="elsevierStyleItalic">Lophomonas blattarum</span>"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "594"
          "paginaFinal" => "596"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Infecci&#243;n pulmonar por <span class="elsevierStyleItalic">Lophomonas blattarum</span>"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1572
              "Ancho" => 1207
              "Tamanyo" => 198430
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A microscopic view of <span class="elsevierStyleItalic">Lophomonas blattarum</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nathalie Pinos V&#233;lez, Ricardo Ordo&#241;ez Vintimilla, Solmayra Agreda Orellana"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Nathalie"
              "apellidos" => "Pinos V&#233;lez"
            ]
            1 => array:2 [
              "nombre" => "Ricardo"
              "apellidos" => "Ordo&#241;ez Vintimilla"
            ]
            2 => array:2 [
              "nombre" => "Solmayra"
              "apellidos" => "Agreda Orellana"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289620305445"
        "doi" => "10.1016/j.arbres.2020.12.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620305445?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002263?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005700000009/v1_202109020614/S1579212921002263/v1_202109020614/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Forum COPD working group consensus on the diagnosis&#44; treatment and follow-up of COPD"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "596"
        "paginaFinal" => "599"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Jos&#233; Luis L&#243;pez-Campos, Myriam Calle Rubio, Jos&#233; Luis Izquierdo Alonso, Alberto Fern&#225;ndez-Villar, Beatriz Abascal-Bolado, Bernardino Alc&#225;zar, Francisco Garc&#237;a-R&#237;o, Germ&#225;n Peces-Barba, Joan Serra Batlles, Jos&#233; Javier Mart&#237;nez Garcer&#225;n, Juan Antonio Riesco Miranda, Juan Marco Figueira-Gon&#231;alves, Juan Jos&#233; Soler-Catalu&#241;a, Mikel Temprano, Francisco Ortega Ruiz, Salud Santos P&#233;rez, Carlos Jos&#233; &#193;lvarez Mart&#237;nez"
        "autores" => array:17 [
          0 => array:4 [
            "nombre" => "Jos&#233; Luis"
            "apellidos" => "L&#243;pez-Campos"
            "email" => array:1 [
              0 => "lcampos@separ.es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Myriam"
            "apellidos" => "Calle Rubio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Jos&#233; Luis"
            "apellidos" => "Izquierdo Alonso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Alberto"
            "apellidos" => "Fern&#225;ndez-Villar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Beatriz"
            "apellidos" => "Abascal-Bolado"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Bernardino"
            "apellidos" => "Alc&#225;zar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Francisco"
            "apellidos" => "Garc&#237;a-R&#237;o"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff0035"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Germ&#225;n"
            "apellidos" => "Peces-Barba"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Joan"
            "apellidos" => "Serra Batlles"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">i</span>"
                "identificador" => "aff0045"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Jos&#233; Javier"
            "apellidos" => "Mart&#237;nez Garcer&#225;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff0050"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "Juan Antonio"
            "apellidos" => "Riesco Miranda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">k</span>"
                "identificador" => "aff0055"
              ]
            ]
          ]
          11 => array:3 [
            "nombre" => "Juan Marco"
            "apellidos" => "Figueira-Gon&#231;alves"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">l</span>"
                "identificador" => "aff0060"
              ]
            ]
          ]
          12 => array:3 [
            "nombre" => "Juan Jos&#233;"
            "apellidos" => "Soler-Catalu&#241;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">m</span>"
                "identificador" => "aff0065"
              ]
            ]
          ]
          13 => array:3 [
            "nombre" => "Mikel"
            "apellidos" => "Temprano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">n</span>"
                "identificador" => "aff0070"
              ]
            ]
          ]
          14 => array:3 [
            "nombre" => "Francisco"
            "apellidos" => "Ortega Ruiz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">o</span>"
                "identificador" => "aff0075"
              ]
            ]
          ]
          15 => array:3 [
            "nombre" => "Salud"
            "apellidos" => "Santos P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">p</span>"
                "identificador" => "aff0080"
              ]
            ]
          ]
          16 => array:3 [
            "nombre" => "Carlos Jos&#233;"
            "apellidos" => "&#193;lvarez Mart&#237;nez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">q</span>"
                "identificador" => "aff0085"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:17 [
          0 => array:3 [
            "entidad" => "Unidad M&#233;dico-Quir&#250;rgica de Enfermedades Respiratorias&#44; Instituto de Biomedicina de Sevilla &#40;IBiS&#41;&#44; Hospital Universitario Virgen del Roc&#237;o&#47;Universidad de Sevilla&#44; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Medicina&#44; Universidad Complutense de Madrid&#44; Hospital Cl&#237;nico de San Carlos&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Medicina y Especialidades&#44; Universidad de Alcal&#225;&#44; Hospital Universitario de Guadalajara&#44; Guadalajara&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Hospital &#193;lvaro Cunqueiro&#44; Instituto de Investigaci&#243;n Sanitaria Galicia Sur &#40;IISGS&#41;&#44; Vigo&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Servicio de Neumolog&#237;a&#44; AIG de Medicina&#44; Hospital de Alta Resoluci&#243;n de Loja&#44; Granada&#44; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Hospital Universitario Fundaci&#243;n Jim&#233;nez D&#237;az&#44; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
          8 => array:3 [
            "entidad" => "Hospital Universitari de Vic&#44; Barcelona&#44; Spain"
            "etiqueta" => "i"
            "identificador" => "aff0045"
          ]
          9 => array:3 [
            "entidad" => "Hospital General Universitario Santa Luc&#237;a&#44; Cartagena&#44; Spain"
            "etiqueta" => "j"
            "identificador" => "aff0050"
          ]
          10 => array:3 [
            "entidad" => "Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#44; Spain"
            "etiqueta" => "k"
            "identificador" => "aff0055"
          ]
          11 => array:3 [
            "entidad" => "Hospital Universitario Nuestra Se&#241;ora de Candelaria&#44; Tenerife&#44; Spain"
            "etiqueta" => "l"
            "identificador" => "aff0060"
          ]
          12 => array:3 [
            "entidad" => "Hospital Universitario Arnau de Vilanova&#44; Valencia&#44; Spain"
            "etiqueta" => "m"
            "identificador" => "aff0065"
          ]
          13 => array:3 [
            "entidad" => "Hospital San Eloy&#44; Bizkaia&#44; Spain"
            "etiqueta" => "n"
            "identificador" => "aff0070"
          ]
          14 => array:3 [
            "entidad" => "Unidad M&#233;dico-Quir&#250;rgica de Enfermedades Respiratorias&#44; Instituto de Biomedicina de Sevilla &#40;IBiS&#41;&#44; Hospital Universitario Virgen del Roc&#237;o&#47;Universidad de Sevilla&#59; Centro de Investigaci&#243;n Biom&#233;dica en Red de Enfermedades Respiratorias &#40;CIBERES&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "o"
            "identificador" => "aff0075"
          ]
          15 => array:3 [
            "entidad" => "Hospital Universitario de Bellvitge-IDIBELL&#44; Hospitalet de Llobregat&#44; Barcelona&#44; Spain"
            "etiqueta" => "p"
            "identificador" => "aff0080"
          ]
          16 => array:3 [
            "entidad" => "Complejo Hospitalario Ruber Juan Bravo&#44; Madrid&#44; Spain"
            "etiqueta" => "q"
            "identificador" => "aff0085"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Consenso sobre el diagn&#243;stico&#44; tratamiento y seguimiento de la EPOC&#58; Grupo de trabajo EPOC Forum"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Despite the numerous strategic plans for the prevention and management of chronic obstructive pulmonary disease &#40;COPD&#41; that have been implemented to date&#44; high prevalence&#44; underdiagnosis&#44; and burden of care all remain a challenge in clinical practice<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a>&#46; Some of the main difficulties in COPD management include the prioritization and degree of control of treatable traits&#44; and problems with inhaled therapy&#44; such as device selection and patient adherence to prescribed maintenance treatment<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5&#8211;8</span></a>&#46; Moreover&#44; new care strategies and&#44; above all&#44; new therapeutic strategies are scene-changers in the clinical management of COPD&#46; The aim of this study was to reach a consensus among COPD experts on controversial issues in the evaluation and treatment of the disease&#44; using Delphi methodology<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A scientific committee of 17 COPD experts participated in the project&#46; The project coordinators selected a committee of SEPAR members whose profile demonstrated a consolidated background in COPD supported by publications&#44; while ensuring that the whole of Spain was represented by regions&#46; The committee analyzed the scientific evidence in four areas&#58; therapeutic adherence&#44; COPD control&#44; COPD treatable traits&#44; and inhalation devices&#46; This evidence was then examined in 15 discussion sessions&#44; to which 5 attending pulmonologists from each area were invited&#44; selected by the expert committee&#46; Using the information obtained at these meetings&#44; a questionnaire of 43 statements &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; was developed and sent to a panel of 95 experienced COPD pulmonologists who were asked to grade them on a Likert scale of 1&#8211;9&#46; Statements that were scored 1&#8211;3 &#40;disagreement&#44; median &#8804;3&#41; or 7&#8211;9 &#40;agreement&#44; median &#8805;7&#41; by more than two-thirds of the panelists&#44; were considered to have achieved consensus&#46; When more than two-thirds scored a statement in the range of 4&#8211;6&#44; it was considered inconclusive&#46; After two consecutive rounds&#44; consensus was reached on 37 statements&#58; 36 in agreement &#40;83&#46;7&#37;&#41; and one in disagreement &#40;2&#46;3&#37;&#41;&#46; Only six statements &#40;14&#37;&#41; failed to achieve consensus&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the scores and the degree of agreement for each statement&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Seven of the nine statements on therapeutic adherence reached a consensus of agreement&#46; The panelists believed that trust between the physician and the patient was important but noted that the information provided by the latter is not always reliable&#46; Although there was no consensus on whether adherence to 12- and 24-h regimens differed significantly&#44; panelists agreed &#40;68&#46;82&#37;&#41; that the 12-h regimen is preferable in patients with more symptomatic COPD&#46; It was agreed that in order to increase adherence&#44; the number of inhalers should be reduced and the patient&#8217;s preferences must be taken into account&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Consensus agreement was achieved in 12 of the 14 statements on COPD control&#46; A high percentage &#40;&#62;72&#37;&#41; agreed that control targets should be established on the basis of severity&#44; symptoms&#44; exacerbations&#44; lung function&#44; and smoking habit&#46; Only 36&#46;57&#37; considered that disease impact and stability were sufficient to assess COPD control&#46; However&#44; there was broad agreement &#40;93&#46;76&#37;&#41; that a patient with controlled COPD shows few symptoms and no exacerbations and remains stable over time&#46; This suggests that&#44; in the participants&#8217; view&#44; a patient with a persistent absence of symptoms or exacerbations over time would probably be well controlled&#44; but it is unclear whether&#44; as a general rule&#44; control can be established solely on the basis of these 2 variables&#46; This becomes clear in statement 18&#44; in which panelists value the importance of lung function in disease control&#46; According to the agreement reached &#40;69&#46;8&#37;&#41;&#44; a low-risk patient must be clinically stable for 1&#8239;year to be considered controlled&#46; However&#44; in high-risk patients&#44; agreement was not reached &#40;27&#46;96&#37;&#41; on the statement that stability should be maintained for 3 months for a patient to be considered controlled&#46; Most panelists &#40;&#62;92&#37;&#41; indicated their agreement with the following criteria for adjusting treatment&#58; adherence&#44; physical activity&#44; comorbidities&#44; and patient preferences&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">All statements on COPD treatable traits achieved consensus agreement&#46; Those with the greatest degree of agreement &#40;&#62;91&#37;&#41; were those that stated that these traits should be prioritized because of their impact on prognosis&#44; symptoms and exacerbations&#46; It was also agreed &#40;&#62;75&#37;&#41; that the definition of treatable traits should include individual&#44; quantifiable&#44; and prognostic traits&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally&#44; of the 14 statements on inhalation devices&#44; 11 achieved consensus agreement and 1 consensus disagreement&#46; Nearly 74&#37; of panelists agreed that if the inhaler is being used properly in stable COPD&#44; treatment outcomes depend on the lung deposition achieved by the device&#46; However&#44; there was consensus disagreement that if the inhalation device is used properly&#44; there are no differences in clinical outcomes&#44; regardless of the type of device used&#46; Nonetheless&#44; panelists agreed that outcomes depend on the type of inhaler&#44; lung deposition&#44; and the characteristics of the drug&#46; The criterion that achieved the highest degree of consensus regarding inhaler choice was inspiratory flow &#40;92&#46;70&#37;&#41;&#46; There was no consensus with the statement that there are no differences in the outcomes obtained with nebulizers or inhalers with spacers in the management of exacerbations&#44; regardless of their severity&#46; It was argued that there was insufficient evidence to claim that both devices are the same in this clinical context&#46; In fact&#44; 67&#46;74&#37; agreed that nebulizers are preferable in severe exacerbations&#46; In the absence of therapeutic response&#44; and before escalating treatment&#44; the main consensus &#40;98&#46;96&#37;&#41; was to check the correct use of the device&#46; No consensus was reached for the statement that the physician should be responsible for educating patients in inhaler use&#46; Panelists considered that the nursing staff would be more appropriate for this task&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">This Delphi study highlights the concerns of panelists surrounding the challenges faced by clinicians in the care of the COPD patient&#46; Although controversial issues still persist&#44; the high degree of agreement reached by the panelists identifies some key messages that should be taken into account in recommendations on the management of these patients&#46; These include the importance of therapeutic adherence&#44; the need to define COPD control&#44; a more personalized approach based on treatable traits&#44; verification of proper use of inhalers before escalating treatment&#44; and consideration of inspiratory flow as a significant criterion in the choice of inhalation device&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">This study was funded by <span class="elsevierStyleGrantSponsor" id="gs0005">Chiesi</span> Espa&#241;a&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">Jos&#233; Luis L&#243;pez-Campos has received honoraria in the past 3 years for lectures&#44; scientific consultancy&#44; clinical trial participation&#44; and preparation of publications from &#40;in alphabetical order&#41;&#58; AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; CSL Behring&#44; Esteve&#44; Ferrer&#44; Gebro&#44; GlaxoSmithKline&#44; Grifols&#44; Megalabs&#44; Menarini&#44; Novartis&#44; and Rovi&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Myriam Calle Rubio has received honoraria for lectures from AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; GlaxoSmithKline&#44; and&#46;Grifols&#46; Jos&#233; Luis Izquierdo has received honoraria for consultancy&#44; projects&#44; and lectures from AstraZeneca&#44; Bayer&#44; Boehringer Ingelheim&#44; Chiesi&#44; GlaxoSmithKline&#44; Grifols&#44; Menarini&#44; Novartis&#44; Orion&#44; Pfizer&#44; Sandoz&#44; and Teva&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Alberto Fern&#225;ndez-Villar has received in the last three years grants for research or training activities and payment for lectures or consultancy from AstraZeneca&#44; Bial&#44; Boehringer Ingelheim&#44; Chiesi&#44; Esteve&#44; Grifols&#44; GlaxoSmithKline&#44; Menarini&#44; Novartis&#44; Roche&#44; and Rovi&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Beatriz Abascal has given lectures and scientific consultancy sponsored by Teva&#44; GlaxoSmithKline&#44; Ferrer&#44; AstraZeneca&#44; and FAES Farma&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Bernardino Alc&#225;zar has received honoraria and&#47;or payments in the last five years from AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; FAES&#44; GlaxoSmithKline&#44; Menarini&#44; and Novartis&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Francisco Garc&#237;a-R&#237;o has been a speaker at activities organized by Boehringer Ingelheim&#44; Pfizer&#44; Chiesi&#44; GlaxoSmithKline&#44; Menarini&#44; Novartis and Rovi&#59; he has received grants for research projects from Chiesi&#44; GlaxoSmithKline&#44; AstraZeneca&#44; Menarini&#44; and Esteve&#59; and he has provided scientific consultancy to Boehringer Ingelheim&#44; Pfizer&#44; GlaxoSmithKline&#44; and Novartis&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Germ&#225;n Peces-Barba has received institutional research grants from GlaxoSmithKline&#44; Boehringer Ingelheim&#44; Chiesi&#44; and Menarini&#44; and has provided scientific consultancy to GlaxoSmithKline and Orion Pharma&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Joan Serra Batlles has no conflict of interest&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Jos&#233; Javier Mart&#237;nez Garcer&#225;n has given talks sponsored by Chiesi&#44; GlaxoSmithKline&#44; Novartis&#44; Pfizer&#44; Almirall&#44; AstraZeneca&#44; Menarini&#44; and Boehringer Ingelheim&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Juan Antonio Riesco Miranda has no conflict of interest&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Juan Marco Figueira-Gon&#231;alves has received speaker fees and funding for conference attendance from Esteve Laboratories&#44; MundiPharma&#44; AstraZeneca&#44; Boehringer Ingelheim&#44; Ferrer&#44; Pfizer&#44; FAES&#44; Menarini&#44; Rovi&#44; GlaxoSmithKline&#44; Chiesi&#44; Novartis&#44; and Gebro Pharma&#44; and he has received research project grants from Boehringer Ingelheim&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Juan Jos&#233; Soler-Catalu&#241;a has received speaker fees from AstraZeneca&#44; Boehringer Ingelheim&#44; Bial&#44; Chiesi&#44; Ferrer&#44; Laboratorio Esteve&#44; Menarini&#44; Mundipharma&#44; Novartis&#44; Rovi and Teva&#59; consultancy fees from Air Liquide&#44; AstraZeneca&#44; Boehringer Ingelheim&#44; Chiesi&#44; Ferrer&#44; GlaxoSmithKline&#44; Laboratorios Esteve&#44; Mundipharma&#44; and Novartis&#44; and research grants from GlaxoSmithKline and Boehringer Ingelheim&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Mikel Temprano has received honoraria for scientific sessions from Boehringer Ingelheim&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Francisco Ortega Ruiz has no conflict of interest&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Salud Santos P&#233;rez has received honoraria for lectures from Almirall&#44; Boehringer Ingelheim&#44; AstraZeneca&#44; Chiesi&#44; Pfizer&#44; GlaxoSmithKline&#44; Menarini&#44; and Novartis&#59; and for consultancy from Almirall&#44; Gebro Pharma&#44; AstraZeneca&#44; Novartis&#44; FAES&#44; Grifols&#44; and Menarini&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Carlos Jos&#233; &#193;lvarez Mart&#237;nez has no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Funding"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Conflict of interest"
        ]
        2 => array:2 [
          "identificador" => "xack552799"
          "titulo" => "Acknowledgements"
        ]
        3 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; L&#243;pez-Campos JL&#44; Calle Rubio M&#44; Izquierdo Alonso JL&#44; Fern&#225;ndez-Villar A&#44; Abascal-Bolado B&#44; Alc&#225;zar B&#44; et al&#46; Consenso sobre el diagn&#243;stico&#44; tratamiento y seguimiento de la EPOC&#58; Grupo de trabajo EPOC Forum&#46; Arch Bronconeumol&#46; 2021&#59;57&#58;596&#8211;599&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">DPI&#58; dry powder inhalers&#59; COPD&#58; chronic obstructive pulmonary disease&#59; IQI&#58; interquartile interval&#59; MDI&#58; metered dose inhalers&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">White&#58; agreement consensus&#59; dark gray&#58; disagreement consensus&#59; light gray&#58; no consensus&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Median &#40;IQI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37; agreement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Therapeutic adherence</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46; Questionnaires are of limited use in clinical practice because of the time required for their completion&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46; A climate of trust between the physician and patient does not guarantee that the patient will reliably report therapeutic adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46; Calculating adherence on the basis of prescriptions filled in pharmacies is useful&#44; but does not confirm that the medication was taken&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46; To improve adherence&#44; pharmacies should participate in programs for training COPD patients on the use of devices&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46; Devices that are easy to use improve adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46; According to the existing evidence&#44; there are no significant differences in adherence if the drug is administered every 12 or 24&#8239;h&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46; In patients with more symptomatic COPD&#44; dosing every 12&#8239;h is preferable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46; Reducing the number of inhalers in the same patient is important to improve adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46; Taking account of patient preferences improves therapeutic adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">COPD control</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46; Disease impact and stability are sufficient to assess COPD control&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46; COPD control targets should be established according to severity&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46; In low-risk patients&#44; COPD control targets should be established according to symptoms&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46; In high-risk patients&#44; COPD control targets should be established according to symptoms and exacerbations&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46; COPD control targets should be defined on the basis of the patient&#8217;s situation at the time of implementing a new therapeutic plan&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46; A patient with controlled COPD is one with mild symptoms and no exacerbations&#44; maintained over time&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46; A patient with low-risk COPD is considered controlled when they have been stable for 1&#8239;year&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46; A patient with high-risk COPD is considered controlled when they have been stable for 3 months&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46; Decrease in lung function should be a criterion for poor COPD control&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46; Active smoking should be a factor associated with poor COPD control&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46; Criteria for treatment adjustment should include therapeutic adherence&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46; Criteria for treatment adjustment should include the patient&#8217;s physical activity&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46; Criteria for treatment adjustment should include comorbidities&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46; Criteria for treatment adjustment should include the patient&#8217;s preferences&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">COPD treatable traits</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46; The definition of COPD treatable traits should state that they are individual characteristics of each patient&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46; The definition of COPD treatable traits should state that they are quantifiable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46; The definition of COPD treatable traits should state that they are prognostic&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46; COPD treatable traits should be prioritized because of their impact on the prognosis of the disease&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46; COPD treatable traits should be prioritized because of their impact on symptoms&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46; COPD treatable traits should be prioritized because of their impact on exacerbations&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Inhalation devices</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46; In stable COPD&#44; when the inhaler is used correctly&#44; treatment outcomes depend on the lung deposition achieved by the device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46; In stable COPD&#44; when the inhaler is used correctly&#44; there are no differences in treatment outcomes&#44; regardless of the type of device used&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46; The main critical errors in the use of MDI inhalation devices are associated with coordination between activation and inhalation&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46; The main critical errors in the use of DPI inhalation devices are associated with an insufficient inspiratory flow&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#46; The use of nebulizers is preferred during severe COPD exacerbations&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46; In COPD exacerbations&#44; regardless of severity&#44; there are no differences in the results obtained with nebulizers and inhalers with spacers&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46; The use of DPI devices should be avoided in exacerbations due to insufficient inspiratory flow in many patients&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#46; In COPD patients who do not respond to treatment&#44; a drug switch should be considered before escalating treatment&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46; In COPD patients who do not respond to treatment&#44; the correct use of the device must always be verified before escalating treatment&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46; Patient age is an important criterion in the choice of inhalation device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46; Inspiratory flow is an important criterion in the choice of inhalation device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#46; Patient preference must always be taken into account when choosing the inhalation device&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46; The physician should be responsible for educating patients on the use of inhalation devices&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46; Nursing staff should be responsible for educating patients on the use of inhalation devices&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2684898.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Results obtained by the panel of experts after 2 rounds of consultations&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:9 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atenci&#243;n a la EPOC en el abordaje al paciente cr&#243;nico en atenci&#243;n primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Llauger Rosell&#243;"
                            1 => "M&#46;A&#46; Pou"
                            2 => "L&#46; Dom&#237;nguez"
                            3 => "M&#46; Freixas"
                            4 => "P&#46; Valverde"
                            5 => "C&#46; Valero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2011.10.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol&#46;"
                        "fecha" => "2011"
                        "volumen" => "47"
                        "paginaInicial" => "561"
                        "paginaFinal" => "570"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22036593"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global strategy for the diagnosis&#44; management&#44; and prevention of chronic obstructive lung disease 2017 report&#58; GOLD executive summary"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;F&#46; Vogelmeier"
                            1 => "G&#46;J&#46; Criner"
                            2 => "F&#46;J&#46; Martinez"
                            3 => "A&#46; Anzueto"
                            4 => "P&#46;J&#46; Barnes"
                            5 => "J&#46; Bourbeau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2017.02.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol&#46;"
                        "fecha" => "2017"
                        "volumen" => "53"
                        "paginaInicial" => "128"
                        "paginaFinal" => "149"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28274597"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic obstructive pulmonary disease &#40;COPD&#41; in Spain and the different aspects of its social impact&#58; a multidisciplinary opinion document"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Bouza"
                            1 => "A&#46; Alvar"
                            2 => "P&#46; Almagro"
                            3 => "T&#46; Alonso"
                            4 => "J&#46; Ancochea"
                            5 => "F&#46; Barb&#233;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Quimioter&#46;"
                        "fecha" => "2020"
                        "volumen" => "33"
                        "paginaInicial" => "49"
                        "paginaFinal" => "67"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and determinants of COPD in Spain&#58; EPISCAN II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;B&#46; Soriano"
                            1 => "I&#46; Alfageme"
                            2 => "M&#46; Miravitlles"
                            3 => "P&#46; de Lucas"
                            4 => "J&#46;J&#46; Soler-Catalu&#241;a"
                            5 => "F&#46; Garc&#237;a-R&#237;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2020.07.024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol&#46;"
                        "fecha" => "2020"
                        "volumen" => "57"
                        "paginaInicial" => "61"
                        "paginaFinal" => "69"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32950310"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of COPD&#58; relationships between daily dosing frequency&#44; adherence&#44; resource use&#44; and costs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;L&#46; Toy"
                            1 => "N&#46;U&#46; Beaulieu"
                            2 => "J&#46;M&#46; McHale"
                            3 => "T&#46;R&#46; Welland"
                            4 => "C&#46;A&#46; Plauschinat"
                            5 => "A&#46; Swensen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Respir Med&#46;"
                        "fecha" => "2011"
                        "volumen" => "105"
                        "paginaInicial" => "435"
                        "paginaFinal" => "441"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medication adherence and persistence in chronic obstructive pulmonary disease patients receiving triple therapy in a USA commercially insured population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Bogart"
                            1 => "R&#46;H&#46; Stanford"
                            2 => "F&#46; Laliberte"
                            3 => "G&#46; Germain"
                            4 => "J&#46;W&#46; Wu"
                            5 => "M&#46;S&#46; Duh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/COPD.S184653"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Chron Obstruct Pulmon Dis&#46;"
                        "fecha" => "2019"
                        "volumen" => "14"
                        "paginaInicial" => "343"
                        "paginaFinal" => "352"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30863037"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Status of and strategies for improving adherence to COPD treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; L&#243;pez-Campos"
                            1 => "E&#46; Quintana Gallego"
                            2 => "L&#46; Carrasco Hern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/COPD.S170848"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Chron Obstruct Pulmon Dis&#46;"
                        "fecha" => "2019"
                        "volumen" => "14"
                        "paginaInicial" => "1503"
                        "paginaFinal" => "1515"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31371936"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatable traits&#58; toward precision medicine of chronic airway diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Agusti"
                            1 => "E&#46; Bel"
                            2 => "M&#46; Thomas"
                            3 => "C&#46; Vogelmeier"
                            4 => "G&#46; Brusselle"
                            5 => "S&#46; Holgate"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/13993003.01359-2015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2016"
                        "volumen" => "47"
                        "paginaInicial" => "410"
                        "paginaFinal" => "419"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26828055"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Research guidelines for the Delphi survey technique"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Hasson"
                            1 => "S&#46; Keeney"
                            2 => "H&#46; McKenna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Adv Nurs&#46;"
                        "fecha" => "2000"
                        "volumen" => "32"
                        "paginaInicial" => "1008"
                        "paginaFinal" => "1015"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11095242"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack552799"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0125" class="elsevierStylePara elsevierViewall">The authors would like to thank Fernando S&#225;nchez Barbero PhD and Luz&#225;n 5 Health Consulting for their help in preparing the manuscript&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005700000009/v1_202109020614/S1579212921002287/v1_202109020614/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "49861"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Scientific letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000009/v1_202109020614/S1579212921002287/v1_202109020614/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002287?idApp=UINPBA00003Z"
]
Article information
ISSN: 15792129
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 6 3 9
2024 October 64 19 83
2024 September 55 12 67
2024 August 72 44 116
2024 July 69 22 91
2024 June 81 26 107
2024 May 73 31 104
2024 April 35 25 60
2024 March 57 27 84
2024 February 58 36 94
2024 January 76 36 112
2023 December 43 39 82
2023 November 61 34 95
2023 October 56 41 97
2023 September 43 41 84
2023 August 47 43 90
2023 July 53 35 88
2023 June 52 29 81
2023 May 43 50 93
2023 April 55 34 89
2023 March 106 40 146
2023 February 59 25 84
2023 January 53 51 104
2022 December 113 35 148
2022 November 104 49 153
2022 October 112 62 174
2022 September 91 55 146
2022 August 101 52 153
2022 July 124 52 176
2022 June 113 58 171
2022 May 77 36 113
2022 April 85 41 126
2022 March 74 58 132
2022 February 28 25 53
2022 January 3 4 7
2021 September 1 1 2
Show all

Follow this link to access the full text of the article

Archivos de Bronconeumología

Are you a health professional able to prescribe or dispense drugs?