Diagnosis of Chronic Obstructive Pulmonary Disease, simpler is better. Complexity and simplicity.

So far, spirometry has always been the basis for diagnosis of COPD using FEV1/FVC fixed ratio or LLN, but no one of these two parameters is actually able to fully characterize the complex diagnostic features of this disease. Indeed, COPD presents additional and remarkable extra pulmonary and systemic manifestations which need to be captured and addressed. For this reason, the GOLD initiative have recently introduced the concept of a COPD staging and classification including factors which stand over the spirometric definition of the disease. Moreover, in the last decade, multidimensional indices such as BODE, ADO, DOSE, and COTE came up from research field in the appropriate attempt to "simplify the complex diagnosis" of a COPD patient. In particular,assessment of different phenotypes according to either clinical and biological features appears to be a still unmet expectation in helping the most accurate identification of each patients, thus providing a therapy targeted on his/her specified needs. In the era of the system biology, this olistic approach appears to be a real step forward a more accurate diagnosis, prognosis and cure rather than the assessment and identification of lung function and bronchodilating properties only in the COPD population.