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May 16, 1990

Pulmonary Medicine

JAMA. 1990;263(19):2677-2678. doi:10.1001/jama.1990.03440190133072

Chronic obstructive pulmonary disease (COPD) has been previously described as a major challenge both to basic scientists, who try to elucidate the disease mechanisms, and clinicians, who aim to alter the course and prognosis of the fifth leading cause of death in the United States.1-3 There were an estimated 75 000 deaths from COPD in 1988, but certainly COPD contributed to the cause of death in many others, perhaps as many as 150 000. Chronic obstructive pulmonary disease will remain a challenge in the future because 51 million Americans continue to smoke. The prevalence of COPD, a degenerative disease, will continue to increase in our aging population.

Although long-term oxygen therapy is now established as a treatment that improves survival in patients with advanced COPD and hypoxemia, two national consensus conferences have emphasized the problems inherent in prescribing and supplying oxygen for Medicare patients and in overall recommendations for