TABLE 1

Final list of statements included in the Delphi survey

Clinical items required to define the association of COPD and bronchiectasis
1. Age >35 years
2. Current or past smoking habit (≥10 pack-years) or other toxic exposure (biomass, industrial, etc.)
3. Presence of at least 15 mL of expectorated sputum most of the days
4. Presence of purulent sputum most of the days
5. Presence of haemoptysis
6. Presence of chronic cough and expectoration for at least 3 consecutive months in the last 2 years
7. Presence of dyspnoea (mMRC ≥1) in the last 2 years
8. History of at least one exacerbation in the previous year
9. History of frequent infectious exacerbations (≥2)
10. History of at least one severe exacerbation in the last year (hospitalisation or intravenous antibiotic therapy)
Radiological items required to define the association of COPD and bronchiectasis
11. Lack of airway tapering sign
12. Airways visible within 1 cm of the pleural surface
13. BE (bronchial dilatation) in at least one pulmonary segment in one lobe
14. BE (bronchial dilatation) in more than one pulmonary segment in one lobe
15. BE (bronchial dilatation) in one or more pulmonary segments in more than one lobe
16. Presence of extensive emphysema
17. Extensive bronchial wall thickening
18. Presence of diffuse mucus plugging
19. Presence of air trapping
Functional items required to define the association of COPD and bronchiectasis
20. Post-bronchodilator FEV1/FVC <0.7
21. Post-bronchodilator FEV1/FVC <LLN
22. A positive BD test excludes the diagnosis of COPD–BE association
23. A mixed (restrictive/obstructive) pattern excludes the diagnosis of COPD–BE association
24. A history of positive BD test excludes the diagnosis of COPD–BE overlap
25. A documented history of asthma excludes the diagnosis of COPD–BE overlap
Microbiological items required to define the association of COPD and bronchiectasis
26. At least one isolation of PPM in sputum in the last year in steady state
27. >1 isolation of PPM in sputum in the last year in steady state
28. History of chronic bronchial infection by any PPM in steady state
29. Isolation of Pseudomonas aeruginosa in sputum
30. No isolation of PPM
Pathophysiological items required to define the association of COPD and bronchiectasis
31. Blood leukocytosis in stable clinical conditions
32. High blood level of C-reactive protein in stable clinical conditions
33. High blood level of fibrinogen in stable clinical conditions
34. High neutrophil count in sputum in stable clinical conditions
35. High eosinophil count in serum in stable clinical conditions

Participants were asked to grade each item, according to their level of agreement on the necessity for the statement to be part of the COPD–BE association definition. mMRC: modified Medical Research Council; BE: bronchiectasis; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; LLN: lower limit of normal; BD: bronchodilation; COPD: chronic obstructive pulmonary disease; PPM: potential pathogenic microorganisms.