We are very grateful to Dr Vanfleteren and colleagues 1 for commenting on our data regarding overdiagnosed COPD 2 and for putting this evidence into the framework of current understanding of the disease. Based on the data presented on overdiagnosis, and on prior Burden of Obstructive Lung Disease (BOLD) observations on underdiagnosis, 3 we truly believe that our worldwide community of pulmonary specialists could do much better in caring for this extremely prevalent and devastating disease.

Michael Studnicka, Andreas Horner , Lea Sator , A Sonia Buist , Bernd Lamprecht , NanShan Zhong , Shengming Liu , Jiachun Lu , Pixin Ran , Dali Wang , Jingping Zheng , Yumin Zhou, Ali Kocabaş, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan , Sema Umut, Turgay Unalan, Torkil Dawes, Eric Bateman, Anamika Jithoo , Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa , Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers , Johanna Ryck, Janita Storbeck, Thorarinn Gislason, Bryndis Benedikdtsdottir, Kristin Jörundsdottir , Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gundmundsson , Ewa Nizankowska-Mogilnicka, Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek , Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Tobias Welte , sabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Amund Gulsvik , Tina Endresen, Lene Svendsen, Wan C Tan, Wen Wang, David M Mannino, John Cain , Rebecca Copeland, Dana Hazen, Jennifer Methvin, Renato B Dantes, Lourdes Amarillo , Lakan U Berratio, Lenora C Fernandez, Norberto A Francisco, Gerard S Garcia, S Teresita , Luisito F Idolor, Sullian S Naval, Thessa Reyes, Camilo C Roa, Ma Flordeliza Sanchez , Kate Hardaker, Brett Toelle, Peter GJ Burney, Caron Amor, James Potts, Michael Tumilty , Fiona McLean, EFM Wouters, GJ Wesseling, Cristina Bárbara, Fátima Rodrigues , Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos , Reis Ferreira, Christer Janson, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz-Nyström , Gunilla Hägg, Gun-Marie Lund, Rain Jõgi, Hendrik Laja, Katrin Ulst, Vappu Zobel , Toomas-Julius Lill, Parvaiz A Koul, Sajjad Malik, Nissar A Hakim, Umar Hafiz Khan , Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde , Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup , Imed Harrabi, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha , Wahbi Belhaj Khalifa,Fernando G Ayuyao, Cecil Z Tady, Daniel T Tan, Sylvia Banal-Yang , Vincent M Balanag, Maria Teresita N Reyes, Renato B Dantes, Sanjay Juvekar , Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke , and Sharda Chaudhary, Suvarna Bondre, Savita Walke. "COPD-Should Diagnosis Match Physiology?." Chest 157, no. 2 (2020): 473-475.