Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Stratified treatment according to risk of deterioration is recommended in primary care. Patients with a higher risk of exacerbation in the following year should be offered more aggressive treatment, while stable patients should be treated with less intervention. This approach requires accurate risk prediction tools. In a study, Jordan and colleagues (doi:10.1136/bmj-2025-084521) presented a new BLISS score. This score is used in primary care in patients with COPD to predict the risk of exacerbations serious for hospitalization in the next two years. Two thirds of the study participants were identified from existing general practice.