A 52-year-old male smoker with a 30 pack-year history presents with progressive dyspnea on exertion. Spirometry shows FEV₁/FVC ratio of 0.68 (post-bronchodilator), FEV₁ 58% predicted, and a normal DLCO. Flow-volume loop demonstrates a scooped-out expiratory limb. What is the most appropriate next step in management?
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