A logical question is, “What is the secret of the group’s
success?” Most of the credit goes to the co-chairpersons, James E.
Dalen, MD, FCCP, and Jack Hirsh, MD, FCCP. They have insisted on
careful and detailed organization of the process, with firm timelines,
well-written and referenced draft statements from working groups (which
become chapters in the final CHEST supplement), and,
whenever possible, “bottom line” recommendations formulated on the
basis of evidence from clinical trial results. To achieve consensus,
the two dozen or so working groups present their summary statements at
a 3-day meeting of specialists convened in Tucson, AZ. Disagreements
are discussed in a time-limited debate; moderators require the debaters
to cite evidence and judge the strength and levels of the evidence;
they cut short those who advocate by anecdote and oratory. After the
meeting concludes, working-group chairpersons submit “final drafts”
to Drs. Dalen and Hirsh, who personally edit them and thus produce the
next edition of the consensus statement.