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Chest. 2004;126(1_suppl):2S-3S. doi:10.1378/chest.126.1_suppl.2S
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The following participants have stated that they do not have a real or potential conflict of interest or commitment:

  • Gregory S. Ahearn, MD

  • Rino Aldrighetti John Conte, MD,

  • FCCP Terry A. Fortin, MD

  • Joe G. N. Garcia, MD, FCCP

  • Joseph A. Govert, MD

  • Sandra Zelman Lewis, PhD

  • Douglas C. McCrory, MD

  • Kenneth W. Presberg, MD, FCCP

  • John Sundy

The following participants have disclosed information regarding potential or real conflicts of interest and commitment:

Steven H. Abman, MD: scientific advisory board for INO Therapeutics; consultant for Pfizer.

Charles W. Atwood, Jr., MD, FCCP: research support from Respironics, Inc.

David B. Badesch, MD, FCCP: consultant or Speaker’s Bureau for Glaxo Wellcome/GlaxoSmithKline, Actelion, InterMune, Encysive, Myogen, Astra-Merck, Astra-Zeneca, Exhale Therapeutics/CoTherix, Forrest Labs, INO Therapeutics, Berlex; research support from Glaxo Wellcome/GlaxoSmithKline, United Therapeutics, Boehringer Ingelheim, Actelion, Encysive, ICOS/Texas Biotechnologies/Encysive, Myogen, INO Therapeutics, Scleroderma Foundation, National Institutes of Health, National Heart, Lung, and Blood Institute, United Therapeutics, Pfizer, American Lung Association.

Robyn J. Barst, MD: consultant and research support from Actelion, Encysive, Exhale Therapeutics, INO, Myogen, United Therapeutics, Pfizer GlaxoSmithKline; unrestricted education grants from GlaxoSmithKline, Encysive, Actelion.

Richard N. Channick, MD, FCCP: research support from Actelion, Pfizer, Myogen, United Therapeutics; consultant and Speaker’s Bureau for Actelion.

Ramona L. Doyle, MD, FCCP: Speaker’s Bureau for Actelion; clinical research for Actelion, Myogen, United Therapeutics.

David D. Gutterman, MD, FCCP: stock options with Johnson & Johnson; relative who is a Vice-President at GlaxoSmithKline.

James E. Loyd, MD, FCCP: relationships with GlaxoSmithKline, United Therapeutics, Actelion, ICOS/Texas Biotechnology, Westat, PRA International, Pfizer, Exhale Therapeutics.

Michael D. McGoon, MD: past research support from Glaxo Wellcome, United Therapeutics, Actelion; research support from Texas Biotech/Encysive, Myogen, Pfizer, Medtronic.

Vallerie V. McLaughlin, MD, FCCP: consultant for Actelion, United Therapeutics, Exhale Therapeutics; Speaker’s Bureau for Actelion; research funding from Actelion, United Therapeutics, Pfizer, Encysive/Texas Biotechnologies, Glaxo Wellcome, Exhale Therapeutics, Myogen.

Stuart Rich, MD: research funding from Actelion, Pfizer, United Therapeutics, Encysive, Myogen; consultant for Actelion, Pfizer, United Therapeutics, GlaxoSmithKline.

Lewis J. Rubin, MD, FCCP: consultant for Actelion, Myogen, Schering, Exhale Therapeutics, United Therapeutics, Pfizer, Celgene; investigator for Actelion, Myogen, Exhale, Pfizer, Celgene; no stock holdings or other ownerships or positions.

Gerald Simonneau, MD: consultant and investigator for Glaxo Wellcome, Pfizer, Actelion, Schering, Myogen, United Therapeutics.

Virginia D. Steen, MD: relationships with Arthritis Foundation, Scleroderma Foundation, Actelion.

Fredrick M. Wigley, MD: research funding from Biogen, Pfizer, Actelion; consultant to Genzyme.

ACCP Guideline Development Process

The American College of Chest Physicians finds it imperative to include individuals who are experts in their respective fields on guideline development committees. Recommendations and publications that are the resulting products from these committees will have far reaching significance that may affect multiple aspects of the practice of chest medicine throughout the world. Therefore, it is essential that the College have full disclosure of outside interests from those individuals serving on policy development committees, including liaison representatives from outside organizations. Both real and potential conflicts of interest may actually or appear to affect impartial or objective decisions.

Practicing evidence-based medicine means using the best available data from the published literature and joining it with clinical knowledge to make appropriate decisions on patient care. The American College of Chest Physicians evidence-based clinical practice guidelines are developed through an approved, rigorous process which involves conducting a systematic literature review (see page 11S for more information on the methodology) and deriving recommendations based on the data. In addition, the guidelines follow a formal review and approval process prior to publication as ACCP policy. Each chapter of this guideline was reviewed and approved by the ACCP Health and Science Policy Committee, the ACCP Pulmonary Vascular NetWork, and then by the ACCP Board of Regents. The guideline was then forwarded to external organizations for their endorsement.

In the ever-changing field of medicine, it is important and necessary to have access to up-to-date information. Clinical practice guidelines are developed to enhance the clinician’s ability to practice evidence-based medicine and also provide an opportunity for the busy clinician to receive the latest evidence on a particular topic. The information provided in the guideline should be used in conjunction with clinical judgment. Although the guideline provides recommendations that are based on evidence from studies involving various populations, the recommendations may not apply to every individual patient. It is important for the physician to take into consideration the role of patient preferences and the availability of local resources.

The ACCP is sensitive to concerns that nationally and/or internationally developed guidelines are not always applicable in local settings. Further, guideline recommendations are just that, recommendations not dictates. In treating patients, individual circumstances, preferences, and resources do play a role in the course of treatment at every decision level. Although the science behind evidence-based medicine is rigorous, there are always exceptions. The recommendations are intended to guide healthcare decisons. These recommendations can be adapted to be applicable at various levels.




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