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Point and Counterpoint |

COUNTERPOINT: Are the CHEST Guidelines Global in Coverage? NoCHEST Guidelines Are Not Global

Atul C. Mehta, MD, FCCP; Amit Banga, MD, FCCP; James K. Stoller, MD, FCCP
Author and Funding Information

From the Respiratory Institute (Drs Mehta, Banga, and Stoller) and the Education Institute (Dr Stoller), Cleveland Clinic.

CORRESPONDENCE TO: Atul C. Mehta, MD, FCCP, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave, A-90, Cleveland, OH 44195; e-mail: Mehtaa1@ccf.org


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(1):13-15. doi:10.1378/chest.14-2235
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Extract

Clinical practice guidelines have proliferated in the last decade, with > 3,700 guidelines reported in the Guidelines International Network database.1 In chest medicine alone, > 150 current guidelines are posted on the websites of official international societies, including the American College of Chest Physicians (now branded as CHEST).2 A central goal in developing guidelines is to provide evidence-based recommendations to optimize care for as many patients as possible. In this context, guidelines should be broadly applicable to impact the care of the most patients possible. Indeed, as stated in CHEST’s Evidence-Based Medicine Overview,3 “our guidelines are used throughout the world” and “have received considerable acclaim and worldwide use.” Also articulating these goals and in keeping with early recommendations,4 the American Thoracic Society Guide to Guidelines for Professional Societies states that guidelines should incorporate “consideration of cost-effectiveness, affordability, and resource implications” and “stakeholder involvement: how to do it right.”5 Key characteristics of an optimal guideline were considered the ability to (1) “globalize the evidence,” (2) “identify ways that help guideline consumers understand and implement guidelines,” (3) “focus on questions that are important to patients and clinicians,” and (4) ensure “adaptation, applicability, and transferability of guidelines.”5

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