The American College of Chest Physicians (CHEST) has been at the forefront of evidence-based clinical practice guideline development for more than two decades. In 2006, CHEST adopted a modified system of GRADE (Grading of Recommendations Assessment, Development and Evaluation) to support their rigorous guideline development methodology. The evolution of CHEST’s Living Guidelines Model as well as their collaborative efforts with other organizations has necessitated improvements in their guideline development methodology.
CHEST has made the decision to transition to the standard GRADE method for rating the certainty of evidence and grading recommendations in their evidence- based clinical practice guidelines, a deviation from the “modified” approach that was adapted in 2006.
A standard GRADE approach will be used to grade recommendations in all CHEST guidelines, including updates to previously published guidelines.
CHEST’s adoption of a standard GRADE approach will ensure that its guideline development methodology is more consistent with that used by other organizations, better align evidence synthesis methods, and result in more explicit and easy to understand recommendations.