Methodologies for the development of CHEST guidelines and expert panel reports.

Area of Science:

• Clinical practice guidelines
• Medical evidence synthesis
• Healthcare decision-making

Background:

• The American College of Chest Physicians (CHEST) introduced a Living Guidelines Model for up-to-date clinical guidance.
• This model addresses gaps in evidence by incorporating expert insights.
• Guidance documents will be updated via evidence-based guidelines, consensus statements, or a hybrid approach.

Purpose of the Study:

• To describe the CHEST Living Guidelines Model.
• To outline the methodologies for developing evidence-based guidelines and consensus statements.
• To ensure sustainable and targeted clinical recommendations.

Main Methods:

• The Guidelines Oversight Committee (GOC) developed a rigorous process for evidence-based guidelines.
• A structured approach, including systematic literature review and expert panels, is used when evidence is insufficient for guidelines.
• The Delphi process is employed for consensus achievement when evidence is limited.

Main Results:

• Existing evidence can be combined with the Delphi process to create trustworthy consensus statements.
• The CHEST methodologies support both evidence-based guidelines and consensus statements.
• This approach ensures guidance is available even with limited peer-reviewed literature.

Conclusions:

• CHEST's guidance documents are based on rigorous methodology and transparency.
• These statements provide reliable guidance for healthcare providers and patients.
• The Living Guidelines Model promotes the maintenance of current and targeted recommendations.