Idiopathic pulmonary fibrosis - clinical management guided by the evidence-based GRADE approach: what arguments can be made against transparency in guideline development?

Bram Rochwerg,Holger J Schünemann,Ganesh Raghu

doi:10.1186/s12916-016-0563-0

Abstract

Evidence-based guidelines have undergone an incredible transformation over the last number of years. Significant advances include explicit linkages of systematic evidence summaries to the strength and direction of recommendations, consideration of all patient-important factors, transparent reporting of the recommendation generation process including conflict of interest management strategies and the production of clinical practice guidelines which use simple and clear language. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology provides a framework for guideline development and was employed to produce the recently published ATS/ERS/JRS/ALAT update on treatment for idiopathic pulmonary fibrosis (IPF). Herein we discuss the advantages of using an evidence-based approach for guideline development using the IPF process and resultant document as an example.

Highlights

Evidence-based guidelines have undergone intense evolution over the last 15 years [1,2,3,4]
This distinction represents a typical misunderstanding as even in the era of evidence-based guidelines, recommendations are developed by clinical experts in the field and require consensus of panel members on the best possible treatment options
It is the transparent link between the evidence and the recommendations and the requirement of making structured expert judgments that represents a shift in the guideline development paradigm

Summary

Introduction

Evidence-based guidelines have undergone intense evolution over the last 15 years [1,2,3,4]. This distinction represents a typical misunderstanding as even in the era of evidence-based guidelines, recommendations are developed by clinical experts in the field and require consensus of panel members on the best possible treatment options.

Results

Conclusion