Abstract
We appreciate Drs Nathanson and Oulette’s 1 response and concur that American College of Chest Physicians (now branded as CHEST) evidence-based guidelines (EBGs) are rigorously prepared and are of high quality. Notwithstanding their considerable value, CHEST EBGs still fail to achieve global coverage. To off er global coverage and relevance, EBGs must satisfy the condition of addressing clinical issues and circumstances of global patient populations (ie, patients throughout the range of socioeconomic circumstances and access to health-care technology and expertise). Our colleagues off er four lines of reasoning to defend their “pro” position; we believe that this rebuttal debunks each.
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