Doctor Evidence, Santa Monica, CA.
CHEST, Glenview, IL.
Chest. 2018 Mar;153(3):756-759. doi: 10.1016/j.chest.2016.04.018. Epub 2016 Apr 30.
The American College of Chest Physicians (CHEST) has been at the forefront of evidence-based clinical practice guideline development for more than 2 decades. In 2006, CHEST adopted a modified system of Grading of Recommendations Assessment, Development, and Evaluation (GRADE) 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 adopted in 2006. The 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, will better align evidence synthesis methods, and will result in more explicit and easy to understand recommendations.
美国胸科医师学会 (CHEST) 一直处于循证临床实践指南制定的前沿地位，已有 20 多年的历史。2006 年，CHEST 采用了改良的推荐评估、制定与评估 (GRADE) 分级系统，以支持其严格的指南制定方法。CHEST 不断发展的循证实践指南模型以及与其他组织的合作，都需要改进其指南制定方法。CHEST 决定在其循证临床实践指南中采用标准的 GRADE 方法来评估证据的确定性和分级推荐，这与 2006 年采用的改良方法有所偏离。标准 GRADE 方法将用于所有 CHEST 指南中的推荐分级，包括对先前发布的指南进行更新。CHEST 采用标准 GRADE 方法将确保其指南制定方法与其他组织使用的方法更加一致，更好地协调证据综合方法，并产生更明确和易于理解的建议。
