title: An Official American Thoracic Society Workshop Report. A Framework for Addressing Multimorbidity in Clinical Practice Guidelines for Pulmonary Disease, Critical Illness, and Sleep Disorders.
abstract: Coexistence of multiple chronic conditions (i.e., multimorbidity) is the most common chronic health problem in adults. However, clinical practice guidelines have primarily focused on patients with a single disease, resulting in uncertainty about the care of patients with multimorbidity. The American Thoracic Society convened a workshop with the goal of establishing a strategy to address multimorbidity within clinical practice guidelines. In this Workshop Report, we describe a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations. For the consideration of multimorbidity in guidelines to be successful and sustainable, the process must be both feasible and pragmatic. It is likely that this will be achieved best by the step-wise addition and refinement of the various components of the framework.
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Wilson
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Gould
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Krishnan
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Boyd
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Brozek
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Colin R
authors.initials: CR
authors.lastname: Cooke
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Ivor S
authors.initials: IS
authors.lastname: Douglas
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Goodman
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Min J
authors.initials: MJ
authors.lastname: Joo
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lareau
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Mularski
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Minal R
authors.initials: MR
authors.lastname: Patel
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Rosenfeld
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Hasan
authors.initials: H
authors.lastname: Shanawani
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Christopher
authors.initials: C
authors.lastname: Slatore
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Marianna
authors.initials: M
authors.lastname: Sockrider
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Beth
authors.initials: B
authors.lastname: Sufian
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Carey C
authors.initials: CC
authors.lastname: Thomson
authors.affiliation: This official Workshop Report of the American Thoracic Society (ATS) was approved by the ATS Board of Directors December 2015.
authors.forename: Renda Soylemez
authors.initials: RS
authors.lastname: Wiener
mesh_terms: D015897:Comorbidity; D016638:Critical Illness / Q000453:epidemiology*; D019468:Disease Management; D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology*; D017410:Practice Guidelines as Topic / Q000592:standards*; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012955:Societies, Medical; D014481:United States
keywords: chronic conditions; comorbidity; guidelines; multimorbidity