title: Making the GRADE: CHEST Updates Its Methodology.
abstract: 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.
authors.affiliation: Doctor Evidence, Santa Monica, CA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Diekemper
authors.affiliation: CHEST, Glenview, IL. Electronic address: spatel@chestnet.org.
authors.forename: Sheena
authors.initials: S
authors.lastname: Patel
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Mette
authors.affiliation: CHEST, Glenview, IL.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ornelas
authors.affiliation: Henry Ford Hospital, Department of Pulmonary and Critical Care Medicine, Detroit, MI.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Ouellette
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Casey
mesh_terms: D003422:Critical Care / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D009937:Organizational Objectives; D017410:Practice Guidelines as Topic / Q000592:standards*; D015272:Pulmonary Medicine / Q000592:standards*; D012955:Societies, Medical; D014481:United States
keywords: evidence-based medicine; guidelines; research-clinical