Spotlight on ATS Committees: Documents Development & Implementation Committee

Michael K. Gould, MD, MS

Michael K. Gould, MD, MS, chair of the ATS Documents Development and Implementation Committee (DDIC), talks about what he and his fellow members are doing to advance the Society’s mission of improving the quality of life of patients with lung diseases, critical illnesses and sleep disorders.

Q. What is the genesis of your committee? When was it established? And what is its charge?
 
A. The DDIC was established in 2005 under the leadership of its inaugural chair, Holger Schunemann, MD, PhD, with the charge of developing policy concerning the creation, review and implementation of official ATS documents. In practice, this included a major effort to bring our documents up to speed with the rapidly evolving science of clinical practice guideline development, in order to maximize their validity, methodological rigor and impact. We made enormous strides toward achieving these goals under the leadership of Jerry Krishnan, MD, PhD, my immediate predecessor, who currently serves as the committee’s vice chair.

Q. Would you say your committee’s focus has changed in the last several years?

A. Given the rapid evolution of DDIC policies and procedures over the last several years, we have actively reached out to project chairs, assembly chairs and the ATS membership at large to educate them about the entire development process—from the initial submission of the project proposal to peer review and approval by the Board of Directors.  We have developed a series of educational vignettes and PowerPoint slides, and posted them on the DDIC Web site, along with the authoritative “Guidelines for ATS Documents.”  In addition, DDIC members are now assigned as a liaison to each project team, in order to facilitate timely communication and troubleshoot any problems that arise. Finally, Kevin Wilson, MD, the Society’s new Documents Editor, has been incredibly helpful to developers by providing timely suggestions for improvement and moving documents rapidly through peer review.

Q. What would you count as your major accomplishments to date?

A. The DDIC is most proud of how the quality and impact of ATS documents continue to improve over time, but we also aim to be responsive to developers and make sure that they are supported appropriately. Accordingly, the ATS hired expert methodologist Jan Brozek, MD, PhD, to work with developers who require assistance. Other specific accomplishments include the introduction of GRADE as the preferred methodology for appraising evidence and rating recommendations; the codification of different types of documents, each with their own methodological standards; implementation of an online system for submitting documents and tracking their progress through peer review; and the establishment of a process for identifying high-priority targets for the development of future documents. 

Toward all of these ends, our committee helped to develop the ATS/ERS Guidelines Conference and Workshop, co-chaired by Dr. Schunemann and Mark Woodhead, MD, which brought together many of the world's experts in guidelines science to provide leadership and direction to the guideline community on a diverse set of topics ranging from globalizing evidence to COI to stakeholder involvement. The proceedings of this conference will be published in PATS in early 2012.

In 2012, ATS leaders will invite members to submit proposals for the development of clinical practice guidelines on mechanical ventilation in ARDS as part of the Society’s first-ever “Request for Documents.”

Q. As an expert in health policy and services, how is the perspective you bring to the table unique?

A. My background in evidence-based medicine, clinical epidemiology and health services research is directly relevant to the work of the DDIC. Having served as a developer of clinical practice guidelines and several other ATS documents, I have a good understanding of the challenges that are faced by project teams and how they can be overcome. My background in health policy serves as a constant reminder that ATS documents must be responsive to the needs of their target audiences of clinicians, patients, policy-makers and society at large.

Q. Is the make-up of your committee representative of the Society’s membership at large or does it represent a “subset” of ATS members?

A. The members of the DDIC are as diverse as the membership at large. Several members are experts in evidence-based medicine, but we also have clinical experts and outstanding bench scientists. The latter is particularly important, considering the scientific research focus of many ATS statements. Of course, we also get tremendous, indispensible support from ATS staff members, especially Judy Corn and Jessica Wisk.

Q. What other projects are in the works?

A. One of our benchmarks for this year is to streamline policies and procedures governing the development of joint guidelines and statements. To accomplish this, we have entered discussions with the ERS and other societies to address such topics as the development of a joint policy for disclosure and management of conflicts of interest, the use of a single project proposal application and the adoption of a shared methodology for developing guidelines.  

Q. Do you see many opportunities for collaboration with other ATS committees?

A. The DDIC collaborates actively with the Program Review Subcommittee to review new project applications and with the Education Committee to develop educational materials that will accompany our clinical practice guidelines. In the coming year, we plan to collaborate with the Quality Improvement Committee, under the leadership of Jeremy Kahn, MD, MS, to develop a process for translating one of our guidelines into a set of performance measures, filling a major unmet need and possibly creating a source of revenue down the road.

Q. How can interested ATS members learn more about the committee’s work?

A. We encourage members to contact the DDIC with questions and suggestions. Those regarding ATS policies on official document development and implementation can be directed to me at Michael.K.Gould@kp.org. Methodological questions related to conducting literature searches, evaluating the evidence base and formulating recommendations for care can be sent to ATS methodologist Jan Brozek, MD, PhD, at brozekj@mcmaster.ca. Those in interested in learning more about the review process used for official ATS documents should be sent to ATS documents editor Kevin Wilson, MD, at kwilson@uptodate.com. And if you need help getting started with documents development, Judy Corn is always available to answer questions. Send her an e-mail at jcorn@thoracic.org.

Meet the Members of the ATS Documents Development & Implementation Committee
Michael K. Gould, MD, MS, chair
Jerry A. Krishnan, MD, PhD, vice chair
David B. Badesch, MD
Jan L. Brozek, MD, PhD
Colin R. Cooke, MD
Judy Corn, staff
Gerard J. Criner, MD
Maureen R. George, PhD, RN
Nicholas S. Hill, MD (non-voting member)
Min J. Joo, MD
Monica Kraft, MD (non-voting member)
Suzanne C. Lareau, RN, MS, FAAN
Victor E. Laubach, PhD
Milo A. Puhan, MD
Dean E. Schraufnagel, MD, (ex-officio and non-voting member)
Marianna M. Sockrider, MD, PhD
Gerard M. Turino, MD
Jadwiga A. Wedzicha, MD
Kevin C. Wilson, MD
Robert A. Wise, MD
Jessica Wisk, staff