President’s Message: ATS Clinical Guidelines
The American Thoracic Society annual conference is a well-known resource for members to learn about cutting edge science and practical treatments. Additionally, throughout the year, the ATS produces a number of additional resources and documents designed to keep members informed of the latest research and treatment options. Among those resources are clinical practice guidelines, which answer important clinical questions with actionable recommendations. These resources are created by ATS members but are used by the entire medical community.
Clinical practice guidelines make recommendations for patient care, based upon a systematic review or pragmatic evidence synthesis, and are then formulated and graded using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. For every guideline that is published in the blue journal, a clinical summary for clinicians is submitted to the Annals of the American Thoracic Society. These clinical summaries provide continuing medical education (CME) credits through the Accreditation Council for Continuing Medical Education (ACCME). An annual Guidelines Symposium is held at the ATS International Conference during which the recommendations from new ATS guidelines are presented publicly, often for the first time. The Symposium is a conference highlight. At the 2018 ATS International Conference in San Diego, we needed two overflow areas to accommodate participation.
There are several advantages to the guidelines. For clinicians, the guidelines improve compliance with best practices, as well as improve clinical outcomes. They are also a step closer to direct patient care than other types of academic work. For the Society at large, there are also benefits. Because they are highly cited, they boost the ATS journals. Similarly, guidelines symposia are well-attended and popular at the ATS conference. Guidelines are often co-sponsored by other organizations and, therefore, they are an opportunity for collaboration.
The ATS releases clinical practice guidelines throughout the year, as they become available. For example, the ATS recently released new clinical practice guidelines to help physicians diagnose primary ciliary dyskinesia (PCD), a rare, chronic disease that affects breathing beginning very early in life. For over four decades, transmission electron microscopy (TEM) has been used to diagnose PCD on the basis of defects in the ciliary axoneme, the central core of the cilium. TEM is not highly sensitive or specific in diagnosing PCD, and several adjuvant diagnostic methods have emerged. The committee found that in the absence of a single definitive test for PCD, a panel of tests can be used to make the diagnosis, which are detailed within the guidelines. The full results and final guideline recommendations are available online and in the June 15 edition of the Society’s American Journal of Respiratory and Critical Care Medicine.
On September 1, the Society will release new guidelines on idiopathic pulmonary fibrosis (IPF) in collaboration with the European Respiratory Society (ERS), the Japanese Respiratory Society (JRS), and the Latin American Thoracic Society (ALAT). The guidelines will update the diagnostic criteria for IPF, based on syntheses and recommendations formulated by a multidisciplinary committee of IPF experts. Once the results are published, the ATS will provide an online opportunity for discussion with the authors of the report, via Twitter. Details will be included in ATS newsletters once the event is finalized. Other forthcoming guidelines will discuss treatment of obesity in obstructive sleep apnea (OSA), as well as management of malignant pleural effusions.
Archived resources from the two most recent releases, Lymphangioleiomyomatosis (LAM) and PCD, are still available. Twitter conversations with experts in LAM and PCD are archived in ‘Moments’ on the @atscommunity page. Members can also access an explainer video on LAM, and a webinar on PCD which was originally hosted as part of PCD Week at the ATS in conjunction with PAR Partner, the PCD Foundation.
To view ATS clinical practice guidelines along with other ATS documents such as policy statements, research statements, technical standards, and workshop reports visit the ATS website. The website will also be updated with video content following each guideline publication.
