Guidelines in pulmonary medicine: a 25-year profile.

Chest

Division of Pulmonary Medicine and Critical Care Medicine, Cedars-SinaiMedical Center, University of Los Angeles California,

Published: October 1999

AI Article Synopsis

  • The study aimed to identify and review clinical practice guidelines and articles related to pulmonary medicine published since 1974 in various peer-reviewed journals.
  • It analyzed a total of 271 articles, highlighting a predominance of consensus statements and expert opinions, while also noting a significant focus on conditions like asthma and COPD.
  • The findings suggest a growing trend in the publication of pulmonary guidelines over the years, but emphasize a lack of clinical testing through randomized controlled trials.

Article Abstract

Objective: We attempted to identify clinical practice guideline and pathway articles in the area of pulmonary medicine published in peer-reviewed journals since 1974.

Design: Review.

Data Sources: MEDLINE, the Cochrane Database, Best Evidence, and Abstracts of Clinical Care Guidelines from January 1974 to December 1998.

Study Selection: All articles contained relevant search terms for pulmonary topics and were included irrespective of setting (primary or specialty, inpatient or outpatient). Controlled and uncontrolled trials as well as observational studies and consensus opinion/statements were all identified. The articles were stratified by design as well as by pulmonary topic.

Data Extraction: Limited data on study type, study focus, year of publication, and results of study were abstracted.

Results: Our criteria yielded 271 articles, including 115 consensus statements and expert opinion guidelines; 30 controlled studies, meta-analyses, or systematic reviews; and 126 uncontrolled trials and observational studies. Of these, 82 articles (30.3%) related to asthma, 46 articles (17.0%) related to COPD, and 36 articles (13.3%) related to pneumonia. In addition, we tracked the increasing publication of all guideline-related pulmonary articles; randomized, controlled trials (RCTs); systematic reviews; and consensus statements by year for the past 25 years.

Conclusion: Pulmonary guidelines are increasingly published in peer-reviewed journals, but few are tested clinically in RCTs. There is continued reliance on consensus statements and expert opinion. Pulmonary guideline publications have continued to dramatically increase in number and in importance since 1974, both on the local level and internationally.

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Source
http://dx.doi.org/10.1378/chest.116.4.1046DOI Listing

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