Evidence-Based Medicine and the American Thoracic Society Guidelines

To the Editor Given our roles in the development of American Thoracic Society (ATS) clinical practice guidelines, we have concerns about the recently published Research Letter by Schumacher and colleagues.¹

The study did not include 17 guidelines published since 2011 (Table), or more if earlier guidelines are also considered. Of the recommendations analyzed, 50% were from guidelines whose development predated publication of the Institute of Medicine’s 2011 standards for trustworthy guidelines² and/or the ATS’s implementation of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.