Diagnosis and Management of Cough: ACCP Evidence-Based Clinical Practice Guidelines

T he American College of Chest Physicians (ACCP) finds it imperative to include individuals who are experts in their respective fields on guideline development committees. Recommendations and publications that are the resulting products from these committees will have far-reaching significance that may affect multiple aspects of the practice of chest medicine throughout the world. Therefore, it is essential that the ACCP have full disclosure of outside interests from those individuals serving on policy development committees, including liaison representatives from outside organizations. In the ever-changing field of medicine, it is important and necessary to have access to up-to-date information. New studies that may have become available late in the process of guideline development may not be incorporated into this document. Therefore, the reader is encouraged to seek out newer information that might impact the diagnostic and treatment recommendations contained within the guideline. Clinical practice guidelines are developed to enhance the clinician’s ability to practice evidence-based medicine and also to provide an opportunity for the busy clinician to receive the latest evidence on a particular topic. The information provided in the guideline should be used in conjunction with clinical judgment. Although the guideline provides recommendations that are based on evidence from studies involving various populations, the recommendations may not apply to every individual patient. It is important for the physician to take into consideration the role of patient preferences and the availability of local resources. The ACCP is sensitive to concerns that nationally and/or internationally developed guidelines are not always applicable in local settings. Further, guideline recommendations are just that, recommendations not dictates. In treating patients, individual circumstances, preferences, and resources do play a role in the course of treatment at every decision level. Although the science behind evidence-based medicine is rigorous, there are always exceptions. The recommendations are intended to guide health-care decisions. These recommendations can be adapted to be applicable at various levels. Correspondence to: Richard S. Irwin, MD, FCCP, University of Massachusetts Medical School, Room S6-842, 55 Lake Ave North, Worcester, MA 01655-0330; e-mail: irwinr@ummhc.org