• chronic obstructive pulmonary disease
• NICE guidelines

Over the years Thorax has published a number of valuable clinical guidelines, and these have been subject to formal peer review as for any original paper.^1–13 With this issue of Thorax we publish as a supplement the full version of the clinical guidelines for the management of chronic obstructive pulmonary disease (COPD).¹⁴ Unlike the previous guidelines mainly produced through the Standards of Care Committee of the British Thoracic Society (BTS), these COPD guidelines have been developed by the NICE (National Institute for Clinical Excellence) Collaborating Centre for Chronic Conditions.

These COPD guidelines were not sent out for further review once received by Thorax as the review process within the guideline development programme has been formal and carried out according to the regulations for guideline development established by NICE. The guideline was developed and produced by the Guideline Development Group (GDG) which met regularly over an 18 month period and consisted of representatives of the BTS, nurses, physiotherapists, and patients. All the recommendations were then voted on by a larger multiprofessional group called the Consensus Reference Group (CRG).

Once all the recommendations were agreed upon by the GDG and CRG, the final draft was sent to stakeholders for comment and also placed on the NICE website. The various stakeholders included the Standards of Care Committee of the BTS who discussed the guidelines at one of their meetings. All the comments from the various stakeholders were then collated and responses were prepared. Any issues that arose from this round of consultation were discussed at a further meeting of the GDG and revisions to the guidelines were agreed. The next draft of the guideline was again placed on the NICE website for a second round of consultation. Any comments that were sent in about the guidelines were again considered, responded to, and the guideline revised. NICE has its own Guideline Review Panel which deals with both the content of the guideline and the methodology, and this panel also reviewed the second round version and raised a number of issues.

The process of guideline development through NICE does not allow for peer review at the time of submission to the journal. However, in view of the detailed process that had been followed in the guideline development, the Editors of Thorax were satisfied that the review process was fair and rigorous and that further peer review was not required before publication.

In addition, I have been a member of both the GDG and the CRG for these guidelines and have thus contributed directly to them. Membership of these guideline groups has allowed me to observe directly the review process during the guideline development programme. My research group has a major interest in exacerbations of COPD, and I have received grant funding for studies of COPD exacerbations together with honoraria for lectures and attendance at advisory boards from a number of pharmaceutical companies. Full details of my competing interests are located on the Thorax journal website at www.thoraxjnl.com.