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What’s new in pleural disease?
  1. Robert Campbell Rintoul1,2,
  2. Stefan John Marciniak2,3
  1. 1 Department of Oncology, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, UK
  2. 2 Department of Thoracic Oncology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, Cambridgeshire, UK
  3. 3 Department of Medicine, University of Cambridge, Cambridge, UK
  1. Correspondence to Professor Robert Campbell Rintoul, Department of Oncology, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SP, Cambridgeshire, UK; robert.rintoul{at}nhs.net

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This month sees publication of the new BTS guideline for pleural disease,1 the first update since 2010. In parallel, advice on pleural interventions is covered by the first BTS Clinical Statement on Pleural Procedures.2 Over the last decade, there has been a burgeoning interest in this subspeciality area and with this have come a number of advances driven by high-quality practice changing studies. For the 2023 update, rather than covering every aspect of pleural disease, the review committee has chosen to focus on spontaneous pneumothorax, undiagnosed unilateral pleural effusion, pleural infection and pleural malignancy (excluding pleural mesothelioma). As with other recent BTS guidelines, the aim is to provide high-quality evidence that has been reviewed and graded by a multidisciplinary guideline committee using the GRADE methodology.3 Although the evidence base for management of pleural disease has improved considerably, there are still a number of areas where high-quality evidence is lacking, and in these cases, lower grade evidence was considered alongside expert opinion via consensus. Unlike some guideline development organisations (eg, National Institute for Health and Care Excellence) cost-effectiveness was not considered in detail as in-depth economic analysis of recommendations falls outside of the scope of the BTS guideline production process.

So, …

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Footnotes

  • Twitter @rintoul_robert, @MarciniakLab

  • Contributors RCR first drafted the editorial that SJM modified. Both authors agreed final content.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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  • BTS Clinical Statement
    Rachelle Asciak Eihab O Bedawi Rahul Bhatnagar Amelia O Clive Maged Hassan Heather Lloyd Raja Reddy Helen Roberts Najib M Rahman
  • Guideline summary
    Mark E Roberts Najib M Rahman Nick A Maskell Anna C Bibby Kevin G Blyth John P Corcoran Anthony Edey Matthew Evison Duneesha de Fonseka Rob Hallifax Susan Harden Iain Lawrie Eric Lim David McCracken Rachel Mercer Eleanor K Mishra Andrew G Nicholson Farinaz Noorzad Kirstie S Opstad Maria Parsonage Andrew E Stanton Steven Walker