What is CHEST's grading system?
CHEST's grading system uses the GRADE approach which is a 5-point Likert scale derived from the GRADE grid. This system is used to grade recommendations as either strong or weak according to the wording used, with strong recommendations using the wording 'we recommend' and weak recommendations using the wording 'we suggest'. The implications of the strength of recommendation are summarized in e-Table 2. In instances with insufficient evidence to grade, a weak suggestion is developed and labelled as an Ungraded Consensus-Based Statement. All drafted recommendations and suggestions are presented to the panel in an anonymous online voting survey to reach consensus, with each recommendation and statement requiring a 75% voting participation rate and at least 80% consensus to pass.