British Thoracic Society publishes a Guideline and Clinical Statement on Pleural Disease

Today the British Thoracic Society (BTS) publishes two key guidance documents in the field of pleural disease, which refers to a range of respiratory disorders affecting the area between the lungs and the membrane lining the chest cavity and the surface of the lungs. The first document is a new BTS Guideline on Pleural Disease, building on the much-cited 2010 BTS guideline in this area. This is accompanied by the publication of a BTS Clinical Statement on Pleural Procedures.

The guidance documents were produced by a multidisciplinary group of experts, led by Professor Nick Maskell, Dr Mark Roberts and Professor Najib Rahman. Both documents reflect significant advances in the diagnosis and management of pleural disorders over recent years, drawing on the latest evidence in this clinical area and capturing best practice. The two documents are complementary and cross-reference each other throughout. While the Pleural Disease Guideline focuses on outlining new evidence and recommendations of investigation and treatment options, the Pleural Procedures Clinical Statement provides information on how to practically deliver the recommendations, including how interventions should be performed safely.

Najib Rahman, a Chair of both the BTS Guideline and the BTS Clinical Statement Group said,

“We are very excited at the release of these two important documents by BTS. There has been a huge shift in the evidence base for the diagnosis and management of pleural disease in the last decade, and an update to reflect current evidence and practice was much needed. We hope the guideline and the procedure statement will result in high quality care for our patients, and vital needed research in pleural disease.”

The new Guideline document includes evidence-based questions on the optimal management of malignant pleural effusion, pleural infection and pneumothorax, and the diagnosis of the unilateral pleural effusion. It provides a range of recommendations to help clinicians improve their daily practice, including the rationale and evidence behind the suggestions.

By comparison, the Pleural Procedures Clinical Statement covers practicalities of how to deliver pleural medicine across a number of areas including procedural specifics, safety, optimal biopsy strategies, and some of the more specialist pleural treatments that are now available including intra-pleural therapies.

Both documents are based on the best available and up to date evidence, aiming to help clinicians provide excellent care for patients. In aligning with the recommendations, it is intended that patients will benefit from seeing the range of potential treatments available to them as well as some of the rationale behind treatment selection. It is hoped that this will assist patients in choosing the best option for them, and support improving informed decision making at the individual level.

BTS Chair, Dr Paul Walker, comments,

“Both the Guideline and Clinical Statement for a pleural disease are an important contribution to delivering best practice in this area. Pleural management is complex and subject to past safety alerts but pleural specialists have already delivered dramatic improvement in pleural care around training standards, service organisation and service delivery. The new guidance further promotes quality improvement and helps empower clinicians to deliver this.”

The new Guideline and Clinical Statement for Pleural Disease are available here.