Dear Editor,

We appreciate the interest of Passos and Lourenço in our clinical practice guideline (CPG). We hope our CPG positively contributes to the care of critically ill patients. CPGs add to the body of scientific evidence that supports clinical decision making, policy making, and education.1 Most important, CPGs are intended to improve patient outcomes.

From a methodological perspective, the American Association for Respiratory Care has evolved in how CPGs are developed. Goodfellow2 notes this change in the July 2024 issue of Respiratory Care. This systematic approach to guideline development is necessary for meeting international standards to avoid bias, summarize the evidence, and provide readers with a resource to develop protocols, further test hypotheses, and ultimately guide patient care.1 Importantly, we have adopted the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to developing CPGs.3 The GRADE process has 2 components—a systematic review of the certainty of evidence and development of recommendations.4,5

Our …

Correspondence: Karsten J Roberts MSc RRT FAARC, Thomas Jefferson University, College of Health Professions, Respiratory Therapy, 130 South 9th Street, Philadelphia, PA 19107. E-mail: karsten.robertsjefferson.edu.