Idiopathic pulmonary fibrosis: guidelines for diagnosis and clinical management have advanced from consensus-based in 2000 to evidence-based in 2011.

I diopathic pulmonary fibrosis (IPF) is increasingly recognised as a well-known clinical and highly complex entity associated with poor prognosis and a median survival of 3–5 yrs after the diagnosis is made. The importance of the need for an accurate diagnosis and appropriate clinical management is evident. In this regard, the first statement/guidelines on the clinical management of IPF, jointly produced by the American Thoracic Society (ATS) and the European Respiratory Society (ERS), provided recommendations that were essentially based on the consensus of the opinions of a few experts, as the evidence available at that time was minimal [1]. In 2000, when the statement was published, the common practice was to develop guidelines based upon available research using a consensus-based approach to formulate recommendations for management. Thus, the recommendations suggested in the first statement were based on a consensus of opinions more than the evidence. Over the years, this approach has evolved and most guideline developers are now using a more robust methodological approach; the umbrella term is ‘‘evidencebased medicine’’, which includes grading of the evidence using a standard system (e.g. Grading of Recommendations Assessment, Development and Evaluation (GRADE)).