Table 2 Suggestions for improvement in the development and implementation of COPD guidelines

Development of CPG must be based on a validate method of evaluation and grading of evidence (GRADE or similar)

In areas in which GRADE may not be applied, consensus or opinion-based recommendations should be incorporated

A clear identification of evidence-based and consensus-based recommendations is mandatory for transparency

Clear and simple algorithms are necessary for interpretation and implementation

All stakeholders must participate in CPGs development

A common European guideline could be used as a reference and can be adapted to local health systems

The European Respiratory Society could be the platform to generate and discuss national European CPGs

Dissemination and adherence is crucial and new technologies may help to this objective

New studies are required to evaluate the impact of CPGs on clinical and economic outcomes in COPD