COPD-X Methodology

COPD-X is produced by Lung Foundation Australia’s COPD Guidelines Committee, which meets to evaluate the current literature and undertake quarterly updates of the Guidelines. The Committee is comprised of a multidisciplinary group of national COPD opinion leaders with expertise in evidence-based medicine, as well as Lung Foundation Australia staff who represent consumer priorities and lived experience perspectives in relevant discussions as the national peak consumer organisation.

A PubMed systematic literature search is performed quarterly by the Guidelines Coordinator for new papers in COPD, emphysema and chronic bronchitis, encompassing systematic reviews, clinical trials, and cohort and case-control studies. Guidelines committee members also propose studies for inclusion in the screening and subsequent review process, noting their awareness of key evidence being published in their respective areas of expertise. The Guidelines co-chairs screen all abstracts for inclusion. Relevant papers are critically appraised by a committee member with expertise in that area.

At the full Committee meeting, a decision about whether to cite a paper is made by consensus, and wording for incorporation is discussed. When making changes to Guideline recommendations, the Committee preferences randomised controlled trials and meta-analyses. The healthcare setting and patient population are also considered for relevance. Study methodology, bias, consistency of results, applicability to local practice and magnitude of benefit are all considered. Potential harms and side effects are also discussed and reported. The Committee discusses all potential Guideline changes and always reaches a group consensus. Guideline updates are focused on changes that are likely to modify or influence practice. Any disagreement is resolved with discussion.

All recommendations are linked to the key evidence used in making the recommendation and this evidence is routinely reviewed and updated. Evidence summaries and tables are provided in the Guidelines. Economic evaluation and funding implications are beyond the scope of the Guidelines in their current format. Although current resources do not allow routine audit and analysis with respect to the impact of and adherence to the Guidelines, independent researchers frequently use the Guidelines to audit local practice.

The Guidelines are endorsed by the Thoracic Society of Australia New Zealand (TSANZ). The TSANZ Clinical Care and Resources Sub-committee provides annual external review and considers key findings and updates, and the strength of recommendations. The reviewers provide written feedback that is addressed by the co-Chairs and expert members as applicable. Furthermore, within the Lung Foundation Australia, key stakeholders such as general practitioners are also invited to provide regular feedback. Following the external approval process, the updated Guidelines including a summary of changes are uploaded quarterly to the COPD-X website (

Ongoing administrative, technical, logistical and financial support for the development of the COPD-X Guidelines is provided by Lung Foundation Australia as part of its national COPD program. This program receives sponsorship funding from a number of industry partners. Industry partners of Lung Foundation Australia have no direct or indirect influence over the content of the COPD-X Guidelines. Lung Foundation Australia has complete editorial and design control over the content of the COPD-X Guidelines as well as all other resources, promotions and educational programs. All members of the Guidelines committee serve as volunteers. No funding body has any influence on content or recommendations. Where applicable, Lung Foundation Australia funds members’ travel and accommodation for in-person Guidelines meetings. Committee members’ conflicts of interest are declared on an annual basis and can be viewed at: Any relevant potential conflict is addressed during the quarterly meetings.