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ACCP’s Delphi Consensus Statement – Management of Spontaneous Pneumothorax

The objective of the study was to provide a professional and consensus recommendation on the management of adults suffering with spontaneous pneumothoraces, either in an emergency department or in an inpatient hospital setting. The opinions were explicit by the employment of structured questionnaire, consensus scores using Delphi technique and by appropriateness scores. The guidelines that were finalized were designed to being relevant to the physicians who are authorized to make decisions regarding the care of pneumothorax patients.

What were the options?

The options available for the study were chest tube placement, radiographic imaging, observation decision and surgical interventions.

What were the outcomes?

The outcomes that were gathered from the study were the duration of tolerance of patient care, recurrence of pneumothorax and effectiveness of resolution of pneumothorax.

What were the pieces of evidence?

The evidence of the study submitted was the literature review conducted from 1967 to 1999 along with Delphi questionnaire.


The values were gathered from the guideline development group that was determined by the consensus for relevant outcomes considered to develop Delphi questionnaire.

What were findings?

The study was to find out the magnitude and type of benefits, expected cost and harms for patients by implementing the guidelines.

What were the recommendations?

The recommendations made in the study were to varying the management decision between primary pneumothoraces patients and secondary pneumothoraces patients.


The recommendations were validated after being reviewed by American College of Chest Physician, Health & Science Policy Committee and top physician experts.


After being validated, the recommended guidelines were published in electronic and printed form that was distributed along with synopses for health care providers and patients.


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