Guideline summary

Introduction Lung cancer is the leading cause of cancer mortality in Australia. In July 2025, the Australian Government launched the National Lung Cancer Screening Program (the Program). The Program has been designed in accordance with the Medical Services Advisory Committee's recommendations. This article summarises the program guidelines, outlining Program parameters and delivery requirements. The screening and assessment pathway defines the Program structure. The purpose of the guidelines is to ensure safe, effective and high-quality Program delivery, detailing key steps for clinical practice and information for participating healthcare providers.Main RecommendationsThe guidelines provide recommendations for the delivery of targeted low-dose CT screening for lung cancer in the Australian context.Program eligibility is assessed using risk-based eligibility criteria recommended by the Medical Services Advisory Committee, targeting people between 50 and 70 years of age with a history of tobacco cigarette smoking.Smoking cessation supports are to be offered to all potential participants by healthcare providers across the lung cancer screening and assessment pathway.Low-dose CT scan assessment and reporting follow the National Lung Cancer Screening Program's nodule management protocol.Changes in Management as a Result of the GuidelineThis guideline provides recommendations for the delivery of targeted low-dose CT screening for lung cancer in the Australian context. Content includes: guidance on assessing Program eligibility; enrolling eligible participants in the National Cancer Screening Register; completing and fulfilling low-dose CT scan requests; assessing and reporting low-dose CT scan results; managing scan outcomes and actionable additional findings; and communicating scan results. The full guideline is available at https://www.health.gov.au/resources/publications/nlcsp-guidelines.

Nicole M. Rankin, Rebecca Zosel, Lisa J. Whop, Raglan Maddox, Annette McWilliams, Miranda Siemienowicz, Jon Emery, Maria A. R. Lantin, Georgia Bartlett, Mikayla Wolfe, Abbey Diaz, Katrina Anderson, Lillian Liu, Cindy Toms, Sarah McDermott, Peter Bligh, Jeremy Chalke, Stephen Melsom, Claire E. Nightingale, Alison Brown, Sam Pope, Julia Brotherton, Anne Fidler, Michel Itel, Mark Brooke, Diane M. Pascoe, Fraser Brims, Tracy L. Leong, Emily Stone, Dorothy Keefe, Vivienne Milch

Introduction: Older people face higher risks of medicine-related harm due to polypharmacy and the use of potentially inappropriate medicines. Current treatment guidelines rarely specify when to stop medicines, leading to medicines often being continued indefinitely without a clear deprescribing plan. While deprescribing guidelines exist for some medicine classes, limited guidance is a major barrier to deprescribing. These new guidelines address this gap by providing structured recommendations that complement more detailed drug-specific deprescribing guidance, disease-specific therapeutic guidelines and non-pharmacological management resources. These guidelines were developed by a team of 72 experts, including consumer representatives, and were further shaped by feedback from public consultation and independent reviewers.Main Recommendations: The guidelines are intended for all healthcare professionals involved in prescribing, dispensing or administering medicines to older people. The guidelines specifically address polypharmacy and medicines commonly dispensed for regular use in people aged ≥ 65 years, as well as other medicines where there is evidence to consider deprescribing in this cohort. The guidelines provide 185 consensus-based recommendations and 70 good practice statements, covering both specific medicine categories and general deprescribing principles. The guidelines are structured into four areas: (1) when to deprescribe; (2) ongoing treatment needs; (3) how to deprescribe; and (4) monitoring requirements.Changes in Care as a Result of the Guideline: This guideline emphasises deprescribing as an integral part of the prescribing continuum. Applying a deprescribing approach encourages prescribers to consider the ongoing need for a medicine each time a prescription is re-issued, to balance benefits and harms as they evolve over time, and to ensure treatment decisions reflect an individual's goals through shared decision-making. The guideline was developed based on currently available evidence for deprescribing and expert multidisciplinary and consumer input. It supports health professionals in reviewing regular medicines, minimising harm and planning ongoing treatment or monitoring. The detailed guideline is available at https://deprescribing.com.

Stephen Tucker, John D. G. Watson, Donna Wellins, Tim Whitmore, Christopher Etherton-Beer, Amy T. Page

Introduction The Australian Guidelines for the Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder were released in May 2025. These guidelines, updated from the 2016 Australian Guide, were developed through extensive stakeholder consultation, a comprehensive review of empirical evidence and the application of a novel Grading of Recommendations, Development and Evaluation (GRADE)-based approach for developing evidence-based diagnostic criteria. Recommendations The guidelines include 11 GRADE-based recommendations, forming the core of the diagnostic criteria, and 11 lived experience statements, supporting client-centred assessment approaches. The guidelines also feature 40 good practice statements and 18 implementation considerations, tools and tips as practical resources and supports for practitioners. Changes in Management as a Result of the Guidelines Key changes in the new guidelines include: A minimum prenatal alcohol exposure threshold for diagnosis to support more precise identification of fetal alcohol spectrum disorder (FASD); The assessment of neurodevelopmental impairments and functioning has been refined, including detailed advice for practitioners seeking to identify clinically significant impairments; Inclusion/exclusion of neurodevelopmental domains as part of the assessment; and Revisions to some of the content of the included neurodevelopmental domains. Changes have also been made with attention to the needs of First Nations Australians and people from other culturally and linguistically diverse backgrounds. The guidelines advocate for the use of shared decision-making approaches, promoting collaboration between practitioners, individuals attending for assessment and their support network. Importantly, the guidelines will enable an accessible, holistic and flexible assessment process, supporting timely and accurate assessment and diagnosis of FASD in Australia. The rigorous development process also provides practitioners with confidence in the guidelines, promoting increased uptake of assessment and diagnostic practices, and informing international diagnostic criteria and guidelines.

Natasha Reid · Nicole Hewlett, Nicole Hayes, Zachary Munn, Haydn Till, Delyse Hutchinson · James Stewart, Max Naglazas, Andrea Crawford, Raewyn C. Mutch, Carmela F. Pestell, Rowena Friend, Lisa K. Akison · Chelsea Vanderpeet, Prue Walker, Matthew Gullo, Doug Shelton, Elizabeth J. Elliott, Fiona Kay, Katrina Harris, Jayden Logan, Storm Anderson · Natalie R. Kippin, Seema Padencheri, Sophie Harrington, Diana Barnett, Kelly Skorka, Robyn Doney · Philippa Middleton

IntroductionThe Australian clinical guideline for diagnosing and managing acute coronary syndromes 2025 establishes a new clinical standard for the diagnosis and management of acute coronary syndromes (ACS) in Australia. The new guideline replaces the 2016 guideline, representing the first major update in nearly a decade.Main RecommendationsThe new guideline features critical new information, including: (1) new terminology and revised definition of myocardial infarction; (2) electrocardiogram (ECG) patterns of acute coronary occlusion myocardial infarction (ACOMI), beyond ST-segment elevation; (3) use of clinical decision pathways incorporating high-sensitivity cardiac troponin (hs-cTn) assays for more efficient risk assessment; (4) stronger emphasis on the optimal timing of primary percutaneous coronary intervention in people with ST-segment elevation myocardial infarction (STEMI); (5) use of intravascular imaging-guided percutaneous coronary intervention in people with non-ST-segment elevation acute coronary syndromes (NSTEACS); (6) treatment guidance for specific groups, including those with cardiogenic shock, multivessel disease or spontaneous coronary artery dissection; (7) timing of platelet P2Y12 inhibitor administration in STEMI and NSTEACS; (8) more detailed advice on post-discharge care, including cardiac rehabilitation and secondary prevention programs, medicine adherence strategies, vaccinations and screening for mental health conditions; (9) treatment algorithms to enable more tailored prescribing of antiplatelet and anticoagulation therapies; (10) new recommended treatment target for low-density lipoprotein cholesterol (LDL-C); and (11) new recommendations on select medicines including PCSK9 inhibitors, β-blockers and angiotensin receptor-neprilysin inhibitors.Changes in Management as a Result of the GuidelineThe new guideline introduces key practice changes including broader recognition of ECG patterns of ACOMI, integration of hs-cTn testing into clinical decisions pathways and selective use of intravascular imaging in NSTEACS. Updated P2Y12 inhibitor timing, stricter LDL-C targets and PCSK9 inhibitor use support more tailored and evidence-based care in the secondary prevention of ACS. The full guideline is available at www.heartfoundation.org.au/for-professionals/acs-guideline.

David B. Brieger, Louise A. Cullen, Tom G. Briffa, Sarah Zaman, Ian A. Scott, Cynthia Papendick, Elaine Ho, Victoria Leitch, Dannii Dougherty, Garry Jennings

These first Australian evidence-based guidelines will serve as a clinical aid to practitioners who provide services to men with infertility and will facilitate evidence-based care for the most common areas of male infertility

Darren J Katz · Liza O’Donnell · Robert I McLachlan · Tim J Moss · Clare V Boothroyd · Veena Jayadev · Sarah R Catford

A summary of recommendations and practice points for key population subgroups who were identified as potentially benefitting from routine hepatocarcinoma surveillance in the form of ultrasound scans, with or without ?-fetoprotein testing

Jacob George · Nicole L Allard · Stuart K Roberts · Leon A Adams · Jane Davies · Behzad Hajarizadeh · Jennifer H MacLachlan · Suzanne E Mahady · Rosalie Altus · Catherine Brown · David C Fry · Belinda Greenwood‐Smith · Natali Smud · Patricia C Valery · Nafisa Yussf · Kate Broun · Denise Campbell · Karen Canfell · Chelsea Carle Harrison · Victoria Freeman · Paul Grogan · Catherine Holliday · Suzanne Hughes · Anna Kelly · Cathelijne Kemenade · Claire Latumahina · Amanda McAtamney · Megan Varlow · Joachim Worthington · Susan Yuill · Eleonora Feletto

Poor bone health is highly treatable with appropriate widely available lifestyle and dietary measures and pharmacological agents; the updated guideline is an evidence-based pragmatic tool to assist general practitioners in the day-to-day care of such patients in partnership with bone specialists

Peter Wong · Weiwen Chen · Dan Ewald · Christian Girgis · Morton Rawlin · John Tsingos · Justine Waters

The 2023 International evidence-based guideline for the assessment and management of polycystic ovary syndrome provides updated evidence-based recommendations for the clinical assessment and management of polycystic ovary syndrome

Helena J Teede · Aya Mousa · Chau T Tay · Michael F Costello · Leah Brennan · Robert J Norman · Alexia S Pena · Jacqueline A Boyle · Anju Joham · Lorna Berry · Lisa Moran

If we are to offer accessible, equitable, cost-effective fertility services to people who desire a child, we need to align to best practice evidence

For the Australian NHMRC Centre for Research Excellence in Reproductive Life UI Guideline Network and the ESHRE guideline group for unexplained infertility

The 2023 SOMANZ guideline presents significant updates on evidence-based recommendations for screening, prevention and management of hypertensive disorders of pregnancy

Renuka Shanmugalingam · Helen L Barrett · Amanda Beech · Lucy Bowyer · Tim Crozier · Amanda Davidson · Marloes Dekker Nitert · Kerrie Doyle · Luke Grzeskowiak · Nicole Hall · Hicham Ibrahim Cheikh Hassan · Annemarie Hennessy · Amanda Henry · David Langsford · Vincent WS Lee · Zachary Munn · Michael J Peek · Joanne M Said · Helen Tanner · Rachel Taylor · Meredith Ward · Jason Waugh · Linda LY Yen · Ellie Medcalf · Katy JL Bell · Deonna Ackermann · Robin Turner · Angela Makris

The 2023 Australian CVD guideline provides a pathway for early detection, clinical assessment and management of CVD risk

Mark R Nelson · Emily Banks · Alex Brown · Clara K Chow · David P Peiris · Nigel P Stocks · Rebecca Davies AO · Natalie Raffoul · Lisa Kalman · Emily Bradburn · Garry Jennings

Management of critical bleeding requires a multidisciplinary approach to haemorrhage control, correction and prevention of coagulopathy, and normalisation of physiological derangements

for the Clinical and Consumer Reference Group for the Update of Patient Blood Management Guidelines (Module 1: Critical Bleeding/Massive Transfusion)

Despite the large national DFD burden, Australian regions implementing guideline-based care have demonstrated large reductions in their regional DFD burdens and costs

Peter A Lazzarini · Anita Raspovic · Jenny Prentice · Robert J Commons · Robert A Fitridge · James Charles · Jane Cheney · Nytasha Purcell · Stephen M Twigg

The incidence, prevalence and burden of chronic kidney disease in First Nations Australians is one of the highest in the world, which is reflective of the social gradient of disadvantage

David J Tunnicliffe · Samantha Bateman · Melissa Arnold‐Chamney · Karen M Dwyer · Martin Howell · Azaria Gebadi · Shilpa Jesudason · Janet Kelly · Kelly Lambert · Sandawan William Majoni · Dora Oliva · Kelli J Owen · Odette Pearson · Elizabeth Rix · Ieyesha Roberts · Ro‐Anne Stirling‐Kelly · Kimberly Taylor · Gary A Wittert · Katherine Widders · Adela Yip · Jonathan Craig · Richard K Phoon

Opioid deprescribing is a complex and challenging practice, with continued prescribing the default behaviour

Aili V Langford · Christine CW Lin · Lisa Bero · Fiona M Blyth · Jason Doctor · Simon Holliday · Yun‐Hee Jeon · Joanna Moullin · Bridin Murnion · Suzanne Nielsen · Rawa Osman · Jonathan Penm · Emily Reeve · Sharon Reid · Janet Wale · Carl R Schneider* · Danijela Gnjidic*

The Taskforce has made seven specific recommendations on care for pregnant women and those who have recently given birth

for the National COVID‐19 Clinical Evidence Taskforce

Eight drug treatments are currently recommended for people who do not require supplemental oxygen and six for those who do

Heath White · Steve J McDonald · Bridget Barber · Joshua Davis · Lucy Burr · Priya Nair · Sutapa Mukherjee · Britta Tendal · Julian Elliott · Steven McGloughlin · Tari Turner

The COPD-X guidelines aspire to standardise COPD care, optimise health outcomes, and enhance the quality of life of people with COPD

Eli Dabscheck · Johnson George · Kelcie Hermann · Christine F McDonald · Vanessa M McDonald · Renae McNamara · Mearon O’Brien · Brian Smith · Nicholas A Zwar · Ian A Yang

The Care of Older People and Palliative Care Panel developed two clinical flow charts with practice points providing guidance on the delivery of quality geriatric and palliative care during the COVID-19 pandemic

for the National COVID‐19 Clinical Evidence Taskforce

These revised guidelines have three key recommendations which provide evidence-based advice on how to reduce the health risks from alcohol consumption

Katherine M Conigrave · Robert L Ali · Rebecca Armstrong · Tanya N Chikritzhs · Peter d’Abbs · Mark F Harris · Nicole Hewlett · Michael Livingston · Dan I Lubman · Anne McKenzie · Colleen O’Leary · Alison Ritter · Scott Wilson · Melanie Grimmond · Emily Banks

Clinical guidelines must be continually updated and tailored to specific populations, including children and adolescents.

Clinical care of children and adolescents with COVID-19: recommendations from the National COVID-19 Clinical Evidence Taskforce

Introduction: The 2001 Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Islander populations were revised in 2010. This 2020 update by the Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children used for the first time the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Main recommendations: We performed systematic reviews of evidence across prevention, diagnosis, prognosis and management. We report ten algorithms to guide diagnosis and clinical management of all forms of otitis media. The guidelines include 14 prevention and 37 treatment strategies addressing 191 questions. Changes in management as a result of the guidelines: A GRADE approach is used. Targeted recommendations for both high and low risk children. New tympanostomy tube otorrhoea section. New Priority 5 for health services: annual and catch‐up ear health checks for at‐risk children. Antibiotics are strongly recommended for persistent otitis media with effusion in high risk children. Azithromycin is strongly recommended for acute otitis media where adherence is difficult or there is no access to refrigeration. Concurrent audiology and surgical referrals are recommended where delays are likely. Surgical referral is recommended for chronic suppurative otitis media at the time of diagnosis. The use of autoinflation devices is recommended for some children with persistent otitis media with effusion. Definitions for mild (21–30 dB) and moderate (> 30 dB) hearing impairment have been updated. New “OMapp” enables free fast access to the guidelines, plus images, animations, and multiple Aboriginal and Torres Strait Islander language audio translations to aid communication with families.

Amanda J Leach · Peter S Morris · Harvey LC Coates · Sandra Nelson · Stephen J O'Leary · Peter C Richmond · Hasantha Gunasekera · Samantha Harkus · Kelvin Kong · Christopher G Brennan‐Jones · Sam Brophy‐Williams · Kathy Currie · Sumon K Das · David Isaacs · Katherine Jarosz · Deborah Lehmann · Jarod Pak · Hemi Patel · Chris Perry · Jennifer S Reath · Jessica Sommer · Paul J Torzillo

Introduction: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) cause significant morbidity and premature mortality among Australian Aboriginal and Torres Strait Islander peoples. RHDAustralia has produced a fully updated clinical guideline in response to new knowledge gained since the 2012 edition. The guideline aligns with major international ARF and RHD practice guidelines from the American Heart Association and World Heart Federation to ensure best practice. The GRADE system was used to assess the quality and strength of evidence where appropriate.Main recommendations: The 2020 Australian guideline details best practice care for people with or at risk of ARF and RHD. It provides up‐to‐date guidance on primordial, primary and secondary prevention, diagnosis and management, preconception and perinatal management of women with RHD, culturally safe practice, provision of a trained and supported Aboriginal and Torres Strait Islander workforce, disease burden, RHD screening, control programs and new technologies.Changes in management as a result of the guideline: Key changes include updating of ARF and RHD diagnostic criteria; change in secondary prophylaxis duration; improved pain management for intramuscular injections; and changes to antibiotic regimens for primary prevention. Other changes include an emphasis on provision of culturally appropriate care; updated burden of disease data using linked register and hospitalisations data; primordial prevention strategies to reduce streptococcal infection addressing household overcrowding and personal hygiene; recommendations for population‐based echocardiographic screening for RHD in select populations; expanded management guidance for women with RHD or ARF to cover contraception, antenatal, delivery and postnatal care, and to stratify pregnancy risks according to RHD severity; and a priority classification system for presence and severity of RHD to align with appropriate timing of follow‐up.

Anna P Ralph · Sara Noonan · Vicki Wade · Bart J Currie

Since the publication of the previous guidelines in 2015, further evidence has emerged that has led to a change in management of paracetamol poisoning

Angela L Chiew · David Reith · Adam Pomerleau · Anselm Wong · Katherine Z Isoardi · Jessamine Soderstrom · Nicholas A Buckley

New Australian clinical practice guideline recommendations to assist GPs with the diagnosis and management of work-related mental health conditions

Danielle Mazza · Samantha P Chakraborty · Bianca Brijnath · Heather Nowak · Cate Howell · Trevor Brott · Michelle Atchison · David Gras · Justin Kenardy · Richard Buchanan · Seyram Tawia