On review of the 212 articles listed in Annals' online “Clinical Guidelines/Position Papers” collection (accessed 9 February 2009), I found 94 unique clinical guidelines. Excluding 2 updates on adult vaccination schedules, 54 of the remaining 92 guidelines used a grading system, whereas 28 guidelines systematically rated the quality of evidence supporting guideline recommendations. Eight of the 10 guidelines providing neither grade nor quality assessment were published before 1998, when such quality assessments became routine. Therefore, the guidelines by Krantz and colleagues are 1 of 2 guidelines published by Annals since 1998 that do not explicitly evaluate or grade the quality of evidence used in guideline recommendations. Using USPSTF criteria (3), the literature cited by Krantz and colleagues would result in a grade of I, indicating that the evidence is insufficient to determine the relationship between the benefits and harms of QTc screening. Had the authors expounded on this and incorporated recent methods (published in Annals) (4) for guidelines based on insufficient evidence, the reader would be better equipped to make rational clinical decisions.