Amir Qaseem, MD, PhD, MHA; Devan Kansagara, MD, MCR; Jennifer S. Lin, MD, MCR; Reem A. Mustafa, MD, MPH, PhD; Timothy J. Wilt, MD, MPH; for the Clinical Guidelines Committee of the American College of Physicians *
Disclaimer: The authors of this article are responsible for its contents.
Financial Support: Financial support for the development of this paper comes exclusively from the ACP operating budget.
Disclosures: Authors have disclosed no conflicts of interest. Authors followed the policy regarding conflicts of interest described at www.annals.org/article.aspx?articleid=745942. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3290. All financial and intellectual disclosures of interest were declared, and potential conflicts were discussed and managed. Dr. Iorio acquired a high-level conflict (industry-supported chair endowment) during the course of works development and upon disclosure was recused from further discussion, authorship, and final manuscript approval. A record of disclosures of interest and management of conflicts of interest is kept for each CGC meeting and conference call and can be viewed at www.acponline.org/clinical_information/guidelines/guidelines/conflicts_cgc.htm.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Amir Qaseem, MD, PhD, MHA, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, email@example.com.
Current Author Addresses: Dr. Qaseem: 190 N. Independence Mall West, Philadelphia, PA 19106.
Dr. Kansagara: 3710 SW US Veterans Hospital Road, Portland, OR 97239.
Dr. Lin: 3800 North Interstate Avenue, Portland, OR 97227.
Dr. Mustafa: 3901 Rainbow Boulevard, MS3002, Kansas City, KS 66160.
Dr. Wilt: VA Medical Center 111-0, Minneapolis, MN 55417.
Author Contributions: Conception and design: A. Qaseem, D. Kansagara, R.A. Mustafa,
Analysis and interpretation of the data: A. Qaseem, D. Kansagara, R.A. Mustafa, T.J. Wilt.
Drafting of the article: A. Qaseem, D. Kansagara, T.J. Wilt.
Critical revision of the article for important intellectual content: A. Qaseem, D. Kansagara, J.S. Lin, R.A. Mustafa, T.J. Wilt.
Final approval of the article: A. Qaseem, D. Kansagara, J.S. Lin, R.A. Mustafa, T.J. Wilt.
Statistical expertise: A. Qaseem.
Administrative, technical, or logistic support: A. Qaseem, T.J. Wilt.
Collection and assembly of data: A. Qaseem, T.J. Wilt.
The American College of Physicians (ACP) was one of the first organizations in the United States to develop evidence-based clinical guidelines and has been developing guidelines since 1981. ACP's Clinical Guidelines Committee (CGC), in collaboration with staff from the Clinical Policy department, develops clinical guidelines and guidance statements and continues to refine and enhance its methodology. This article presents an update of the CGC's 2010 paper outlining policies, methods, and presentation format of ACP's clinical guidelines and guidance statements. Updated methods include more stringent policies about disclosure of interests and conflict management; inclusion of public perspective; full adoption of GRADE (Grading of Recommendations Assessment, Development and Evaluation) methods; more standardized reporting formats that consider value of care, patient comorbid conditions, patient values and preferences, and costs; and further clarification of guidance statement methods.
Table. Additions and Changes in the 2019 CGC Methods Paper Compared With the 2010 CGC Methods Paper
Overview of development and approval process for CGC clinical guidelines and guidance statements.
ACP = American College of Physicians; AGREE II = Appraisal of Guidelines for Research and Evaluation II; CGC = Clinical Guidelines Committee; PICO = population, interventions, comparators, and outcomes.
Grading the certainty of evidence and strength of recommendations for ACP clinical guidelines using GRADE.
ACP = American College of Physicians; GRADE = Grading of Recommendations Assessment, Development and Evaluation.
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Qaseem A, Kansagara D, Lin JS, Mustafa RA, Wilt TJ, for the Clinical Guidelines Committee of the American College of Physicians. The Development of Clinical Guidelines and Guidance Statements by the Clinical Guidelines Committee of the American College of Physicians: Update of Methods. Ann Intern Med. [Epub ahead of print 11 June 2019]170:863–870. doi: 10.7326/M18-3290
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Published: Ann Intern Med. 2019;170(12):863-870.
Published at www.annals.org on 11 June 2019
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