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Ann Intern Med. 2019 Jun 18;170(12):863-870. doi: 10.7326/M18-3290. Epub 2019 Jun 11.

The Development of Clinical Guidelines and Guidance Statements by the Clinical Guidelines Committee of the American College of Physicians: Update of Methods.

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American College of Physicians, Philadelphia, Pennsylvania (A.Q.).
Oregon Health & Science University and Veterans Affairs Medical Center, Portland, Oregon (D.K.).
Kaiser Permanente Northwest, Portland, Oregon (J.S.L.).
University of Kansas Medical Center, Kansas City, Kansas (R.A.M.).
Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota (T.J.W.).


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.


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