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In this issue of JAMA, Neuman et al1 assessed the proportion of class I clinical practice guideline recommendations from the American College of Cardiology/American Heart Association (ACC/AHA) that changed their level of support or were omitted from subsequent versions of the guideline. This is a significant topic as practice guidelines have become important tools to improve the quality of medical care. Practice guidelines are used by clinicians to help determine what care patients will receive, are used by patients to understand what their treatment options may be, are used to create performance measures to benchmark clinician care quality, and are used to help set payment policies (for example, the recommendations from the US Preventive Services Task Force and insurance coverage under the Affordable Care Act). Reflecting this increasing importance, the Institute of Medicine (IOM) recently released standards for developing clinical practice guidelines.2
Shekelle PG. Updating Practice Guidelines. JAMA. 2014;311(20):2072-2073. doi:10.1001/jama.2014.4950