The ACC and American Heart Association (AHA) Guideline Recommendation Classification System continues to become more precise and rely more heavily on high-quality evidence, according to a statement from the ACC/AHA Task Force on Clinical Practice Guidelines, published Sept. 23 in the Journal of the American College of Cardiology.

The statement explains changes to the latest recommendation classification system, which have been integrated into the “ACC/AHA/HRS 2015 Guideline on the Management of Patients With Supraventricular Tachycardia,” and better align with the Institute of Medicine’s 2011 recommendations.

The latest classification system allows clinicians to compare the strength and quality of recommendations and evidence, respectively, with categories used by other guideline developers. In ACC/AHA guidelines, this includes the range in the Class of Recommendation (COR) from COR I to COR III, and the range of the Level of Evidence (LOE) from LOE A to LOE C, with further classification for randomized and non-randomized studies for LOE B. A new subcategorization has been added to LOE for lower-quality evidence, either because the data are limited (LOE C-LD) or because the recommendation is based on clinical evidence or consensus of expert opinion (LOE C-EO).

The Task Force notes that moving forward, “among the many remaining challenges are the development of more objective and standardized criteria for assessment of the quality of evidence, incorporation of cost and health economic methodology into guidelines, formulation of more efficient processes for revising and updating recommendations as new evidence emerges, and creation of tools to integrate context-sensitive guideline recommendations with electronic health records.”

Keywords: Advisory Committees, American Heart Association, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Resin Cements, Tachycardia, Supraventricular

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