Appropriate Use Criteria (AUC) consist of common clinical scenarios associated with given disease states and ratings that define when it is reasonable to perform testing and, importantly, when it is not. AUC methodology relies on content development work groups, which create patient scenarios, and independent rating panels, which use a modified Delphi process to rate the relevant options for testing and intervention as Appropriate, May Be Appropriate, or Rarely Appropriate. AUC should not replace clinician judgment and practice experience, but rather function as tools to improve patient care and health outcomes in a cost-effective manner. Current scientific evidence is provided as one element for consideration during rating but cost, other tests, and physician judgment also are implicitly considered. Appropriate Use Criteria fall under the purview of the Solution Set Oversight Committee and are published in JACC.

Clinical alerts respond to new clinical information and evidence, which may or may not be covered in existing ACC clinical policy, that could affect patient morbidity or mortality. Generally, they do not exceed 1,000 words and are developed rapidly in response to time-sensitive clinical issues. Clinical alerts are official policy of the College, and are published on and in JACC.

The ACC develops competencies to cover the entire career spectrum of a cardiologist, from core cardiovascular training to advanced cardiovascular training and throughout practice. These competencies – both clinical and nonclinical – define the knowledge, skills, and behaviors that physicians, patients, the public, and accrediting bodies can reasonably expect clinical cardiologists in training to achieve and those in practice to maintain or enhance throughout the span of their career. ACC's competencies are developed using the 6 ACGME/ABMS competency domains that lead to the overarching Entrustable Professional Activities (EPAs) for cardiology that were developed and approved by ACC. Each competency and training statement contains examples of assessment tools that can be used to obtain objective evaluation of competence and needs assessment. These competencies represent official ACC policy and are published in JACC and other journals as appropriate. These documents fall under the purview of the ACC Competency Management Committee. For more information, please visit the competencies webpage here.

The ACC recognizes the importance of refining the lexicon used to describe the process and outcomes of clinical care, whether in randomized trials, observational studies, registries, or quality-improvement initiatives. Broad professional agreement on a common vocabulary with common definitions will facilitate cross-study comparisons or, when advantageous, combining of data across studies and will improve the assessment of any project's generalizability to clinical practice. Under the purview of the ACC/AHA Task Force on Clinical Data Standards, the ACC and AHA have undertaken the development and publication of clinical data standards, sets of standardized data elements and corresponding definitions that can be used in a variety of data collection efforts for a range of cardiovascular conditions. In addition to the expertise of the members of the ACC/AHA Task Force on Clinical Data Standards and related writing committees, current scientific evidence, clinical trials, and national registries, provide the foundation for the selection and definition of data elements. Data Standards are published in JACC.

Expert Consensus Decision Pathways (ECDPs) offer guidance where evidence may be limited, new, or evolving or where there is lack of sufficient data. The methodology for ECDPs is grounded in assembling a group of clinical experts to develop content that builds consensus advice to support clinical decision(s) around topics where there is a need for guidance, but that has not yet been addressed elsewhere. They are not meant to be a comprehensive academic review, rather answer a few key clinical questions using figures and/or tables to illustrate the clinical decision-making process. ECDPs often function as a complement to the knowledge provided by Clinical Practice Guidelines transforming recommendations into clinically actionable information.

Expert Consensus Systems of Care Documents (ECSOCDs) are intended to summarize the position of the ACC and partnering societies on the availability, delivery, organization, and quality of cardiovascular care with the intention of establishing appropriate benchmarks. With the rapid evolution and dissemination of new technologies for treatment of patients with cardiovascular disease, there is an imperative for the practicing community to work together to identify the provider, institutional and systems-based standards for the delivery of high-quality care, in the spirit of optimizing the balance between access to services and quality outcomes. Wherever feasible, recommendations are evidence based.

Both ECDPs and ECSOCDs fall under the purview of the Solution Set Oversight Committee, are official ACC policy and are published in JACC.

Health Policy Statements generally promote or advocate the ACC's approach to health care policies and programs (e.g., value-based care, retrospective review) and are aimed at external stakeholders, including health systems, government agencies, and standards organizations. Health Policy Statements are not intended to offer clinical guidance for treating patients, though they periodically focus on clinical topics. These statements are official ACC policy and are published in JACC.

The development of physician-level Performance Measures for important cardiovascular diseases and procedures is intended to promote the implementation of evidence-based guidelines. The intent of these measures is to provide practitioners with an opportunity to measure the quality of care for cardiovascular patients and to identify areas for further improvement. While these measures are based on and directly promote the use of ACC/AHA Practice Guidelines, it is important to note that they are not practice guidelines. Rather, they are specific measures that are indicative of quality, evidence-based care. As state and federal level efforts to measure quality and publicly report outcomes continue to expand, it is important that physicians be involved in every step of the process. As such, the ACC, through the ACC/AHA Task Force on Performance Measures, will continue to ensure that cardiovascular specialists play a central and guiding role in defining and measuring quality of care. ACC/AHA Performance Measures are published in JACC and Circulation.

Clinical Practice Guidelines are developed through a rigorous methodological approach that mandates the review and consideration of the available medical literature. Practice Guidelines define the role of specific diagnostic and therapeutic modalities, including noninvasive and invasive procedures, in the diagnosis and management of patients with various cardiovascular diseases. These evidence-based guidelines are intended to assist physicians in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions. They attempt to define practices that meet the needs of most patients in most circumstances by categorizing the recommendations into a classification system. The development of Practice Guidelines is the domain of the ACC/AHA Task Force on Practice Guidelines. Practice Guidelines are published in JACC and Circulation.

Consensus Conference Reports: Consensus conferences are designed to facilitate consideration of significant and timely issues regarding the practice of cardiovascular medicine and matters affecting patient care, research, and training for which data are incomplete. Appropriate organizations other than the ACC are invited to send representatives to participate in the process. These may include physicians and health care specialists as well as representatives from industry, government, foundations, and the public sector. A report is published to highlight recommendations, along with dissenting opinion, if appropriate. Consensus Conference Reports generally evolve as conference proceedings. They include a disclaimer that the recommendations in the report are those of the conference participants and do not necessarily reflect the official position of the ACC. Consensus Conference Reports are published in JACC.

Survey and Data Reports: Survey and Data Reports are developed by an ACC Committee for the sole purpose of presenting data and/or scientific research evolving from a Committee initiative. The articles undergo a modified peer review process, including the groups that sponsored the articles, and are published in JACC. The articles represent the views of the writers and carry the caveat that the findings and conclusions in the report are those of the writing committee and do not necessarily reflect the official position of the ACC.