The past few weeks have been busy for clinical guidelines. Just last week the ACC Foundation (ACCF) and American Heart Association released a summary of changes to current ACCF/AHA Guideline methodology, in order to continue to develop timely clinical practice guidelines that also meet new Institute of Medicine (IOM) standards.

Earlier this week, the ACCF and AHA jointly released clinical practice guidelines for the management of ST-Elevation Myocardial Infarction (STEMI). The guidelines focus on clinical decision making at all stages, beginning with the onset of symptoms, and recommend regional systems of care to ensure that patients get immediate treatment, provide recommendations for the rapid restoration of flow down the obstructed coronary artery, and recommend post-hospitalization plans of care. A particular emphasis was placed on advances in reperfusion therapy, transfer algorithms, evidence-based antithrombotic and medical therapies, and secondary prevention strategies to optimize patient-centered care.

In addition, today the 2008 Device Based Therapy Guideline has been officially updated to include the focused update from earlier this year.

Since the early 1980s, the ACCF and AHA have jointly developed and published 17 clinical practice guidelines through a highly robust process.  These guidelines are broadly disease based, and focus on a shared commitment of translating the best available scientific evidence into clinical practice guidelines and performance measures that can be used by health care professionals to improve patient outcomes and quality cardiovascular care. Through the development of guidelines we have truly set a new standard of care.

Moving forward, the guidelines process and methodology will continue to evolve through ongoing process and methodology improvement initiatives that address how to best incorporate the continual stream of new knowledge while maintaining a robust process for development, peer review and organization approval.

With a rapidly changing field and continuously evolving science, it is more than ever important to stay relevant. We are always looking to improve and streamline processes, but it must be done in an evidence-based manner. Kudos to the practice guideline task force and STEMI writing committee for their hard work in developing these documents.
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