About Guidelines and Clinical Policy

The American College of Cardiology provides a framework of evidence-based clinical policy and guidelines developed by leaders in the field of cardiovascular medicine.

• Clinical Policy Approval
• ACC Clinical Policy Definitions
• Methodology
• Relationship with Industry Policy

Clinical Policy Approval

ACC clinical policy are approved by either the Clinical Policy Approval Committee or the Lifelong Learning Oversight Committee, depending on policy type.

• Clinical Policy Approval Committee | The Clinical Policy Approval Committee is the central approval body for Appropriate Use Criteria, Clinical Practice Guidelines, Concise Clinical Guidance, Expert Consensus Decision Pathways, ACC Scientific Statements, and Performance Measures, Data Standards.
• Lifelong Learning Oversight Committee | The Lifelong Learning Oversight Committee is the approval body for ACC Competence and Training Statements.

ACC Clinical Policy Definitions

• Appropriate Use Criteria | Appropriate Use Criteria (AUC) define common clinical scenarios for specific disease states and provide ratings indicating when testing/procedures are reasonable. AUC methodology involves writing groups that create patient scenarios and independent rating panels that use a modified Delphi process to classify options as Appropriate, May Be Appropriate, or Rarely Appropriate. While AUC do not replace clinician judgment or experience, they serve as tools to enhance patient care and cost-effectiveness. Ratings consider scientific evidence, costs, alternative tests, and physician judgment.
  Oversight Committee: SSOC | Approval Body: CPAC | Publication: JACC
• Clinical Practice Guidelines (ACC/AHA) | Developed through a rigorous review of medical literature, Clinical Practice Guidelines define the role of diagnostic and therapeutic interventions—both noninvasive and invasive—in managing cardiovascular diseases. They assist clinicians in clinical decision-making by outlining a range of acceptable approaches for diagnosis, management, and prevention. Recommendations are categorized using a classification system grading the strength of the recommendation and the level of evidence. Guidelines are developed in partnership with the American Heart Association.
  Oversight Committee: ACC/AHA JCCPG | Approval Body: ACC: CPAC/SQC; AHA: SACC/EC | Publication: ACC: JACC; AHA: CIRC
• Competence and Training | ACC develops competencies covering a cardiologist's career spectrum, from core and advanced training to ongoing practice, as well as competencies for nurse practitioners and physician associates. These competencies—both clinical and nonclinical—define the knowledge, skills, and behaviors expected of cardiologists that align with the six ACGME/ABMS competency domains and contribute to the Entrustable Professional Activities (EPAs) the ACC has defined for the cardiovascular profession. Each competency statement includes assessment tools for evaluating proficiency and identifying learning needs.
  Oversight Committee: CMC | Approval Body: LLOC | Publication: JACC
• Concise Clinical Guidance | Concise Clinical Guidance policy provide clear, focused guidance, using figures, tables, and checklists to illustrate clinical decision-making processes. Consensus- and evidence-based, these translate research into practice by outlining actionable steps to support clinicians at the point of care.
  Oversight Committee: SSOC | Approval Body: CPAC | Publication: The JACC Journals
• Expert Consensus Decision Pathways | Expert Consensus Decision Pathways (ECDPs) offer "how to" guidance in areas where evidence is limited, new, or evolving. s, These share expert consensus on key clinical questions using figures and tables to clarify complex decisions clinicians face in everyday practice. ECDPs complement Clinical Practice Guidelines by transforming recommendations into practical, actionable insights.
  Oversight Committee: SSOC | Approval Body: CPAC | Publication: JACC
• Expert Consensus Systems of Care | Systems of Care summarize ACC and partner society positions on the organization, delivery, and quality of cardiovascular care. As new technologies rapidly evolve, these consensus statements help establish benchmarks for clinicians, institutions, and health care systems to optimize access and outcomes. Wherever feasible, recommendations are evidence-based.
  Oversight Committee: SSOC | Approval Body: CPAC | Publication: JACC
• Performance Measures | Performance Measures for cardiovascular diseases and procedures support the implementation of evidence-based guidelines. They help practitioners assess and improve care quality by defining specific, measurable elements of care. Developed in collaboration with the American Heart Association, these measures provide tools for evaluation and improvement.
  Oversight Committee: ACC/ AHA JCPM | Approval Body: ACC: CPAC/SQC; AHA: SACC/EC | Publication: ACC: JACC; AHA: CIRC
• Scientific Statements | Scientific Statements provide expert analyses of emerging clinical challenges or trends in cardiovascular care, particularly in areas classified as Class 2a or 2b in the latest ACC/AHA Clinical Practice Guidelines. They offer timely synthesis of available evidence to answer therapeutic and clinical questions, helping clinicians integrate new scientific developments into practice with consensus recommendations.
  Oversight Committee: SQC/SPC Leadership | Approval Body: CPAC | Publication: JACC

ACC = American College of Cardiology; AHA = American Heart Association; CIRC = Circulation; CMC = Competency Management Committee; CPAC = Clinical Policy Approval Committee; EC = Executive Committee; JACC = Journal of the American College of Cardiology; JCCPG = Joint Committee on Clinical Practice Guidelines; JCPM = Joint Committee on Performance Measures; LLOC = Lifelong Learning Oversight Committee; SACC = Science Advisory and Coordinating Committee; SQC = Science and Quality Committee; SPC = Scientific Publications Committee; SSOC = Solution Set Oversight Committee

Methodology

The methods ACC uses to develop clinical policy and guidelines:

• Practice Guidelines: Methodology Manual and Policies From the ACCF/AHA Task Force on Practice Guidelines
  • 2025 ACC/AHA Clinical Practice Guidelines Core Principles and Development Process JACC
  • 2025 Guidance for Incorporating FDA Processes into the ACC/AHA Clinical Practice Guideline Methodology JACC
  • 2025 AHA/ACC Statement on Cost/Value Methodology in Clinical Practice Guidelines JACC
  • 2019 Innovations, Modifications, and Evolution of ACC/AHA Clinical Practice Guidelines JACC
  • 2017 Clinical Practice Guideline Implementation Strategies JACC
  • 2015 Clinical Practice Guideline Recommendation Classification System JACC
  • 2014 Clinical Practice Guidelines, the Evolution and Future: A 30-Year Journey JACC
  • 2012 Guideline Methodology Summit Report JACC
• Expert Consensus Decision Pathways: 2019 Methodology for Creating Expert Consensus Decision Pathways (J Am Coll Cardiol 2019; 74:1138-50)
• Appropriate Use Criteria: ACC Appropriate Use Criteria Methodology: 2018 Update (J Am Coll Cardiol 2018;71:935-48)
• Data Standards: ACC/AHA 2007 Methodology for the Development of Clinical Data Standards (J Am Coll Cardiol 2007;49:831-7 )
• Performance Measures: ACC/AHA Methodology for the Selection and Creation of Performance Measures for Quantifying the Quality of Cardiovascular Care (J Am Coll Cardiol 2005;45:1147–56)

Relationships with Industry Policy

• Relationships with Industry and Other Entities: AHA/ACC Policies for Development of Guidelines, Performance Measures, and Data Standards
• Relationships with Industry and Other Entities Policy (ACC-led Policy)