The purpose of this focused update is to update the “2013 ACCF/AHA Guideline for the Management of Heart Failure” 9 (2013 HF guideline) in areas in which new evidence has emerged since its publication. When a formal systematic review has been commissioned, the recommendations developed by the writing committee on the basis of the systematic review are marked with “SR”. ERC members may include methodologists, epidemiologists, healthcare providers, and biostatisticians. Criteria for commissioning an ERC and formal systematic review include: a) the absence of a current authoritative systematic review, b) the feasibility of defining the benefit and risk in a time frame consistent with the writing of a guideline, c) the relevance to a substantial number of patients, and d) the likelihood that the findings can be translated into actionable recommendations. This systematic review will strive to determine which patients are most likely to benefit from a drug, device, or treatment strategy and to what degree. Only key references are cited.Īn independent evidence review committee (ERC) is commissioned when there are 1 or more questions deemed of utmost clinical importance that merit formal systematic review. 4 – 7 Literature searches focus on randomized controlled trials (RCTs) but also include registries, nonrandomized comparative and descriptive studies, case series, cohort studies, systematic reviews, and expert opinion. When developing recommendations, the writing committee uses evidence-based methodologies that are based on all available data. 5 – 8Įvidence Review and Evidence Review Committees For additional information and policies regarding guideline development, we encourage readers to consult the ACC/AHA guideline methodology manual 4 and other methodology articles. Publication of new, potentially practice-changing study results that are relevant to an existing or new drug, device, or management strategy will prompt evaluation by the Task Force, in consultation with the relevant guideline writing committee, to determine whether a focused update should be commissioned. To ensure that guideline recommendations remain current, new data are reviewed on an ongoing basis, with full guideline revisions commissioned in approximately 6-year cycles. Recognizing the importance of cost-value considerations in certain guidelines, when appropriate and feasible, an analysis of the value of a drug, device, or intervention may be performed in accordance with the ACC/AHA methodology. Ongoing efforts to further limit text are underway. Given time constraints of busy healthcare providers and the need to limit text, the current guideline format delineates that each recommendation be supported by limited text (ideally, <250 words) and hyperlinks to supportive evidence summary tables. Similarly, the presentation and delivery of guidelines are reevaluated and modified on the basis of evolving technologies and other factors to facilitate optimal dissemination of information at the point of care to healthcare professionals. The ACC/AHA Task Force on Clinical Practice Guidelines (Task Force) continuously reviews, updates, and modifies guideline methodology on the basis of published standards from organizations including the Institute of Medicine 1,2 and on the basis of internal reevaluation. Reviewer Relationships With Industry and Other Entities (Comprehensive) e158 Author Relationships With Industry and Other Entities (Relevant) e156Īppendix 2. Sleep-Disordered Breathing: Recommendations e149Īppendix 1. Treating Hypertension in Stage C HF pEF: Recommendation e149ĩ.6. Treating Hypertension in Stage C HF rEF: Recommendation e149ĩ.5.3. Treating Hypertension to Reduce the Incidence of HF: Recommendation e149ĩ.5.2. Pharmacological Treatment for Stage C HF pEF: Recommendations e146ĩ.5.1. Renin-Angiotensin System Inhibition With Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker or ARNI: Recommendations e144ħ.3.2.11. Pharmacological Treatment for Stage C HF With Reduced Ejection Fraction: Recommendations e144ħ.3.2.10. Biomarkers for Prognosis or Added Risk Stratification: Recommendations e142ħ.3.2. Biomarkers for Diagnosis: Recommendation e142Ħ.3.3. Biomarkers for Prevention: Recommendation e142Ħ.3.2. Initial and Serial Evaluation of the HF Patient e141Ħ.3.1.
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