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Opinion Editorials represent the opinions of the authors and JAMA EDITORIAL and not those of the American Medical Association. Paul G. Shekelle, MD, PhD In this issue of JAMA, Neuman et al assessed the proportion toexplicitlyreconsideratregularintervalswhetherotherchanges of class I clinical practice guideline recommendations from the may have occurred that might warrant an update, in particular American College of Cardiology/American Heart Association changes in the outcomes that are considered important and (ACC/AHA) that changed their level of support or were omitted changes in the values placed on those outcomes. For example, from subsequent versions of the current reassessments of recommendations for screening the guideline. This is a signifi- mammography are in large part due to the increased recognition Related article page 2092 cant topic as practice guide- of overdiagnosis as an outcome of interest. Less likely, but still lines have become important worth considering as criteria that might warrant an update, are tools to improve the quality of medical care. Practice guide- whether there are changes in the evidence that current practice lines are used by clinicians to help determine what care pa- is optimal or in the resources available for health care. tients will receive, are used by patients
JAMA – American Medical Association
Published: May 28, 2014
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