2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk.

Filed under Consensus

PREFACE

The American College of Cardiology (ACC) develops a number of clinical policy documents to provide members with guidance on clinical topics. Although clinical practice guidelines remain the primary mechanism for offering evidence-based recommendations, such guidelines may contain gaps in their guidance regarding clinical decision making, particularly when equipoise is present in a topic. Expert Consensus Documents are intended to provide guidance for clinicians in areas where evidence may be limited, new and evolving, or lack sufficient data to fully inform clinical decision making. In an effort to increase the impact of ACC clinical policy on patient care, an ACC Presidential Task Force was formed in 2014 to examine the processes and format of ACC’s clinical documents. The main recommendation of the Task Force was a new focus on concise decision pathways and/or key points of care, instead of the traditional longer documents. The Task Force also established criteria for identifying high-value clinical topics to be addressed, as well as an innovative approach to collecting stakeholder input through roundtable or think tank meetings. To complement the new focus on brief decision pathways and key points, Expert Consensus Documents were rebranded Expert Consensus Decision Pathways (ECDPs). Although Decision Pathways have a new format, they maintain the same goal of Expert Consensus Documents: to develop clinical policy based on expert opinion in areas which important clinical decisions are not adequately addressed by the available existing trials. ECDPs are designed to complement the guidelines and bridge the gaps in clinical guidance that remain. In some cases, topics covered by ECDPs will be addressed subsequently by ACC/AHA guidelines as the evidence base evolves. The writing groups are charged with developing algorithms that are more actionable and can be implemented in the form of tools or apps to accelerate the use of these documents at point of care. Expert Consensus Decision Pathways are intended not to provide a single correct answer but to encourage clinicians to ask certain questions and consider important factors as they reach a decision on a treatment plan together with patients. There may be multiple pathways that can be taken for treatment decisions and the goal is to help clinicians and patients make a more informed decision together.

James L. Januzzi, MD, FACC

Chair, ACC Task Force on Clinical Expert Consensus Documents

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