Guideline Development

CCS Guideline Development Process

The CCS is committed to developing statements that high quality and transparent.  In addition to the CCS specific procedures and policies, CCS follows the AGREE II Instrument as an overarching methodology to guide development. In addition, the CCS has adopted the GRADE Scale for rating the strength of recommendations and the quality of evidence. The following documents describe for co-chairs, panel members, members and CCS staff the policies and procedures for development of guidelines and position statements including special consideration of the “closed-loop” development programs for Heart failure and Atrial Fibrillation:

  • The CCS Guideline Development Policies and Procedures document addresses all policies and procedures related to the CCS development process including topic selection, panel selection, evidence review, defining and achieving consensus, statement format, approval process, CCC presentation and CJC publication for both guidelines and position statements.

  • To ensure high quality and transparency, the CCS strongly suggests all guideline and position statement developers use the international AGREE II Instrument as a tool for guiding development and assessing the quality and methodological transparency of guidelines. For a copy of the AGREE II Instrument and background information on AGREE II, please visit

  • To ensure high quality and transparency, the CCS has adopted the GRADE Scale for rating the strength of recommendations and the quality of evidence.  As of January 2010, the CCS uses the GRADE system of evidence assessment for all guidelines and position statements.   In June 2015, CCS developed a CCS Grade framework to guide co-chairs and writing panels through the systematic review of evidence and the application of GRADE when developing recommendations.  It is meant to be used as a framework to a more rigorous application of GRADE and is presented in five high level steps with examples for documentation that can be adapted to suit the specific needs of the writing panel.

CCS GP Pol proc
 Agree GradeFramwork

For more information on GRADE, please refer to the BMJ GRADE primer articles below:

Part 1 - GRADE: an emerging consensus on rating quality of evidence and strength of recommendations

Part 2 - GRADE: what is "quality of evidence" and why is it important to clinicians?

Part 3 - GRADE: going from evidence to recommendations

Part 4 - GRADE: grading quality of evidence and strength of recommendations for diagnostic tests and strategies

Part 5 - GRADE: Incorporating considerations of resources use into grading recommendations

Part 6 - Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive


Guidelines and Position Statements Currently Under Development

Guidelines and Position Statements Currently Under Development Co-Chairs Expected
Atrial Fibrillation Guideline Update Laurent Macle
Atul Verma
Jason Andrade
October 2018
CCS/CTS Joint Position Statementon Pulmonary Hypertension  L. Mielniczuk
D. Langleben
S. Mehta
October 2018
A Heart Team-based Approach to Percutaneous Mechanical Cardiac Support Devices in Cardiogenic Shock or High Risk Cardiac Interventions Hung Ly
Darren Free 
October 2018
CCS Guidelines on Management of Adults with Congenital Heart Disease A. Marielli
C. Silversides
October 2018
Familial Hypercholesterolemia R. Hegele
J. Genest
October 2018
Investigation and Management of Orthostatic Hypotension and Postural Tachycardia Syndrome Satish R Raj
J. Guzman
October 2018
CCS/CAIC Joint Position Statement on Management of ST-Elevation Myocardial Infarction in Canada W. Cantor
G. Wong
October 2018
Cardiovascular Pre-participation Screening of Athletes Amer Johri
P. Poirier
October 2018
Transcatheter Aortic Valve Implantation John Webb
A. Asgar
M. Ouzounian
October 2018
Management of Ventricular Tachycardia in Structural Heart Disease Marc Deyell
J. Sapp
October 2018
Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult    G. Pearson
G. Thanassoulis
October 2019
Heart Transplant Patient Eligibility, Selection, and Post-Transplant Care B. Clarke
S. Chih   
October 2019
Canadian Consensus Statement on Recent International Guidelines on the Assessment and Management of Syncope    R. Sandhuu
B. Sheldon
October 2019
An Update on Safety for Cardiovascular Patients Undergoing Magnetic Resonance Imaging I. Paterson
J. White
October 2019
CCS Position Statement on the Evaluation and Management of Patients with Cardiac Amyloidosis    M. Davis
N. Fine   
October 2019