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 www.agreetrust.org
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.

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 Completion
CCS Position Statement on the Investigation and Management of Orthostatic Hypotension and Postural Tachycardia Syndrome	S.R. Raj J. Guzman	Early 2020
CCS/CSCS/CAIC/CanCare Position Statement on a Heart Team-based Approach to Percutaneous Mechanical Cardiac Support Devices in Cardiogenic Shock or High Risk Cardiac Interventions	H. Ly D. Freed	Early 2020
CCS/CACHnet Guidelines for the Management of Adults with Congenital Heart Disease	A. Marielli C. Silversides	Early 2020
CCS/CHRS Position Statement on the Management of Ventricular Tachycardia in Structural Heart Disease	M. Deyell J. Sapp	Early 2020
CCS Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult	G. Pearson G. Thanassoulis	October 2020
CCS/CCTN Position Statement on Heart Transplant Patient Eligibility, Selection, and Post-Transplant Care	B. Clarke S. Chih	Early 2020
CCS Position Statement on Recent International Guidelines on the Assessment and Management of Syncope	R. Sandhuu B. Sheldon	Early 2020
CCS/CanSCMR Update on Safety for Cardiovascular Patients Undergoing Magnetic Resonance Imaging	I. Paterson J. White	Spring 2020
CCS/CHFS Position Statement on the Evaluation and Management of Patients with Cardiac Amyloidosis	M. Davis N. Fine	Spring 2020
CCS/CSE Position Statement on Indications and Appropriate Use of Echocardiography in Canada	H. Leong-Poi L. Rudski	October 2020
CCS/CanCare/CNCS Position Statement on Neurologic Prognostication in the Post Cardiac Arrest Patient	C. Fordyce A. Kramer	October 2020
CCS Comprehensive Atrial Fibrillation Guideline Update	J. Andrade L. Macle A. Verma	October 2020
CCS Guidelines on the Fitness to Drive and Fly	P. Guerra C. Simpson	October 2020
CCS/CHFS Guidelines on Use of AHA to Reduce CV and Renal Disease in Patients with Type 2 Diabetes Mellitus	J. Mancini E. O’Meara	October 2020
CCS Guidelines on Peripheral Arterial Disease	S. Anand B. Abramson M. Al-Omran	October 2020
CCS/CANCARE/CSCS Guidelines on Post-Operative Critical Care Management of Patients Undergoing Cardiac Surgery	A. Hassan R. Arora S. van Diepen	October 2020
CCS Clinical Practice Update on the Cardiovascular Management of the Pregnant Patient	J. Windram J. Grewal	Summer 2020
CCS/CPCA Clinical Practice Update on the Screening and Management of Lipid Disorders in Children and Adolescents	B. McCrindle M. Khoury	Summer 2020
CCS Clinical Practice Update on Smoking Cessation and the Cardiovascular Specialist	A. Pipe A. Gupta	Summer 2020
CCS Clinical Practice Update on Cardiac Tumors	R. Cusimano D. Jassal	Summer 2020
CCS Clinical Practice Update on Measuring Long QTc	R. Davies C. MacIntrye	Summer 2020