Guideline Development

CCS Guideline Development Process

CCS is committed to developing statements that are 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 and has adopted the GRADE Scale for rating the strength of recommendations and the quality of evidence.

Development Resources

The following documents describe the policies and procedures for development of guidelines and clinical practice updates.

CCS Guidelines Development Procedures
and Policies


CCS Clinical Practice Updates: Purpose,
Process & Policies


AGREE II Instrument

Addresses all policies and procedures related to the CCS guideline development process including topic selection, panel selection, evidence review, defining and achieving consensus, statement format, approval process, CCC presentation and CJC publication.   Outlines  the  policies  and procedures that guide CCS and its affiliates in the development of Clinical Practice Updates (CPUs), including the processes of topic selection, co-chair selection, panel formation, format, review, approval and submission to the CJC.   CCS strongly suggests all guideline developers use the international AGREE II Instrument as a tool for guiding development and assessing the quality and methodological transparency of guidelines. Visit www.agreetrust.org for a copy of the AGREE II Instrument.
PDF   PDF     

CCS GRADE Framework

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 has used the GRADE system of evidence assessment for all guidelines and position statements. In June 2015, CCS developed a GRADE Framework to provide an overview of the systematic review of evidence and the application of GRADE when developing recommendations.


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 Statements Currently Under Development

Guidelines and Statements Currently Under Development

Co-Chairs Expected
CCS/CHRS Position Statement on the Management of Ventricular Tachycardia in Structural Heart Disease M. Deyell
J. Sapp

CCS Position Statement on Recent International Guidelines on the Assessment and Management of Syncope R. Sandhuu
B. Sheldon
CCS Atrial Fibrillation Guidelines Comprehensive Update J. Andrade
L. Macle
A. Verma
CCS Heart Failure Guidelines Update M. McDonald
S. Virani
CCS/CHFS Clinical Practice Update: HF Phenotype Pathway S. Zieroth
CCS Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult G. Pearson
G. Thanassoulis  
CCS/CACHnet Guidelines for the Management of Adults with Congenital Heart Disease A. Marelli
C. Silversides
CCS/CanSCMR Update on Safety for Cardiovascular Patients Undergoing Magnetic Resonance Imaging I. Paterson
J. White
CCS/CSE Position Statement on Indications and Appropriate Use of Echocardiography in Canada H. Leong-Poi
L. Rudski
CCS/CanCare/CNCS Position Statement on Neurologic Prognostication in the Post Cardiac Arrest Patient C. Fordyce
A. Kramer
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
G. Singh
CCS Clinical Practice Update on the Cardiovascular Management of the Pregnant Patient J. Windram
J. Grewal
CCS Guidelines on the Fitness to Drive and Fly P. Guerra
C. Simpson
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
CCS Guidelines on Peripheral Arterial Disease S. Anand
B. Abramson
M. Al-Omran
CCS/CANCARE/CSCS Guidelines on Post-Operative Critical Care Management of Patients Undergoing Cardiac Surgery A. Hassan
R. Arora
S. van Diepen
CCS/CPCA Clinical Practice Update on the Screening and Management of Lipid Disorders in Children and Adolescents B. McCrindle
M. Khoury
CCS Clinical Practice Update on Smoking Cessation and the Cardiovascular Specialist A. Pipe
A. Gupta
CCS Clinical Practice Update on Cardiac Tumors R. Cusimano
D. Jassal
CCS Clinical Practice Update on Measuring Long QTc R. Davies
C. MacIntrye