Guideline Development

CCS Guideline Development Process

The CCS Council appoints Co-chairs who then select the panel members and oversee the development of CCS statements in accordance with CCS policies and procedures. 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 Heart Failure Guidelines: Comprehensive Rewrite and 2017 Update	J. Ezekowitz E. O'Meara	October 2017
Focused Update on CCS Guidelines for the Use of Antiplatelet Therapy	S. Mehta JF. Tanguay	October 2017
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