The AGA Institute Process for Developing Clinical Practice Guidelines Part One: Grading the Evidence

This article, by Dr John Inadomi and colleagues, is the first of a 2-part series (the second part to be published later this year) on the AGA's process for developing guidelines. The importance of guidelines has increased considerably over the last 25 years. In the first wave of managed care, we were practicing with few if any clinical guidelines. Now, as we move forward toward a value-based reimbursement system, the need for evidence-based practice is paramount. Dr Inadomi and the AGA Clinical Practice and Quality Management Committee have fine-tuned this process over the last 3 years and now describe their results. While many guidelines are labeled as "GRADE," some are simply opinion documents designed with GRADE wording. A fully implemented GRADE process involves rigorous analysis of published data, input from trained GRADE methodologists, and opportunities for both public and expert comment from all involved stakeholders. John I. Allen, MD, MBA, AGAF Special Section Editor