Canadian Cardiovascular Society

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.

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.

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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.

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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 for a copy of the AGREE II Instrument.

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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.

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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 – GRADE: Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive

Guidelines and Statements Currently Under Development

Guidelines and Statements TitleCo-ChairsExpected Completion
CCS/CanCare/CNCS Position Statement on Neurologic
Prognostication in the Post Cardiac Arrest Patient
C. Fordyce
A. Kramer
CCS Clinical Practice Update on Measuring Long QTcR. Davies
C. MacIntyre
CCS/CHFS Clinical Practice Update: HF Phenotype PathwayS. Zieroth2022
CCS Guidelines on the Fitness to Drive and FlyP. Guerra
C. Simpson
CCS/CSE Position Statement on Indications and Appropriate Use of Echocardiography in CanadaH. Leong-Poi
L. Rudski
CCS/CANCARE/CSCS Guidelines on Post-Operative Critical Care Management of Patients Undergoing Cardiac SurgeryA. Hassan
R. Arora
S. van Diepen
CCS Clinical Practice Update on Smoking Cessation and the Cardiovascular SpecialistA. Pipe
A. Gupta
CCS Clinical Practice Update on Cardiac TumorsR. Cusimano
D. Jassal
CCS Guidelines on Presentation, Diagnosis, and Medical Update of the Management of Heart Failure in ChildrenA. Jeewa
J. Conway
CCS/CAIC Focused Update of the Guidelines for the Use of Antiplatelet TherapyK. Bainey
G. Marquis-Gravel
CCS/CSCS/CSVS/CAIR CPU: The Aortic Team Model and Collaborative Decision Pathways for the Management of Complex Aortic Disease -A Multi-Society Expert ConsensusS. McClure2023
CCS Clinical Practice Update on the Contemporary Management of the Patient with Hypertrophic CardiomyopathyA. Crean
R. Tadros
CCS/Canadian Women’s Heart Health Alliance (CWHHA) Clinical Practice Update on Myocardial Infarction with No Obstructive Coronary Artery Disease (MINOCA)C. Pacheco
T. Coutinho
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