Most Current ACEP Clinical Practice Guidelines Are Based on Expert Opinion and Low-Quality Evidence

A 26-year review found that the proportion of clinical policies based on low-level evidence has increased significantly over time.

Clinical policies have been developed by the American College of Emergency Physicians (ACEP) Clinical Policies Committee since 1990. For each policy, the ACEP rates both the strength of the recommendations (from Level A to C, with the latter being equivalent to inconclusive/limited evidence or committee consensus) and the level of evidence on which those recommendations have been made (from Class I to III, with the latter being case series/reports or expert consensus). These authors reviewed all 54 ACEP clinical policies issued from 1990–2015, analyzing the proportion of Level C recommendations and Class III evidence.

Overall, 48% of recommendations (200/421) were Level C, and 49% of evidence was Class III (1371 of 2801). Proportions were hi…

Reviewing Author

Ali S. Raja, MD, MBA, MPH

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Ali S. Raja, MD, MBA, MPH

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Most Current ACEP Clinical Practice Guidelines Are Based on Expert Opinion and Low-Quality Evidence

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Reviewing Author