National Guideline Clearinghouse

The National Guideline Clearinghouse (NGC) is an initiative of the Agency for Healthcare Research and Quality (AHRQ) External Web Site Policy, U.S. Department of Health and Human Services. NGC was originally created by AHRQ in partnership with the American Medical Association and the American Association of Health Plans (now America’s Health Insurance Plans [AHIP]). The NGC mission is to provide physicians and other health care professionals, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use.


Updated Summary: VA/DoD clinical practice guideline for the management of pregnancy. [Department of Veterans Affairs]

Major Recommendations Note from the Department of Veterans Affairs and the Department of Defense (VA/DoD) and the National Guideline Clearinghouse (NGC): The recommendations for the management of pregnancy are organized into 4 sections with 1 algorithm. The accompanying recommendations are provided below. See the original guideline document  for the algorithms […]


New Summary: Clinical practice guideline on systemic lupus erythematosus. [Evaluation Service of the Canary Is. Health Service]

Levels of evidence (1++ to 4 or Ia to IV) and grades of recommendation (A to D, GCP or A to D) are defined at the end of the “Major Recommendations” field. Diagnosis of Systemic Lupus Erythematosus (SLE) Early Detection Prognosis Do early detection and early treatment improve the prognosis […]


New Summary: The implementation of targeted temperature management: an evidence-based guideline from the Neurocritical Care Society. [Neurocritical Care Society]

Definitions of the strength of recommendations (strong, conditional, good practice) and quality of the evidence (high, moderate, low, very low) are provided at the end of the “Major Recommendations” field. Induction and Maintenance of Targeted Temperature Management (TTM) Does a Pre-defined Duration of TTM Result in Similar Outcomes as Goal-Directed […]


New Summary: Occupational therapy practice guidelines for adults with musculoskeletal conditions. [American Occupational Therapy Association, Inc.]

Note from the National Guideline Clearinghouse: In addition to the evidence-based recommendations below, the guideline includes extensive information on the evaluation process and intervention strategies for adults with cancer. Definitions for the strength of recommendations (A–D, I) and levels of evidence (I–V) are provided at the end of the “Major […]


New Summary: Occupational therapy practice guidelines for adults with arthritis and other rheumatic conditions. [American Occupational Therapy Association, Inc.]

Major Recommendations Note from the National Guideline Clearinghouse: In addition to the evidence-based recommendations below, the guideline includes extensive information on the evaluation process and intervention strategies for adults with arthritis and other rheumatic conditions. Definitions for the strength of recommendations (A–D, I) and levels of evidence (I–V) are provided […]


Updated Summary: Practice guidelines for moderate procedural sedation and analgesia 2018: a report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. [American Society of Anesthesiologists]

Major Recommendations Patient Evaluation Review previous medical records and interview the patient or family to identify: Abnormalities of the major organ systems (e.g., cardiac, renal, pulmonary, neurologic, sleep apnea, metabolic, endocrine) Adverse experience with sedation/analgesia, as well as regional and general anesthesia History of a difficult airway Current medications, potential […]


New Summary: American Academy of Orthopaedic Surgeons appropriate use criteria for the management of osteoarthritis of the hip. [American Academy of Orthopaedic Surgeons]

The 2017 Clinical Practice Guideline on the Management of Osteoarthritis of the Hip was used as the evidence base for this appropriate use criteria (AUC). This guideline helped to inform the decisions of the writing panel and voting panel where available and necessary. See the clinical practice guideline for the […]


Updated Summary: ACR Appropriateness Criteria® radiologic management of uterine leiomyomas. [American College of Radiology]

ACR Appropriateness Criteria® Radiologic Management of Uterine Leiomyomas Variant 1: Middle-aged woman with multiple uterine fibroids resulting in a 20-week-sized uterus on physical examination and menorrhagia. Bulk symptoms of urinary frequency and bloating are present. The patient has a recent negative serum pregnancy test and has no desire for future […]


Updated Summary: ACR Appropriateness Criteria® post-treatment follow-up of prostate cancer. [American College of Radiology]

ACR Appropriateness Criteria® Post-treatment Follow-up of Prostate Cancer Variant 1: Prostate cancer follow-up. Status post radical prostatectomy. Clinical concern for residual or recurrent disease. Note: Abbreviations used in the tables are listed at the end of the “Major Recommendations” field. Variant 2: Prostate cancer follow-up. Clinical concern for residual or […]


Updated Summary: ACR Appropriateness Criteria® orbits, vision and visual loss. [American College of Radiology]

ACR Appropriateness Criteria® Orbits, Vision and Visual Loss Variant 1: Traumatic visual defect. Suspect orbital injury. Initial imaging. Note: Abbreviations used in the tables are listed at the end of the “Major Recommendations” field. Variant 2: Nontraumatic orbital asymmetry, exophthalmos, or enophthalmos. Initial imaging. Note: Abbreviations used in the tables […]


Updated Summary: ACR Appropriateness Criteria® headache — child. [American College of Radiology]

ACR Appropriateness Criteria® Headache — Child Variant 1: Child. Primary headache. Initial imaging. Note: Abbreviations used in the tables are listed at the end of the “Major Recommendations” field. Variant 2: Child. Secondary headache. Initial imaging. Note: Abbreviations used in the tables are listed at the end of the “Major […]


Updated Summary: ACR Appropriateness Criteria® multiple gestations. [American College of Radiology]

ACR Appropriateness Criteria® Multiple Gestations Variant 1: Known or suspected multiple gestations. Monochorionic or dichorionic. First trimester US. Procedure Appropriateness Category Relative Radiation Level US pregnant uterus transvaginal Usually Appropriate O US pregnant uterus transabdominal Usually Appropriate O US cervix transvaginal Usually Not Appropriate O US duplex Doppler velocimetry Usually […]


New Summary: Cystic Fibrosis Foundation pulmonary guidelines. Use of cystic fibrosis transmembrane conductance regulator modulator therapy in patients with cystic fibrosis. [Cystic Fibrosis Foundation]

Definitions of the strength of recommendations (Strong, Conditional) and quality of the evidence (High, Moderate, Low, Very Low) are provided at the end of the “Major Recommendations” field. Note from the National Guideline Clearinghouse (NGC): See the original guideline document  for remarks regarding the recommendations. Question 1: Should Ivacaftor (IVA) […]


New Summary: Congress of Neurological Surgeons systematic review and evidence-based guidelines on emerging therapies for the treatment of patients with vestibular schwannomas. [Congress of Neurological Surgeons]

Definitions for the classification of evidence (I-III) and levels of recommendations (1-3) are provided at the end of the “Major Recommendations” field. Medical Therapy Question What is the role of bevacizumab in the treatment of patients with vestibular schwannomas (VSs)? Target Population Adults with histologically proven or suspected vestibular schwannomas […]


New Summary: Congress of Neurological Surgeons systematic review and evidence-based guidelines on surgical resection for the treatment of patients with vestibular schwannomas. [Congress of Neurological Surgeons]

Definitions for the classification of evidence (I-III) and levels of recommendations (1-3) are provided at the end of the “Major Recommendations” field. Please see the full-text version of this guideline (see the “Availability of Companion Documents” field) for the target population of each recommendation listed below. Question 1 What surgical […]


New Summary: Congress of Neurological Surgeons systematic review and evidence-based guidelines on the role of radiosurgery and radiation therapy in the management of patients with vestibular schwannomas. [Congress of Neurological Surgeons]

Definitions for the classification of evidence (I-III) and levels of recommendations (1-3) are provided at the end of the “Major Recommendations” field. Please see the full-text version of this guideline (see the “Availability of Companion Documents” field) for the target population of each recommendation listed below. Radiosurgery vs Observation Question […]


New Summary: Congress of Neurological Surgeons systematic review and evidence-based guidelines on pathological methods and prognostic factors in vestibular schwannomas. [Congress of Neurological Surgeons]

Major Recommendations Definitions for the classification of evidence (I-III) and levels of recommendations (1-3) are provided at the end of the “Major Recommendations” field. Target Population Adults diagnosed with vestibular schwannomas Question 1 What is the prognostic significance of Antoni A vs B histologic patterns in vestibular schwannomas? Recommendation No […]


New Summary: Congress of Neurological Surgeons systematic review and evidence-based guidelines on the role of imaging in the diagnosis and management of patients with vestibular schwannomas. [Congress of Neurological Surgeons]

Definitions for the classification of evidence (I-III) and levels of recommendations (1-3) are provided at the end of the “Major Recommendations” field. Question 1 What sequences should be obtained on magnetic resonance imaging (MRI) to evaluate vestibular schwannomas before and after surgery? Target Population Adults with vestibular schwannomas. Recommendations Initial […]


New Summary: Congress of Neurological Surgeons systematic review and evidence-based guidelines on intraoperative cranial nerve monitoring in vestibular schwannoma surgery. [Congress of Neurological Surgeons]

Definitions for the classification of evidence (I-III) and levels of recommendations (1-3) are provided at the end of the “Major Recommendations” field. Facial Nerve Monitoring Question 1 Does intraoperative facial nerve monitoring during vestibular schwannoma surgery lead to better long-term facial nerve function? Target Population This recommendation applies to adult […]