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Clinical guidelines have an increasing role in the delivery of standardized health care and appropriate treatments to patients. Japanese Circulation Society (JCS) and Japanese Heart Rhythm Society (JH...RS) regularly issue guidelines relating to cardiac arrhythmias. In this article, author described practical steps of guideline publication as a steering committee member of the JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias. Nowadays, guidelines are developed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). GRADE system has been adopted by many working groups producing guidelines. GRADE approach is important to guarantee the transparency in working group communication of how the guideline was developed and how the recommendation was reached. Patient and public involvement is important in setting clinical question and subsequent development steps in clinical practice. GRADE is important also in distinction between the level of the evidence and the strength of recommendation to the individual clinical question. To determine the strength of recommendation, GRADE takes the quality of evidence and the balance of benefit and harm into account. Japanese Counsil for Quality Health Care has started Medical Information Distribution Service (so-called ‘Minds’) to disseminate and implement the evidence-based medicine (EBM) and developed a protocol and schedule of evidence-based guideline publication. The current Japanese guidelines contain Minds grade of recommendation and Minds classification of evidence. In conclusion, the frequency of guideline publication is increasing. Understanding GRADE and Minds approaches enable practitioners to make reasonable informed clinical choice.show more
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