The American Heart Association and American Stroke Association produce many types of scientific publications. The different types of documents and their purposes are explained here.
The Institute of Medicine defines a guideline as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.” The AHA often develops practice guidelines in conjunction with the American College of Cardiology (ACC), but also may develop them alone or in partnership with other organizations as appropriate. All guidelines adhere to the levels of evidence and classes of recommendation as established by the ACC/AHA Guidelines Task Force. AHA also publishes emergency cardiovascular care guidelines developed through the AHA Committee on Emergency Cardiovascular Care (ECC). All American Stroke Association/American Heart Association guidelines adhere to levels of evidence and classes of recommendation derived from the ACC/AHA levels mentioned previously. The ECC guidelines adhere to levels of evidence and classes of recommendation derived from these ACC/AHA levels. All guidelines undergo peer review and are reviewed and approved by the AHA SACC.
Readers are referred to the Methodology Manual for ACC/AHA Guideline Writing Committees for more information specific to ACC/AHA practice guideline development.
The purpose of a scientific statement is to increase knowledge and awareness by healthcare professionals of effective, state-of-the art science related to the causes, prevention, detection, or management of cardiovascular diseases and stroke. AHA and AHA/ASA scientific statements represent the consensus of the leading experts in cardiovascular disease and stroke. All AHA scientific statements undergo blinded peer review and are reviewed and approved by the AHA Science Advisory and Coordinating Committee (SACC), the highest scientific body of the AHA/ASA.
The purpose of an AHA or AHA/ASA Science Advisory is to provide rapid, clear and consistent AHA and ASA positioning on scientific issues. Advisories are statements on an evolving, prominent scientific issue of great interest to the public and to health professionals. All AHA and AHA/ASA Science Advisories undergo peer review and are reviewed and approved by the AHA SACC.
The purpose of an AHA Statistical Advisory/Alert is to provide a rapid and clear picture about urgent statistical issues related to cardiovascular disease and stroke. Statistical advisories/alerts are AHA positioning statements of great interest to the public and to heath professionals. All AHA Statistical Advisories/Alerts undergo review by the Statistical Committee of the Council on Epidemiology and Prevention and are reviewed again and approved by the AHA SACC.
Policy Recommendations (or Policy Statements)
The AHA convenes expert panel working groups to study timely issues such as quality health care, stroke center identification, disease management, and other topics as appropriate. These panels examine the complex issues around their topics, issue recommendations, and considerations for clinical and public policy. These reports are reviewed by the AHA SACC before publication.
AHA conferences disseminate new and emerging scientific knowledge and stimulate discussion of implications for future research and the application of knowledge. AHA often sponsors conferences with other societies or organizations, such as the National Heart, Lung, and Blood Institute; the Centers for Disease Control and Prevention; the ACC; and the American Diabetes Association, among others. Experts assembled at such conferences work together to address a common topic, such as scientific issues related to the definition of the metabolic syndrome and publish their results in conference proceedings. Conference proceedings reflect the opinion of the conference participants and not necessarily of the AHA. However, conference proceedings are reviewed by the AHA SACC before publication to be certain that they are not contradictory to the AHA mission and to evaluate agreement or disagreement with AHA statements or guidelines in development.
Clinical Data Standards
The AHA works with the ACCF to develop clinical data standards under the guidance of the ACCF/AHA Task Force on Clinical Data Standards. Clinical data standards are sets of standardized elements and corresponding definitions that can be used in a variety of data collection efforts. The hope is that these standards will improve the ability to compare clinical outcomes between various trials and registries and to facilitate data management in future trials and registries. These standardized definitions also may improve quality-of-care assessment and clinical performance measures.
The AHA and the ACCF, under the leadership of the ACCF/AHA Task Force on Performance Measures, have launched an initiative to develop performance measures for healthcare providers for certain cardiovascular diseases and procedures. This effort is intended to promote the implementation of clinical evidence guidelines. Performance measures are derived from practice guidelines and are intended to provide practitioners with tools for measuring the quality of care they provide, by defining specific, measurable elements of care. By assessing performance on these elements, although such elements are not all inclusive, practitioners can identify opportunities for improvement.
Clinical Competence and Training Statements
The American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine (ACC/AHA/ACP-ASIM) Task Force on Clinical Competence was formed in 1998 to develop recommendations for attaining and maintaining the cognitive and technical skills necessary for the competent performance of a specific cardiovascular service, procedure or technology. These documents are evidence-based, and when evidence is not available, expert opinion is used to formulate recommendations. Indications and contraindications for specific services or procedures are not included in the scope of these documents. Readers are referred to the ACC/AHA/ACP Manual for Clinical Competence and Training Statement Writing Committees for more information.