Note: Clinical practice guidelines are “guides” only and may not apply to all patients and all clinical situations. Thus, they are not intended to override clinicians' judgment. All ACP clinical practice guidelines are considered automatically withdrawn or invalid 5 years after publication, or once an update has been issued.
Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations.
Financial Support: Financial support for the development of this guideline comes exclusively from the ACP operating budget.
Disclosures: Dr. Barry reports grants and personal fees from the Informed Medical Decisions Foundation and Healthwise outside the submitted work. Dr. Boyd reports royalties from UpToDate outside the submitted work. Authors not named here have disclosed no conflicts of interest. Authors followed the policy regarding conflicts of interest described at www.annals.org/aim/article/745942. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0570. All financial and intellectual disclosures of interest were declared, and potential conflicts were discussed and managed. Dr. Manaker was recused from voting on this guideline because of an active indirect financial conflict. Dr. McLean was recused from voting on this guideline because of an inactive direct financial conflict. A record of disclosures of interest and management of conflicts of interest is kept for each Clinical Guidelines Committee meeting and conference call and can be viewed at www.acponline.org/about-acp/who-we-are/leadership/committees-boards-councils/clinical-guidelines-committee/disclosure-of-interests-for-clinical-guidelines-committee.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Requests for Single Reprints: Amir Qaseem, MD, PhD, MHA, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, [email protected].
Current author addresses and author contributions are available at www.annals.org.
For author affiliations, see end of text.
This article was published at www.annals.org on 1 November 2016.
* This paper, written by Amir Qaseem, MD, PhD, MHA; Russell P. Harris, MD, MPH; and Mary Ann Forciea, MD, was developed for the Clinical Guidelines Committee of the American College of Physicians. Individuals who served on the Clinical Guidelines Committee from initiation of the project until its approval were Mary Ann Forciea, MD† (Chair); Thomas D. Denberg, MD, PhD† (Immediate Past Chair); Michael J. Barry, MD†; Cynthia Boyd, MD, MPH†; R. Dobbin Chow, MD, MBA†; Nick Fitterman, MD†; Russell P. Harris, MD, MPH†; Linda L. Humphrey, MD, MPH†; Devan Kansagara, MD, MCR†; Scott Manaker, MD, PhD‡; Robert M. McLean, MD‡; Sandeep Vijan, MD, MS†; and Timothy J. Wilt, MD, MPH†. Approved by the ACP Board of Regents on 7 November 2015.
† Author (participated in discussion and voting).
‡ Nonauthor contributor (participated in discussion but excluded from voting).
Current Author Addresses: Dr. Qaseem: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Dr. Harris: University of North Carolina School of Medicine, 725 Martin Luther King Boulevard, Chapel Hill, NC 27599-7590.
Dr. Forciea: University of Pennsylvania Health System, 3615 Chestnut Street, Philadelphia, PA 19104.
Author Contributions: Conception and design: A. Qaseem, R.P. Harris, M.A. Forciea, T.D. Denberg, M.J. Barry.
Analysis and interpretation of the data: A. Qaseem, R.P. Harris, M.A. Forciea, M.J. Barry, C. Boyd, N. Fitterman, L.L. Humphrey, D. Kansagara, S. Vijan, T. Wilt.
Drafting of the article: A. Qaseem, R.P. Harris, M.A. Forciea, T.D. Denberg.
Critical revision of the article for important intellectual content: R.P. Harris, T.D. Denberg, M.J. Barry, C. Boyd, R.D. Chow, N. Fitterman, L.L. Humphrey, D. Kansagara, S. Vijan, T. Wilt.
Final approval of the article: A. Qaseem, R.P. Harris, M.A. Forciea, T.D. Denberg, M.J. Barry, C. Boyd, R.D. Chow, N. Fitterman, L.L. Humphrey, D. Kansagara, S. Vijan, T. Wilt.
Statistical expertise: A. Qaseem.
Administrative, technical, or logistic support: A. Qaseem.
Collection and assembly of data: A. Qaseem, R.P. Harris.
