This process entails delineation of a rec- ommendation addressing a specific clinical question, followed by concise text (ideally <250 words) and hy- perlinked to supportive evidence. This approach better accommodates time constraints on busy clinicians, facil- itates easier access to recommendations via electronic search engines and other evolving technology, and sup- ports the evolution of guidelines as living documents that can be dynamically updated as needed. Guideline-Directed Evaluation and Management The term guideline-directed evaluation and management (GDEM) refers to care defined mainly by ACC/AHA Class I recommendations. For these and all recommended drug treatment regimens, the reader should confirm dosage with product insert material and carefully evaluate for contraindications and interactions. Recommendations are limited to treatments, drugs, and devices approved for clinical use in the United States. Class of Recommendation and Level of Evidence The Class of Recommendation (COR) and Level of Evi- dence (LOE) are derived independently of each other according to established criteria. The COR indicates the strength of recommendation, encompassing the es- timated magnitude and certainty of benefit of a clinical action in proportion to risk. The LOE rates the quality of scientific evidence supporting the intervention on the basis of the type, quantity, and consistency of data from clinical trials and other sources (Table 1). Recommenda- tions in this focused update reflect the new 2015 COR/ LOE system, in which LOE B and C are subcategorized for the purpose of increased granularity.1,5,8 Relationships With Industry and Other Entities The ACC and AHA exclusively sponsor the work of guide- line writing committees without commercial support, and members volunteer time for this activity. Selected orga- nizations and professional societies with related interests and expertise are invited to participate as partners or collaborators. 