This entails delineation of recommendations addressing specific clinical ques- tions, followed by concise text, with hyperlinks to supportive evidence. This approach better accommo- dates time constraints on busy clinicians, facilitates easier access to recommendations via electronic search engines and other evolving technology (eg, smart phone apps), and supports the evolution of guidelines as living documents that can be dynami- cally updated as needed. INTENDED USE Practice guidelines provide recommendations ap- plicable to patients with or at risk of developing cardiovascular disease. The focus is on medical practice in the United States, but guidelines devel- oped in collaboration with other organizations may have a broader target. Although guidelines may inform regulatory or payer decisions, they are intended to improve quality of care in the interest of patients. CLASS OF RECOMMENDATION AND LEVEL OF EVIDENCE The Class of Recommendation (COR) and Level of Evidence (LOE) are derived independently of one another according to established criteria. The COR indicates the strength of recommendation, encompass- ing the estimated magnitude and certainty of benefit of a clinical action in proportion to risk. The LOE rates the quality of scientific evidence supporting the inter- vention on the basis of the type, quantity, and consis- tency of data from clinical trials and other sources RELATIONSHIPS WITH INDUSTRY AND OTHER ENTITIES The ACC and AHA sponsor the guidelines without commercial support, and members volunteer their time. The Task Force zealously avoids actual, potential, or perceived conflicts of interest that might arise through relationships with industry or other entities (RWI). All Guideline Writing Committee (GWC) members and reviewers are required to disclose current industry rela- tionships or personal interests from 12 months before initiation of the writing effort. 