Methodology and Modernization The ACC/AHA Joint Committee on Clinical Practice Guidelines (Joint Committee) continuously reviews, up- dates, and modifies guideline methodology on the ba- sis of published standards from organizations, including the Institute of Medicine,1,2 and on the basis of internal reevaluation. Similarly, presentation and delivery of guidelines are reevaluated and modified in response to evolving technologies and other factors to optimally fa- cilitate dissemination of information to healthcare pro- fessionals at the point of care. Numerous modifications to the guidelines have been implemented to make them shorter and enhance user- friendliness. Guidelines are written and presented in a modular knowledge chunk format, in which each chunk includes a table of recommendations, a brief synopsis, recommendation-specific supportive text and, when appropriate, flow diagrams or additional tables. Hyperlinked references are provided for each modular knowledge chunk to facilitate quick access and review. Word limit targets and a web supplement for useful but noncritical tables and figures are 2 recent modifications. In recognition of the importance of cost value con- siderations, in certain guidelines, when appropriate and feasible, an analysis of value for a drug, device, or in- tervention may be performed in accordance with the To ensure that guideline recommendations remain current, new data will be reviewed on an ongoing ba- sis by the writing committee and staff. Going forward, targeted sections or knowledge chunks will be revised dynamically after publication and timely peer review of potentially practice-changing science. The previous designations of full revision and focused update will be phased out. 