H. Pragmatic, Evidence-based Dietary Studies Studies of dietary interventions are problematic because of adherence and monitoring issues. The best study would be carefully monitored by a dietitian yet it would be impractical to have every patient pursue a dietitian-led plan. The other issue is the specific elements of the dietary program. This is seen primarily in the low saturated fat dietary intervention, where the replacement of saturated fat with polyunsaturated fat appears beneficial in men only. There is more evidence for the Mediterranean diet, which includes a high level of plant-based foods and low levels of saturated fats (replaced by monounsaturated and polyunsaturated fats). More study of the replacement of saturated fats with polyunsaturated fats alone and large, pragmatic dietary studies could help resolve the issues. There is also a need to study a whole- food, plant-based dietary strategy for CVD risk reduction in primary prevention. I. Comparative Studies of Cardiac Rehabilitation Programs While strong evidence supports the use of cardiac rehabilitation programs shortly after coronary events or revascularization procedures, there is little comparison of the elements of these programs. A comparison of different programs could help determine the most cost-effective form of rehabilitation. Appendix A: Evidence Review Methodology A. Developing the Key Questions The CPG Champions, along with the Work Group, were tasked with identifying KQs to guide the systematic evidence review on the management of dyslipidemia. These questions, which were developed in consultation with the Lewin Team, addressed clinical topics of the highest priority for the VA and DoD populations. The KQs follow the population, intervention, comparison, outcome, timing, and setting (PICOTS) framework for evidence questions, as established by the Agency for Healthcare Research and Quality (AHRQ). Table A-1 provides a brief overview of the PICOTS typology. 