Evidence Review and Evidence Review Committees In developing recommendations, the writing commit- tee uses evidence-based methodologies that are based on all available data.P-4 P-6 Literature searches focus on randomized controlled trials (RCTs) but also include registries, nonrandomized comparative and descriptive studies, case series, cohort studies, systematic reviews, and expert opinion. Only key references are cited. An independent evidence review committee is commissioned when there are one or more questions deemed of utmost clinical importance that merit formal systematic review to determine which patients are most likely to benefit from a drug, device, or treatment strat- egy, and to what degree. Criteria for commissioning an evidence review committee and formal systematic re- view include absence of a current authoritative system- atic review, feasibility of defining the benefit and risk in a timeframe consistent with the writing of a guide- line, relevance to a substantial number of patients, and likelihood that the findings can be translated into ac- tionable recommendations. Evidence review committee members may include methodologists, epidemiologists, clinicians, and biostatisticians. Recommendations de- veloped by the writing committee on the basis of the systematic review are marked SR . Guideline-Directed Management and Therapy The term guideline-directed management and therapy encompasses clinical evaluation, diagnostic testing, and both pharmacological and procedural treatments. For these and all recommended drug treatment regimens, the reader should confirm dosage with product insert material and evaluate for contraindications and interactions. Rec- ommendations are limited to drugs, devices, and treat- ments approved for clinical use in the United States. Class of Recommendation and Level of Evidence The Class of Recommendation (COR) indicates the strength of recommendation, encompassing the esti- mated magnitude and certainty of benefit in proportion to risk. 