Clinical GuidelinesIndexed for Doctors.

Caring for Women and Men Of Reproductive Age with Possible Zika Virus Exposure

This ASRM guideline provides updated preconception counseling and clinical protocols for reproductive healthcare providers treating non-pregnant patients with possible Zika virus exposure. It details testing paradigms, required wait times before attempting conception (e.g., 3 months for men, 8 weeks for women), and specific handling procedures for ART, gametes, and embryos to mitigate the risk of congenital Zika virus infection.

Medication-Related Osteonecrosis of the Jaw

Medication-related osteonecrosis of the jaw (MRONJ) is a complication that occurs in 1% to 9% of advanced cancer patients receiving bone-modifying agents (BMAs). It is characterized by exposed, unhealed bone in the maxillofacial region. The guideline seeks to establish standardized definitions, preventive strategies, and management algorithms to optimize oral care and patient outcomes.

Evaluation and Management of Obesity Hypoventilation Syndrome

This official American Thoracic Society clinical practice guideline aims to optimize the evaluation and management of adults with obesity hypoventilation syndrome (OHS). Using the GRADE methodology, the multidisciplinary panel formulated five conditional recommendations regarding diagnostic screening with serum bicarbonate, the application of positive airway pressure (PAP) therapy (CPAP or NIV) for both stable outpatient and hospitalized individuals, and the necessity of targeted, sustained weight loss interventions.

Sudden Hearing Loss

Sudden hearing loss is a frightening symptom that often prompts an urgent medical visit. Sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually in the United States. This guideline update provides recommendations for diagnosing, managing, and following up on adult patients with sudden hearing loss to improve diagnostic accuracy, reduce unnecessary testing, and enhance patient outcomes.

Psychological Practice for People with Low-Income and Economic Marginalization

This APA guideline provides recommendations for psychologists to deliver culturally competent care to individuals experiencing low-income and economic marginalization (LIEM). It covers four main domains: training and education, health disparities, treatment considerations, and the intersection of LIEM with career concerns and unemployment. The document emphasizes the need for practitioners to address social class biases, understand systemic barriers to healthcare access, and utilize flexible, evidence-based treatments tailored to this population.

Responsible, Safe, and Effective Use of Antithrombotics and Anticoagulants in Pa

These guidelines provide evidence-based recommendations on the perioperative management of antithrombotic and anticoagulant therapy for patients undergoing interventional pain procedures, stratifying interventions into low, intermediate, and high bleeding risks to minimize adverse events like epidural hematomas and thromboembolisms.

Management of Severe Asthma

The guideline provides clinical recommendations for the management of severe asthma, focusing on the use of novel biological therapies for type 2 high asthma, antimuscarinic agents, macrolides, and the use of biomarkers for predicting treatment response.

Management of Growth Hormone Deficiency in Adults and Patients Transitioning fro

Adult growth hormone deficiency is associated with multiple adverse metabolic abnormalities and increased cardiovascular morbidity. This guideline update summarizes current knowledge regarding the accuracy of available GH-stimulation tests, rhGH dosing regimens targeting IGF-1 normalization, and the long-term safety profile of rhGH replacement.

Treatment of Immune Thrombocytopenia

Immune Thrombocytopenia (ITP) is a rare autoimmune disorder where the immune system destroys platelets, causing significant bleeding episodes. The guidelines offer updated treatment evidence to optimize care and avoid unnecessary interventions, particularly in children.

Germline and Somatic Tumor Testing in Epithelial Ovarian Cancer

KEYTRUDA (pembrolizumab) is a programmed death receptor-1 (PD-1)-blocking antibody. The prescribing information outlines its indications for various advanced cancers, recommended dosage, contraindications, and comprehensive warnings regarding immune-mediated adverse reactions.

Role of Endoscopy in the Management of Acute Colonic Pseudo-Obstruction and Colo

Colonic volvulus and acute colonic pseudo-obstruction (ACPO) are two causes of benign large-bowel obstruction. Colonic volvulus occurs most commonly in the sigmoid colon from bowel twisting, whereas ACPO stems from altered autonomic regulation of colonic motility resulting in dilation without a mechanical cause. Prompt diagnosis and intervention improve outcomes for both conditions.

Opioids in Total Joint Arthroplasty

This clinical practice guideline provides evidence-based recommendations regarding the use of opioids before, during, and after primary total joint arthroplasty (TJA). It highlights the risks of preoperative opioid use, advocates for prescribing the lowest effective quantity at discharge, and details the effects of perioperative opioids.

Multimodality Assessment of Congenital Coronary Anomalies

Congenital coronary artery anomalies are recognized as important lesions with significant potential morbidity and mortality, including sudden cardiac death. Multimodality imaging techniques have replaced cardiac catheterization as the primary tool for characterization of most congenital CA anomalies in children.

Therapeutic Monitoring Of Vancomycin For Serious Methicillin-Resistant Staphyloc

This revised consensus guideline provides updated recommendations for the therapeutic monitoring of vancomycin in patients with serious MRSA infections. It advocates transitioning from trough-only monitoring to an individualized AUC/MIC target of 400-600 to maximize clinical efficacy and minimize acute kidney injury risk, providing specific dosing guidance for adults, pediatrics, neonates, and special populations.

Nonsteroidal Anti-Inflammatory Drugs in Total Joint Arthroplasty

This clinical practice guideline provides evidence-based recommendations on utilizing NSAIDs for postoperative pain management and reducing opioid consumption in primary total joint arthroplasty patients.

Alcohol Withdrawal Management

This guideline updates previous ASAM guidelines to address current practice concerns and provide clear guidance for consistent treatment practices in the field. It emphasizes risk assessment and proper level of care determination, detailing comprehensive management protocols for both ambulatory and inpatient settings.

Management of Gout

Gout is the most common form of inflammatory arthritis, affecting approximately 9.2 million adults in the US. Despite the availability of effective and inexpensive medications, gaps in quality of care persist. The 2020 guideline was developed using GRADE methodology to update the 2012 recommendations, incorporating new clinical trial evidence regarding treat-to-target strategies, urate-lowering therapies (ULT), and patient preferences to improve gout management.

ASGE guideline on the management of achalasia

Achalasia is a primary esophageal motor disorder characterized by degeneration of the myenteric plexus, impaired relaxation of the esophagogastric junction (EGJ), and loss of organized peristalsis. It causes dysphagia and regurgitation, and is diagnosed using high-resolution esophageal manometry.

Gabapentinoids in Total Joint Arthroplasty

This clinical practice guideline evaluates the efficacy and safety of gabapentinoids in primary total joint arthroplasty (TJA). It concludes that while gabapentinoids do not significantly reduce postoperative pain in the perioperative period, pregabalin does reduce opioid consumption. Post-discharge, pregabalin effectively reduces pain and opioid use, whereas gabapentin does not. The guideline advises caution, particularly regarding respiratory depression when used concurrently with opioids and increased risks of confusion and sedation in elderly patients.

Management of Patients With Valvular Heart Disease

Management of Hereditary Breast Cancer

This ASCO Rapid Recommendation Update advises that one year of adjuvant olaparib should be offered to patients with high-risk, early-stage, HER2-negative breast cancer and germline BRCA1 or BRCA2 mutations after completing local treatment and chemotherapy, based on the efficacy results from the OlympiA phase III trial.

Non-Arthroplasty Treatment of Osteoarthritis of the Knee

Osteoarthritis results from an imbalance between breakdown and repair of the tissues in the synovial joint organ. This guideline systematically reviews evidence to make clinical recommendations for non-arthroplasty management.

Tympanostomy Tubes in Children

Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With

Since the 2016 guidelines, new data allow for further guidance on the use of genomic tests (e.g., Oncotype Dx, MammaPrint, Prosigna, EndoPredict, Breast Cancer Index) according to the age of patients and the number of involved lymph nodes. This guideline update provides evidence-based recommendations to optimally use currently available biomarkers to guide endocrine and chemotherapy decisions in individuals with early-stage breast cancer.

Standards and Guidelines for Perfusion Practice

The 2023 AmSECT Standards and Guidelines for Perfusion Practice outlines 19 mandatory standards and associated guidelines for adult cardiopulmonary bypass (CPB). Key topics include institutionally-based protocols, staffing, safety devices, patient monitoring, anticoagulation, blood flow and management, and crisis management.

Probiotics and Prebiotics

This guideline reviews the history, definitions, mechanisms of action, product safety, and commercial marketplace of probiotics and prebiotics, and outlines the clinical evidence for their applications in specific gastrointestinal diseases.

Evidence-based Treatments for Couples with Unexplained Infertility

Up to 30% of couples experiencing infertility are diagnosed with unexplained infertility after a standard evaluation. Since no treatable cause is identified, treatment is by necessity empiric. Commonly used treatments include ovarian stimulation with oral medications or injectable gonadotropins with intrauterine insemination, and in vitro fertilization.

Acetaminophen in Total Joint Arthroplasty

This clinical practice guideline evaluates the efficacy and safety of perioperative intravenous and oral acetaminophen for pain management and opioid consumption reduction in patients undergoing primary total joint arthroplasty.

Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes

This guideline provides a comprehensive framework for using multimodality cardiovascular imaging (TTE, CMR, CTA) to evaluate competitive athletes. It outlines how to differentiate physiological exercise-induced cardiac remodeling from pathologic cardiomyopathies and details the appropriate clinical scenarios for incorporating diagnostic imaging following pre-participation screening or symptom presentation.

Treatment of Opioid Use Disorder

This guideline provides comprehensive, evidence-based recommendations for assessing, diagnosing, and treating Opioid Use Disorder (OUD). It details the appropriate use of FDA-approved pharmacotherapies including methadone, buprenorphine, and naltrexone, managing opioid withdrawal, administering psychosocial interventions, preventing overdoses with naloxone, and tailoring treatments for special populations such as pregnant women, adolescents, and justice-involved individuals.

Management of Glenohumeral Joint Osteoarthritis

This document addresses the management of patients with primary glenohumeral joint osteoarthritis, evaluating the effectiveness of both non-surgical and surgical approaches to minimize dysfunction and pain.

Role of Elastography in the Evaluation of Liver Fibrosis

This guideline provides evidence-based recommendations on utilizing noninvasive imaging tools, specifically vibration-controlled transient elastography (VCTE) and magnetic resonance elastography (MRE), for evaluating liver fibrosis, diagnosing cirrhosis, and ruling out varices across various chronic liver diseases.

Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making

Intraoperative transesophageal echocardiography is a standard diagnostic and monitoring tool employed in the management of patients undergoing an entire spectrum of cardiac surgical procedures. Utilizing a protocol as a starting point enables standardization of image acquisition and better patient care.

Prevention And Management Of Chemotherapy-Induced Peripheral Neuropathy In Survi

Chemotherapy-induced neuropathy is a serious clinical problem caused by cytotoxic drugs like taxanes and platinums. Symptoms can acute or chronic, causing marked effects on the quality of life and potentially limiting cancer treatments.

Diagnosis and Management of Adults with Community-Acquired Pneumonia

Understanding of the diagnosis and treatment of adults with community-acquired pneumonia (CAP) has evolved. This document updates evidence-based clinical practice guidelines on four key questions: LUS versus chest radiography, empiric antibacterial therapy with positive respiratory virus testing, antibiotic duration, and systemic corticosteroids.

Metastatic Pancreatic Cancer

This ASCO guideline update provides evidence-based recommendations for second-line and maintenance therapies in metastatic pancreatic cancer. It highlights the use of targeted treatments such as PARP inhibitors (olaparib) for patients with germline BRCA mutations and TRK inhibitors (larotrectinib/entrectinib) for patients with NTRK fusions.

Treatment of Rheumatoid Arthritis

This guideline updates recommendations for the pharmacologic management of rheumatoid arthritis, addressing treatment with conventional, biologic, and targeted synthetic DMARDs, the use of glucocorticoids, and DMARD use in specific high-risk patient populations.

Management of Hip Fractures in Older Adults

This guideline offers evidence-based recommendations for the surgical and perioperative management of hip fractures in older adults. It focuses on aspects such as optimal surgical timing, venous thromboembolism prophylaxis, multimodal analgesia, surgical approaches, and the efficacy of interdisciplinary care programs in improving patient outcomes.

Management of Heart Failure

Heart failure remains a leading cause of morbidity and mortality globally. This 2022 guideline replaces the 2013 ACCF/AHA Guideline and the 2017 focused update to provide contemporary, evidence-based approaches to manage patients with heart failure, with the intent to improve quality of care and align with patients' interests.

Diagnosis and Treatment of Low Back Pain (LBP)

This clinical practice guideline updates the 2017 VA/DoD framework for the diagnosis and treatment of acute, subacute, and chronic low back pain in adults. Emphasizing a biopsychosocial model and shared decision-making, the guideline strongly recommends against routine imaging for acute LBP without red flags. It promotes non-pharmacologic treatments like structured exercise, cognitive behavioral therapy, and spinal manipulation over invasive therapies, and expressly advises against the use of opioids and benzodiazepines for LBP management.

Management of Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast

Brain metastases are common in patients with advanced HER2-positive breast cancer, with up to half of patients experiencing brain relapse over time. Improved systemic therapies for extracranial disease have extended survival, creating a need to optimize initial brain metastasis treatments and strategies for subsequent intracranial progression.

Perioperative Management Of Antithrombotic Therapy

This guideline updates the 2012 iteration and addresses the perioperative management of patients receiving long-term oral anticoagulant (VKAs, DOACs) or antiplatelet therapy who require elective surgery, focusing on optimal interruption, resumption, and bridging strategies.

Management of Anterior Cruciate Ligament Injuries

This clinical practice guideline evaluates the management of anterior cruciate ligament injuries based on a systematic review of published studies in skeletally mature and immature patients, offering practice recommendations while highlighting gaps in the literature.

Surgical Management of Knee Osteoarthritis

Osteoarthritis is a progressive disease causing joint pain, stiffness, and difficulty with movement. This guideline systematically reviews evidence to provide recommendations for its surgical management, prioritizing pain relief and improved function while balancing potential operative benefits and harms.

Nonhormonal Management Of Menopause-Associated Vasomotor Symptoms

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Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer

HER2 testing guidelines focus on identifying protein overexpression or gene amplification to identify patients for HER2-targeted therapies. This update addresses a new indication for trastuzumab deruxtecan for tumors with HER2 IHC 1+ or 2+ without amplification, highlighting the clinical relevance of distinguishing IHC 0 from 1+.

Practical Assessment and Management of Vulnerabilities in Older Patients Receivi

This update builds upon the 2018 ASCO guideline by recommending the mandatory integration of geriatric assessment (GA) and GA-guided management (GAM) for patients 65 and older receiving systemic cancer therapy. Revisions were driven by large randomized clinical trials demonstrating significant benefits in reducing serious chemotherapy-related toxicity.

Systemic Therapy for Melanoma

Systemic treatment for melanoma has changed rapidly since the introduction of ipilimumab in 2011, substantially improving overall and long-term survival. Due to the increasing availability of new therapies, rising melanoma incidence, and treatment costs, rational evidence-based selection of appropriate therapy is essential.

Management of Patients With Atrial Fibrillation

This guideline provides comprehensive, evidence-based recommendations for the diagnosis and management of atrial fibrillation. It emphasizes a new staging classification, lifestyle and risk factor modifications, stroke risk assessment, and strategies for both rate and rhythm control.

Management of Osteoarthritis of the Hip

Osteoarthritis of the hip has a global prevalence of 7.2% and leads to significant functional impairment, pain, and decreased quality of life. This guideline provides evidence-based recommendations for both non-surgical management and total hip arthroplasty for adult patients.

Management of Patients With Lower Extremity Peripheral Artery Disease

Lower extremity PAD is a common cardiovascular disease associated with an increased risk of amputation, myocardial infarction, stroke, and death. This comprehensive guideline updates the 2016 AHA/ACC PAD Guideline, providing evidence-based practices for clinical assessment, physiological testing, and interdisciplinary management—including GDMT, structured exercise, wound care, and revascularization strategies.

Management Of Fatigue In Adult Survivors Of Cancer

Management of Carpal Tunnel Syndrome

Management of Stroke Rehabilitation

This clinical practice guideline provides an evidence-based framework for the rehabilitation of adult stroke survivors, addressing transitions to community, motor therapy, dysphagia, aphasia, spatial neglect, and mental health complications.

Assessment and Management of Patients at Risk for Suicide

The annual rate of death by suicide among adults in the United States increased over the first two decades of the 21st century. This guideline provides updated evidence-based guidance for the assessment and management of patients at risk for suicide within VA and DoD populations.

Perioperative Cardiovascular Evaluation and Management of Patients Undergoing No

Cardiovascular risk factors and disease are prevalent among adults undergoing noncardiac surgery, and perioperative cardiovascular complications are an important cause of morbidity and mortality. Each year, approximately 14.4 million inpatient and 19.2 million ambulatory surgeries are performed in the United States.

Rehabilitation of Lower Limb Amputation

This clinical practice guideline provides an evidence-based framework for evaluating and managing care for adult patients who have experienced lower limb amputation. It emphasizes a patient-centered, multidisciplinary approach to optimize functional independence, health outcomes, and quality of life.

Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer

The identification and treatment of patients with ovarian cancer remains a critical challenge. For advanced stages, primary cytoreductive surgery (PCS) has historically been the cornerstone. The emergence of neoadjuvant chemotherapy (NACT) offers an alternative approach to potentially optimize surgical outcomes and reduce perioperative morbidity.

Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea

This clinical practice guideline provides evidence-based recommendations for the screening, diagnosis, and management of chronic insomnia disorder and obstructive sleep apnea (OSA) in adult patients. It emphasizes objective diagnostic testing, prioritizes cognitive behavioral therapy for insomnia (CBT-I) as a first-line treatment for chronic insomnia, and advocates for positive airway pressure (PAP) and mandibular advancement devices (MAD) as initial therapies for OSA. The guideline heavily incorporates shared decision-making and patient-centered care.

Fertility Preservation in Patients With Cancer

Many cancer-directed therapies, including chemotherapy, radiation, and surgery, pose a risk to reproductive health, making it critical to address fertility concerns as early as possible. This guideline provides a comprehensive approach to assessing, discussing, and offering evidence-based fertility preservation options to adult, adolescent, and pediatric cancer patients to ensure reproductive potential is preserved whenever possible.

Outpatient Management of Asymptomatic Elevated Blood Pressure

Approximately half of adults in the US are affected by hypertension, and there is wide variation in practice patterns among emergency physicians for managing asymptomatic elevated blood pressure. This clinical policy updates the 2013 ACEP policy by incorporating new evidence to guide emergency physicians on whether initiating antihypertensive medications at ED discharge is safe and effective.

Pediatric and Congenital Perfusion Practice

The document provides an updated framework for safe and effective extracorporeal support care for pediatric and congenital patients, updated in 2024 to include new crisis management standards and modifications for better interpretation.

Accelerated Partial Breast Irradiation

Partial breast irradiation (PBI) delivers radiation locally to the lumpectomy cavity. Accelerated PBI (APBI) condenses treatment from 5-6 weeks to a week or less. This guide helps breast surgeons interpret multiple guidelines on APBI and apply them in clinical practice, noting comparable recurrence rates, reduced toxicity, and improved convenience compared to whole breast irradiation (WBI).

Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adul

The document reviews the background, history, missions, governance, values, and principles related to ACC/AHA guideline development, as well as the format of guideline documents and optimization strategies.

Management of Rotator Cuff Injuries

Shoulder disease is a major cause of musculoskeletal disability in the United States, affecting approximately 8% of all American adults. Rotator cuff pathology is the leading cause of shoulder-related disability seen by orthopaedic surgeons, with surgical volume and associated costs on the rise.

Management of Acute Compartment Syndrome

This guideline provides evidence-based recommendations for the diagnosis and treatment of acute compartment syndrome in adult patients with extremity trauma, addressing diagnostic criteria, pressure monitoring methods, fasciotomy techniques, and subsequent wound and fracture management.

Management of Adults With Congenital Heart Disease

Reviews the background and history of ACC/AHA guidelines, ACC/AHA missions, governance, values and principles related to guideline development, format of guideline documents, and guideline optimization.

Use of Transcutaneous and Percutaneous Ablation for the Treatment of Benign and

Traditional open excisional biopsy for benign breast tumors is effective but can cause scarring and contour changes. Percutaneous therapies like cryoablation and ultrasound-guided excision are comparable in efficacy with better cosmetic outcomes. Minimally invasive ablation is also being investigated and utilized for malignant tumors, offering an alternative to surgical excision for biologically low-risk early-stage breast cancer, particularly in older patients.

Patient-Clinician Communication

Effective health care communication is associated with improvements in patient health outcomes. This guideline updates the 2017 ASCO communication guideline by providing oncology clinicians with evidence-based practices for effective communication across the continuum of care, while addressing new challenges such as telehealth, interprofessional communication, and boundary setting.

Global Strategy for Asthma Management and Prevention

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It imposes a massive global health burden. The GINA Strategy Report provides an evidence-based approach to the diagnosis, assessment, and personalized management of asthma to achieve long-term symptom control, minimize exacerbation risks, and reduce asthma mortality.

Stage IV Non-Small Cell Lung Cancer without Driver Alterations

In 2022, ASCO launched living clinical practice guidelines for systemic therapy for patients with stage IV NSCLC with and without driver alterations. This version (2026.3.1) reviews evidence from a routine literature search up to January 21, 2026, and provides updated recommendations on new therapeutics, such as the inclusion of retifanlimab plus platinum-based chemotherapy as a first-line option.