Clinical Practice Guidelines

The American College of Rheumatology (ACR) places a high priority on developing methodologically rigorous, evidence-based clinical practice guidelines that take into consideration the expertise and viewpoints of multiple stakeholders in a transparent fashion. Individuals and organizations interested in quality care for patients with rheumatic disease are encouraged to review the information on this page and provide input into ACR guideline activities.


About ACR Clinical Practice Guidelines

Clinical practice guidelines and recommendations are developed to:

  • Reduce inappropriate care
  • Minimize geographic variations in practice patterns
  • Enable effective use of health care resources

Guidelines and recommendations developed and/or endorsed by the ACR are intended to provide guidance for patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to these guidelines and recommendations to be voluntary, with the ultimate determination regarding their application to be made by the clinician in light of each patient's individual circumstances.

Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and/or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice.


Available ACR Guidelines

Clinical Practice Guideline Project Steps

Step 1: Define project scope and identify team

Step 2: Identify important clinical questions and outcomes

Step 3: Obtain feedback on project plan via public comment

Step 4: Conduct literature review

Step 5: Consider evidence in light of clinical expertise and experience and draft recommendations

Step 6: Draft guideline manuscript

Step 7: Peer review by ACR

Step 8: Post guideline summary

Step 9: Peer review by journal

Step 10: Final guideline published and disseminated

Step 11: Update literature searches and reevaluate the need for updating and revising


Guideline Policies and Procedures

To promote transparency and assist ACR guideline development groups in their work, the ACR has outlined its policies and procedures for guideline development and maintenance in the ACR Guideline Manual.

woman looking at computer

Patient Involvement

Patients are active participants in ACR guideline development. For each guideline, a Patient Panel is convened and provides input just before the Voting Panel meets to decide the guideline recommendations. At least two patients from the Patient Panel sit on the Voting Panel, tasked with sharing patient perspectives during the discussions and decision-making. Learn more about the ACR’s initial pilot project to test its current process for patient involvement in guideline work.


When Patients Write the Guidelines: Patient Panel Recommendations for the Treatment of Rheumatoid Arthritis


When Patients Write the Guidelines Appendix: Evidence Reports

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