Preamble
These recommendations provide a data-supported approach.
They are based on the following: (1) formal review
and analysis of the recently published world
literature on the topic (Medline search); (2) American
College of Physicians Manual for Assessing Health Practices
and Designing Practice Guidelines1; (3) guideline
policies, including the AASLD Policy on the development
and use of Practice Guidelines and the American
Gastroenterological Association Policy Statement on
Guidelines2; and (4) the experience of the authors in the
specified topic.
Intended for use by physicians, these recommendations
suggest preferred approaches to the diagnostic, therapeutic,
and preventive aspects of care. They are intended
to be flexible, in contrast to standards of care, which are
inflexible policies to be followed in every case. Specific
recommendations are based on relevant published information.
To more fully characterize the quality of evidence
supporting recommendations, the Practice Guideline
Committee of the AASLD requires a Class (reflecting
benefit versus risk) and Level (assessing strength or certainty)
of Evidence to be assigned and reported with each
recommendation (Table 1, adapted from the American
College of Cardiology and the American Heart Association
Practice Guidelines).3,4