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

  • Lupus
  • Lyme Disease
  • Optimal Timing of Total Hip/Knee Arthroplasty
  • Osteoarthritis
  • Perioperative Management
  • Psoriatic Arthritis
  • Axial Spondyloarthritis
  • Glucocorticoid-Induced Osteoporosis
  • Gout
  • Integrative RA Treatment
  • Interstitial Lung Disease
  • Juvenile Idiopathic Arthritis

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.

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

Roles of the Interdisciplinary Rheumatology Team

To work together effectively, clinicians and rheumatology professionals need to understand the roles of every member of the interdisciplinary team. Explore our new series of fact sheets that describe the modern roles of members of the interdisciplinary care team.
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