title: An explanation of recommendation differences: illustrations from recent atrial fibrillation guidelines.
abstract: The development of guidelines and their use in all areas of medicine has greatly expanded in recent years. However, despite a shared evidence base, recommendations provided by different professional societies and healthcare authorities often vary considerably. The rapid advances in atrial fibrillation (AF) and the multiplicity of guidelines devoted to AF have made it particularly susceptible to this problem. Many nonmedical aspects are important in the development of guidelines, and without understanding them correct interpretation of guidelines is difficult. Conflicts of interest, the regulatory environment, and local data all influence guidelines. Nuanced wording, resource availability, and strategic purpose add complexity to guideline recommendations. This article reviews major AF guidelines from around the world and discusses aspects which have nothing to do with the scientific evidence base in order to help the practicing physician understand and make better use of differing guideline recommendations.
authors.affiliation: New College, University of Oxford, Oxford, UK.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Camm
authors.forename: A John
authors.initials: AJ
authors.lastname: Camm
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002309:Cardiology / Q000592:standards*; D006801:Humans; D038622:Internationality; D017410:Practice Guidelines as Topic
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: antiarrhythmic drug; atrial fibrillation; left atrial ablation; left atrial appendage device; novel oral anticoagulants; thromboembolism