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There are single and/or aggregate recommendations made and a strength level is assigned. Potential benefits and harms, costs, and patient preferences are identified, as well as any gaps in research, and each is documented. 7. Write the Draft: The AOA staff sends the Articulation results to the writer to develop draft 1. 8. Draft Review and Edits*: The GDG reads draft 1, discusses, and edits. 9. Rewrite/Final Drafts: The AOA staff sends the draft results to the writer for writing/revisions for draft 2 (Peer Review Draft) and sends to medical editor for copy editing. Additional reviews are completed as necessary. 10. Approval and Posting for Peer Review: The AOA staff and/or EBO Committee chair sends the Peer Review Draft to AOA Board of Trustees for approval to post for peer and public review. The draft is posted on the AOA website, along with a comment form, and the review period is announced. Comments are solicited/collected to a separate email and comment authors are not made public. 11. Final Document Produced: The GDRG and GDG clinical experts review all peer comments and revise the final document. They may choose to include the peer review comment, not include the comment, and/or identify further gaps to review when preparing the next edition. All comments are documented regarding actions taken/not taken and the Final Draft is produced. 12. Final Draft Approval and Legal Review: The Final Draft is reviewed by the AOA Board of Trustees and AOA Legal Counsel for approval and verification that the GDG followed the evidence-based process as outlined by the National Academies of Sciences, Engineering, and Medicine (NASEM) - Health and Medicine Division, previously the Institute of Medicine. 13. Post Guidelines: The AOA staff posts the evidence-based guideline to AOA website for public use. 14. Schedule Reviews: The GDG schedules a review to meet the NASEM guideline development standards and reviews all previously identified gaps in medical research and any new evidence and revises the evidence-based guideline every 2 to 5 years. **Denotes face-to-face meeting 8 aoa.org B. HOW TO USE THIS GUIDELINE The following table provides the grading system used in this guideline for rating evidence-based clinical statements.
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