AASLD Practice Guidelines Diagnosis and Management of Hemochromatosis

Practice guidelines, intended for use by physicians, suggest preferable approaches to the diagnostic, therapeutic, and preventative aspects of care. These guidelines are intended to be flexible, in contrast with “standards of care,” which are inflexible policies to be followed in almost every case.1 They are developed in a manner consistent with the American Gastroenterological Associations’ Policy Statement on Development and Use of Practice Guidelines.2 Specific recommendations are based on relevant published information. In an attempt to standardize recommendations, the Practice Guidelines Committee of the American Association for the Study of Liver Diseases modified the categories of the Infectious Diseases Society of America’s Quality Standards.3 These categories are reported with each recommendation, using the letters A through E to determine the strength of recommendation (Table 1) and Roman numerals I through IV to determine quality of evidence upon which recommendations are based (Table 2). These guidelines provide data-supported peer-reviewed recommendations for the care of patients with hemochromatosis. They are based on the following: (1) a formal review and analysis of the recent published literature on hemochromatosis (Medline Search from 1990-2000); (2) the American College of Physicians’ Manual for Assessing Health Practices and Designing Practice Guidelines; (3) several published guidelines, including the American Association for the Study of Liver Diseases’ Policy Statement on Development and Use of Practice Guidelines and the American Gastroenterological Association’s Policy Statement on Guidelines2; and (4) the experience of the author in the clinical care of patients with hemochromatosis. BACKGROUND