Methodology to update the practice recommendations in the American College of Occupational and Environmental Medicine's Occupational Medicine Practice Guidelines, second edition.

OBJECTIVE To ensure that revisions to the second edition of the American College of Occupational and Environmental Medicine (ACOEM) guidelines are as valid and useful as possible. METHODS The ACOEM Guideline Methodology Committee searched and synthesized the evidence-based medicine literature on systematic review and guideline development. The resulting process and tools were tested during guideline revision, and changes were made to the tools and process. RESULTS The methodology specifies problem formulation, literature search methods, screening of studies, quality rating, summarization of the body of literature, recommendation drafting and rating, "first principles" of medical logic and ethics, training, expert panel review, stakeholder input, external review, pilot testing and Board of Directors approval. CONCLUSIONS The process and tools developed are consistent with international guideline assessment criteria, robust, and internally and externally valid.