Clinical practice guidelines (CPGs) are essential documents offering practical recommendations developed to enhance patient care and inform health care. Properly formulated through meticulous assessment of scientific evidence and medical expertise by multidisciplinary teams, CPGs strive to ensure an optimal balance between care benefits and potential risks. Because of the dynamic nature of medicine, health care professionals often balance delicate decisions with significant uncertainties. These professionals rely on scientific literature, personal skills and experience, patient preferences, and guidelines from different organizations. Yet, these sources can suggest different paths derived from the same evidence, as is the case in contemporary guidelines on the management of valvular heart disease. [1]

No universally accepted standards for developing CPGs exist, even though multiple methodologies exist for evaluating and translating research evidence into treatment recommendations. [2–5] The Institute of Medicine (IOM) provides an authoritative and comprehensive guide for CPG development, introducing several pivotal characteristics regarded as essential for producing reliable documents: (1) transparency, (2) diversity in the writing group composition, (3) conflict of interest (COI) management, (4) thorough systematic literature reviews, (5) synthesis of evidence and evidence strength ratings, (6) clear communication in recommendation and supporting text, (7) external validation, and (8) regular updates. Although these criteria may seem straightforward, aligning with them can be challenging. [6] Many organizations have hesitated to embrace the IOM’s criteria entirely, emphasizing the increase in expenses and publication delays without substantial added value.