We stuck purely to the evidence. There was no evidence panel or committee to vote on the evidence like is often done by the American college of rheumatology and no expert opinion statements where their only citation is themselves like can be seen with the ACC. This was purely 100% evidence recommendations. So lets start try to make it quick because guidelines on a podcast a boring, I want to hit the high points and get out of here This guideline does not cover 1) adults < age 40 years old o 2) patients with ejection fraction s guidance, particularly for primary prevention. By performing a more comprehensive systematic review of the key clinical questions and not making any recommendations that go beyond the supporting evidence, the VA/DoD ensured that its guideline is the most likely to improve patient outcomes and minimize harms.