The CAP Pathology and Laboratory Quality Center develops evidence-based guidelines and consensus statements related to the practice of pathology and laboratory medicine.

The phases are outlined to help pathologists understand the rigorous development process that CAP Guidelines undergo before final approval.

Phase I: Submit and Select Ideas

Pathologists and others can submit guideline ideas at any time through the year to improve the quality of diagnostic medicine and patient outcomes.

Phase II: Determine Scope and Form Workgroup

During this phase, volunteer physicians and experts clearly define the key questions that the guideline will answer and address other needs including:

  • What panel and chair expertise is necessary?
  • Should consideration be given to partnering with another pathology or clinical partner group?
  • Once partners are chosen and administrative documents are shared, the rigorous and transparent screening for potential conflicts of interest among members begins.
  • Pathologists and others can submit guideline ideas at any time through the year to improve the quality of diagnostic medicine and patient outcomes.

Phase III: Research and Review Evidence

The process begins with a systematic review of the literature based on questions that surface during the scoping phase.

Next, the team undertakes increasingly detailed reviews of the literature culminating in articles selected for methodologist review. This approach ensures that evidence selection and grading are free from bias and in accordance with the review processes and standards used throughout the standard-setting communities.

Phase IV: Open Comment

Once drafted, the guideline and consensus statement recommendations undergo an open comment period, during which community feedback provides another prism for the authors to view their recommendations.

Phase V: Complete Recommendations

Following the public comment period, guideline authors complete the recommendations and supporting manuscript and forward the manuscript to an Independent Review Panel (IRP).

Phase VI: Review and Approve Guidelines

The College of American Pathologists (CAP) approval requires review and approval by an IRP comprising individuals with topical expertise who are free from conflicts of interest. The IRP recommends approval or nonapproval to the CAP Transformation Program Office Steering Committee, the final approval authority.

Phase VII: Publish and Implement

The guideline manuscript is submitted for simultaneous publication and release to the CAP and its partners' journals. Prior to release, the CAP develops tools and educational activities for use by pathologists and other care providers to support the adoption and implementation of guidelines.

Phase VIII: Maintain

The CAP Guidelines and consensus papers are reviewed every four years, or earlier, with the publication of substantive and high-quality medical evidence that could potentially alter the original guideline recommendations


If you have questions or comments about CAP Guidelines, our process, or our projects or to report any concerns related to conflict of interest, you may contact the CAP Pathology and Laboratory Quality Center anonymously.