In addition to adopting a uniform grading system for evidence-based guidelines, the ACCP also began a systematic evaluation of how recommendations might impact resource utilization. To date, no evidence-based guideline, regardless of its sponsoring organization, has provided a consistent and transparent approach to resource/cost considerations in its recommendations. In part, this is due to the widespread differences in resource utilization internationally, the rapidly changing or variable costs from region to region, and the complexity of the resource issue impacting patients, caregivers, insurance providers, and others. It is important to note that resource/cost considerations involve not simply assessing the easily recognized immediate dollars consumed, but all surrounding and downstream resource effects of implementing a particular evidence-based guideline recommendation. One ideally must consider all consumed resources.