In clinical practice guideline (CPG) implementation, A&F has been used to attempt to increase guideline adherence across a wide variety of settings and conditions, such as inpatient management of chronic obstructive pulmonary disease (COPD)[1], test ordering in primary care[2,3], and angiotensin-converting enzyme (ACE) inhibitor and beta-blocker usage in cardiac patients[4]. The gene discussed is ACE; the disease is chronic obstructive pulmonary disease.