Perhaps the most famous example of a guideline for diagnosis is the Apgar score, developed in 1952 by the obstetric anesthesiologist Virginia Apgar. Assessing whether a newborn baby is in distress used to be a matter of clinical judgment for physicians and midwives. Apgar’s score gave them a standard guideline instead. The evaluator measures the baby’s color, heart rate, reflexes, muscle tone, and respiratory effort, sometimes summarized as a “backronym” for Apgar’s name: appearance (skin color), pulse (heart rate), grimace (reflexes), activity (muscle tone), and respiration (breathing rate
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