Background: Unlike other clinical practice guidelines, the American College of Chest Physicians 9th edition of the Antithrombotic Guidelines is giving methodologists a prominent role. A clinical epidemiologist with GRADE expertise is leading each of the guideline s fifteen chapters as its editor. The lead content expert serves as the chapter deputy editor. A new conflict of interest policy is placing equal emphasis on intellectual and financial conflicts and allowing panel members with important conflicts to contribute to the evidence review but not to the recommendations. The goal is to utilize the experience and insight of experts while ensuring that financial and intellectual conflicts do not influence recommendations. Objectives: To explore participating editors and deputy editors views regarding the structural and process changes. Methods: We completed the first phase of the study in the summer of 2009 before the guidelines chapter panels initiated their work. We conducted semi-structured personal interviews with 23 chapter editors and deputy editors and analyzed data qualitatively. Results: Editors and deputy editors agreed that the changes will help in the handling of conflicts of interest and the public perception of the guidelines. While editors believed the changes will ensure more rigorous evidence-based guidelines, some deputy editors were worried that methodologists lack of content expertise could hurt the quality of the guidelines. Editors were worried about their lack of content expertise and the possibility of conflicts with content experts. Deputy editors perceived their title as an unfair demotion. They also expressed frustration with the conflict of interest policy as they perceived it as judging experts as ethically suspect and intellectually compromised. Conclusions: Editors and deputy editors agreed the changes would help in handling conflicts of interest but disagreed on the impact on guideline quality. While editors were worried about their involvement, deputy editors expressed frustration with their demotions .