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Doctors are seeking professional guidelines to help them identify the latest evidence for appropriate medical treatments, but a Friday study shows that most of these heart disease guidelines are not based on the highest level of evidence. 19659008] An American Medical Association (JAMA) journal, published in advance online, states that less than 10 percent of cardiovascular guidelines are based on carefully conducted scientific studies known as randomized controlled trials. The rest is based much on weak evidence.
Renato Lopes, a cardiologist at Duke University, and his colleagues decided to become familiar with the guidelines of the American College of Cardiology and the American Heart Association. The scientists also reviewed the guidelines of the European Society of Cardiology and found a similar pattern.
Colleagues who did a similar analysis a decade ago made a surprising and disappointing remark: only 12.5 percent of these guidelines are based on the highest evidence.
This study, "as you can imagine, generated a lot of buzz because the numbers were not what everyone expected," says Lopes. The community of heart disease researchers decided to close these important knowledge gaps.
Ten years later, Lopes and his colleagues decided to see if there had been any progress. If anything, the situation has worsened a bit.
The new study concludes that only 8.5 percent of the guidelines are backed by randomized, controlled trials in which patients receiving treatment are compared to a similar group it is not.