Correlation between the level of evidence and the class of recommendations concerning the pharmacological aspects of the Guidelines of the European Society of Cardiology.

Autor:	Milbradt S; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein. Electronic address: stephan.milbradt@gmx.de., Eichhorn J; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Fetzner U; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Fietz R; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Gross R; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Jung K; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Klement M; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Konzett K; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Larcher B; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Manz B; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Mareth C; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Schmieder E; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Severgnini L; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Sternbauer S; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Wehrli MRT; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Weifenbach N; Private University in the Principality of Liechtenstein (UFL), Triesen, Liechtenstein., Saely C; Vorarlberg Institute for Vascular Investigation & Treatment (VIVIT), Austria., Drexel H; Department of Medicine, Academic Teaching Hospital Bregenz, Bregenz, Austria; Drexel University College of Medicine, Philadelphia, PA, USA.
Jazyk:	angličtina
Zdroj:	International journal of cardiology [Int J Cardiol] 2023 Mar 15; Vol. 375, pp. 119-123. Date of Electronic Publication: 2022 Dec 16.
DOI:	10.1016/j.ijcard.2022.12.027
Abstrakt:	Background The reliability of the recommendations affecting the clinical decisions is being continuously weighed in everyday practice (Gershlick, 2018). The objective of our study was to assess the consistency of the evidence behind the recommendations. Methods We narrowed our focus on the pharmacotherapeutic aspects of the most recent 38 European Society of Cardiology guidelines and analyzed the correlation between the level of evidence (LoE) classified as A, B and C and the class of recommendations (CoR) subdivided into I, IIa, IIb and III. Results Contrary to the majority of recommendations based on a LoE C (43,0%), fewer recommendations were proposed on heavily evidence-supported LoE A (23.8%), which percentage increased with subsequent updates of the guidelines. The most common recommendation was CoR I (44,9%), while the least common recommendation was CoR III (9,2%). While a similar share of A (39,1%) and C (30,1%) LoE shaped the CoR I nearly half (48,8%) of the CoR III were based on LoE C. Conversely, the overwhelming majority of the recommendations within the scope of LoE A were indisputably strong and classified as CoR I (73,7%). Conclusion The pharmacological aspects of the ESC guidelines are predominantly based on LoE C. A greater number of pharmacological recommendations are based on LoE A in comparison to the general ones. Various constraints significantly skew the credibility due to paucity of scientific data. A more nuanced approach is needed, as the guidelines cannot completely substitute the clinical experience and the patient-centered approach in shaping the optimal therapeutic outcome. Competing Interests: Declaration of Competing Interest None. (Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Full Text from ScienceDirect