Not Enough Evidence for Evidence-Based Guidelines?

The ACC/AHA guidelines have continued to expand, yet a new study suggests that the evidence to support most recommendations has declined.

The American College of Cardiology and the American Heart Association currently use a dual grading scheme for guideline recommendations. The class (I through III) indicates the strength of the recommendation, and the level of evidence (LOE; A through C) characterizes the supportive research data, including expert consensus opinion.

These investigators examined changes to recommendations in ACC/AHA cardiovascular guidelines over time and evaluated the LOEs supporting the recommendations. Fifty-three ACC/AHA practice guidelines published from 1984 through September 2008 were included in the study. The guidelines covered 22 topics and included a total of 7196 recommendations.

In the guidelines that were revised at least once during the period as…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)