Evaluating the Quality of Evidence in Clinical Guidelines
Author Information
Author(s): McAlister Finlay A, van Diepen Sean, Padwal Rajdeep S, Johnson Jeffrey A, Majumdar Sumit R
Primary Institution: University of Alberta, Edmonton, Canada
Hypothesis
How evidence-based are the recommendations in evidence-based guidelines?
Conclusion
Fewer than half of the cardiovascular risk management recommendations in the guidelines were based on high-quality evidence.
Supporting Evidence
- Of the 338 treatment recommendations, 231 (68%) cited RCT evidence.
- Only 105 (45%) of RCT-based recommendations were based on high-quality evidence.
- 64 recommendations were downgraded due to applicability concerns.
- 59 recommendations were downgraded because they reported surrogate outcomes.
Takeaway
This study looked at treatment recommendations for heart health and found that many were not based on strong evidence, which means doctors should be careful when following these guidelines.
Methodology
A cross-sectional analysis of cardiovascular risk management recommendations from nine guidelines was performed.
Potential Biases
Potential misattribution of citations to particular recommendations due to inconsistent citation practices.
Limitations
The study analyzed a subset of recommendations in only a few guidelines.
Digital Object Identifier (DOI)
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