Comparative analysis of level of evidence and class of recommendation for 50 clinical practice guidelines released by the European Society of Cardiology from 2011 to 2022

•The European Society of Cardiology (ESC) clinical practice guidelines are essential tools for decision making.•An analysis of the level of evidence (LOE) and of the class of recommendations was performed, by evaluating the 50 ESC guidelines released in the last 12 years.•The recommendations include...

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Vydáno v:European journal of internal medicine Ročník 114; s. 1 - 14
Hlavní autoři: Boriani, Giuseppe, Venturelli, Andrea, Imberti, Jacopo F, Bonini, Niccolò, Mei, Davide A, Vitolo, Marco
Médium: Journal Article
Jazyk:angličtina
Vydáno: Netherlands Elsevier B.V 01.08.2023
Témata:
Arrhythmia
Atrial fibrillation
Diabetes
Guidelines
Heart failure
Pacing
Prevention
Heart failure
Prevention
Arrhythmia
Atrial fibrillation
Pacing
Diabetes
Guidelines
ISSN:0953-6205, 1879-0828, 1879-0828
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Shrnutí:•The European Society of Cardiology (ESC) clinical practice guidelines are essential tools for decision making.•An analysis of the level of evidence (LOE) and of the class of recommendations was performed, by evaluating the 50 ESC guidelines released in the last 12 years.•The recommendations included in the ESC guidelines widely differ in terms of quality of evidence, with only 16% supported by the highest quality of evidence.•A slight global increase in LOE a recommendations was observed in recent years, but further scientific research efforts are needed. The European Society of Cardiology (ESC) clinical practice guidelines are essential tools for decision-making. To analyze the level of evidence (LOE) and the class of recommendations in the ESC guidelines released in the last 12 years. We evaluated 50 ESC guidelines released from 2011 to 2022, related to 27 topics and categorized them into seven macro-groups. We analyzed every recommendation in terms of LOE and class of recommendation, calculating their relative proportions and changes over time in consecutive editions of the same guideline. A total of 6972 recommendations were found, with an increase in number per year over time. Among the 50 ESC guidelines, the proportional distribution of classes of recommendations was 49% for Class I, 29% for Class IIa, 15% for Class IIb, and 8% for Class III. Overall, 16% of the recommendations were classified as LOE A, 31% LOE B and 53% LOE C. The field of preventive cardiology had the largest proportion of LOE A, while the lowest was in the field of valvular, myocardial, pericardial and pulmonary diseases. The overall proportion of LOE A recommendations in the most recent guidelines compared to their prior versions increased from 17% to 20%. The recommendations included in the ESC guidelines widely differ in terms of quality of evidence, with only 16% supported by the highest quality of evidence. Although a slight global increase in LOE A recommendations was observed in recent years, further scientific research efforts are needed to increase the quality of evidence. [Display omitted]
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:0953-6205
1879-0828
1879-0828
DOI:10.1016/j.ejim.2023.04.020