Funding of Studies Supporting IA Guideline Recommendations in Cardiovascular Medicine-A Systematic Review

Area of Science:

• Cardiovascular Medicine
• Clinical Guidelines
• Research Funding

Background:

• Guideline recommendations from the American Heart Association (AHA) and American College of Cardiology (ACC) are graded by evidence level and strength.
• Level IA recommendations represent the highest quality evidence with minimal uncertainty regarding benefit.

Purpose of the Study:

• To systematically analyze study types and funding sources for AHA/ACC IA guideline recommendations over the past five years.
• To identify trends in research funding for high-quality cardiovascular evidence.

Main Methods:

• Tabulation of study types (e.g., randomized controlled trials) and funding sources (public vs. industry) for IA guideline recommendations.
• Analysis of funding trends over time and by intervention type (device, diagnostic, pharmacological).

Main Results:

• Nearly half (45%) of studies supporting IA recommendations were randomized controlled trials.
• Industry sources funded 43.5% of studies, compared to 34.9% from public sources.
• Industry funding predominated for randomized controlled trials of device, diagnostic, and pharmacological interventions, and has doubled public funding over time.

Conclusions:

• High-quality evidence supporting cardiovascular guidelines originates from diverse sources, including randomized controlled trials.
• Industry funding plays a substantial role, particularly for interventional studies, and has grown relative to public funding.
• Understanding funding landscapes is crucial for interpreting evidence underpinning clinical practice guidelines.