Accumulating scientific evidence in cardiology with special reference to the Japanese contribution

Area of Science:

• Medical research methodology
• Evidence-based practice

Background:

• Clinical practice guidelines synthesize current scientific evidence.
• Evidence-based medicine (EBM) is the prevailing paradigm for evaluating medical evidence.
• High-quality studies, including randomized controlled trials (RCTs) and meta-analyses (MAs), are crucial for EBM.

Purpose of the Study:

• To outline the principles and sources of evidence-based medicine.
• To discuss the characteristics of valid RCTs and MAs.
• To address controversial issues in clinical practice and summarize Japanese RCTs.

Main Methods:

• Review of scientific evidence sources, focusing on RCTs and MAs.
• Analysis of criteria for evaluating study quality in EBM.
• Discussion of specific clinical controversies and a summary of Japanese RCTs.

Main Results:

• Identified RCTs and MAs as primary sources for EBM.
• Highlighted the importance of study quality in evidence appraisal.
• Summarized controversial topics like calcium channel blocker safety and magnesium efficacy in myocardial infarction.
• Provided an overview of Japanese RCTs, both completed and in progress.

Conclusions:

• Emphasizes the critical role of high-quality RCTs and MAs in EBM.
• Underscores the need for careful consideration of controversial clinical issues.
• Predicts increased importance of international collaboration for evidence management and updating.