支持美国心脏病学院/美国心脏协会和欧洲心脏病学会指南的证据水平,2008-2018年
在PubMed上查看摘要
概括
此摘要是机器生成的。大多数心血管指南缺乏随机对照试验 (RCT) 的强有力的证据. 近年来,在主要社会指南中,A级证据建议的比例没有显著提高.
科学领域
- 心脏病学
- 临床指南
- 基于证据的医学
背景情况
- 理想情况下,临床决策依赖于多项随机对照试验 (RCT) 的强有力的证据.
- 从历史上看,很少有临床指南建议仅基于高水平的RCT证据.
研究的目的
- 评估目前支持心血管学会指南的证据水平.
- 分析 LOE 随着时间的推进而发生的变化.
主要方法
- 审查了美国心脏病学会/美国心脏病学会 (ACC/AHA) 和欧洲心脏病学会 (ESC) 的现行指南 (2008-2018).
- 根据LOE分类的建议:A (多个/单个大型RCT),B (观察性/单个RCT),C (专家意见).
- 与之前的指南相比,目前的 LOE 分布情况.
主要成果
- 目前的ACC/AHA指南有8.5%的LOE A建议; 经济委员会指南有14.2%的LOE A.
- 与ACC/AHA和ESC的先前指南版本相比,LOE A建议的比例没有显著增加.
- 大多数建议被归类为LOE B或C,表明依赖于较低水平的证据.
结论
- 主要心血管学会指南中很少有推得到高水平RCT证据的支持.
- 这种依赖低级别证据的情况在2008年至2018年之间并没有大大改善.
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