■欧洲心脏病学会(ESC)临床实践指南目前被认为是支持许多心脏病专家进行临床决策的重要工具,不仅在欧洲,而且在世界各地。在这项研究中,我们分析了这些建议的建议类别(COR)和证据水平(LOE),以检测这些建议背后的科学背景有多可靠。
■我们已将所有当前的指南抽象为“到2022年10月1日在ESC网站上提供的指南”。所有建议都根据其COR进行分类(I类,IIa,IIb,或III)和LOE(A,B,orC).由于每个主题都有不同数量的建议,我们在不同主题之间的比较中使用了中值,以使所有主题具有相同的权重。
■当前的ESC指南包括37个临床主题,包括总共4289个建议。它们的分布为2140,在I类中中位数为49.9%,II类和III类分别为1825,中位数为42.6%,324,中位数为7.5%。LOEA仅出现在667条(15.5%)建议中,LOEB中的1285(30%),虽然LOEC支持大多数建议,2337,中位数为54.5%。
■尽管ESC指南被认为是心血管疾病管理的黄金标准,但令人惊讶的是,超过一半的建议是基于这样的科学证据。临床试验的缺陷在所有指南的主题中都是不同的,有些更需要临床研究。
UNASSIGNED: European Society of Cardiology (ESC) clinical practice guidelines are currently considered as an essential tool supporting many cardiologists in clinical decision-making not only in Europe but all-over the world. In this study we analyzed these recommendations regarding their class of recommendations (COR) and level of evidence (LOE) to detect how solid is the scientific background behind these recommendations.
UNASSIGNED: We have abstracted all the current guidelines defined as \"the guidelines available on the ESC website by 01 October 2022\". All recommendations were classified according to their COR (Class I, IIa, IIb, or III) and LOE (A, B, or C). As every topic has different number of recommendations, we have used the median values in comparisons between different topics to give all the topics the same weight.
UNASSIGNED: Current ESC guidelines consist of 37 clinical topics including a total of 4289 recommendations. Their distribution was 2140 with a median of 49.9% in Class I, Class II and Class III were 1825 with a median of 42.6% and 324 with a median of 7.5% respectively. LOE A was only present in 667(15.5%) recommendations, 1285(30%) in LOE B, while LOE C was behind the majority of the recommendations, 2337 with a median of 54.5%.
UNASSIGNED: Although ESC guidelines are considered a gold standard for management of cardiovascular diseases, but surprisingly more than half of its recommendations are based on such scientific evidence. Deficiency in clinical trials is not the same across all guideline\'s topics, some are needier for clinical research.