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Doctors are turning to professional guidelines to help them identify the latest thinking about appropriate medical treatments, but a study published on Friday notes that in the field of heart disease, most of these guidelines are not based on the highest level of evidence  An article in JAMA, the magazine of the American Medical Association, which was published online before the press, notes that less than 10% of cardiovascular guidelines are based on the most accurately conducted, known scientific studies as randomized controlled trials. Much of the rest is based on much weaker evidence.
Renato Lopes, a cardiologist at Duke University and his colleagues decided to investigate the guidelines of the American College of Cardiology and the American Heart Association. The scientists also examined the guidelines of the European Cardiology Society and found a similar model.
Colleagues who had made a similar analysis about ten years ago presented a surprising and disappointing observation: only 12.5% of these guidelines are based on the highest level of evidence.
That studio "created a lot of enthusiasm, as you can imagine, because the numbers weren't what everyone expected," says Lopes. The community of heart disease researchers has decided to address these important knowledge gaps.
Ten years later, Lopes and his colleagues decided to see if progress had been made. If nothing else, the situation has deteriorated slightly.
The new study concludes that only 8.5% of the guidelines are supported by randomized controlled trials, in which people receiving treatment are compared to a similar group that is not.