Type of evidence supporting ACC/AHA and ESC clinical practice guidelines for acute coronary syndrome
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany..
AIM: The aim of clinical practice guidelines for ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS) is to assist healthcare professionals in clinical decision-making. We evaluated the type of studies supporting these guidelines and their recommendations.
METHODS: All references and recommendations in the 2013 and 2014 ACC/AHA and 2017 and 2020 (ESC clinical guidelines for STEMI and NSTE-ACS were reviewed. References were classified into meta-analyses, randomised, non-randomised, and other types (e.g., position papers, reviews). Recommendations were classified according to class and their level of evidence (LOE).
RESULTS: We retrieved 2128 non-duplicated references: 8.4% were meta-analyses, 26.2% randomised studies, 44.7% non-randomised studies, and 20.7% 'other' papers. Meta-analyses were based on randomised data in 78% of cases and used individual-patient data in 20.2%. Compared to non-randomised studies, randomised studies were more frequently multicentre (85.5% vs. 65.5%) and international (58.2% vs. 28.5%). The type of studies supporting recommendations varied as per the LOE of the recommendation. For LOE-A recommendations, the breakdown of supporting recommendations was: 18.5% meta-analyses, 56.6% randomised studies, 16.6% non-randomised studies and 8.3% 'other' papers; for LOE-B this breakdown was 9%, 39.8%, 38.2%, and 12.9%; and for LOE-C; 4.6%, 19.3%, 30.3%, and 45.9%.
CONCLUSIONS: The references supporting the ACC/AHA and ESC guidelines on STEMI and NSTE-ACS consisted of non-randomised studies in ~ 45% of cases, with less than a third of the references consisting of meta-analyses and randomised studies. The type of studies supporting guideline recommendations varied widely by the LOE of the recommendation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:113 |
|---|---|
| Enthalten in: |
Clinical research in cardiology : official journal of the German Cardiac Society - 113(2024), 4 vom: 20. März, Seite 546-560 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Gonzalez-Del-Hoyo, Maribel [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute coronary syndrome |
|---|
| Anmerkungen: |
Date Completed 21.03.2024 Date Revised 21.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00392-023-02262-9 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM35937364X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM35937364X | ||
| 003 | DE-627 | ||
| 005 | 20240321235317.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00392-023-02262-9 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1338.xml |
| 035 | |a (DE-627)NLM35937364X | ||
| 035 | |a (NLM)37436514 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Gonzalez-Del-Hoyo, Maribel |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Type of evidence supporting ACC/AHA and ESC clinical practice guidelines for acute coronary syndrome |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.03.2024 | ||
| 500 | |a Date Revised 21.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. | ||
| 520 | |a AIM: The aim of clinical practice guidelines for ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS) is to assist healthcare professionals in clinical decision-making. We evaluated the type of studies supporting these guidelines and their recommendations | ||
| 520 | |a METHODS: All references and recommendations in the 2013 and 2014 ACC/AHA and 2017 and 2020 (ESC clinical guidelines for STEMI and NSTE-ACS were reviewed. References were classified into meta-analyses, randomised, non-randomised, and other types (e.g., position papers, reviews). Recommendations were classified according to class and their level of evidence (LOE) | ||
| 520 | |a RESULTS: We retrieved 2128 non-duplicated references: 8.4% were meta-analyses, 26.2% randomised studies, 44.7% non-randomised studies, and 20.7% 'other' papers. Meta-analyses were based on randomised data in 78% of cases and used individual-patient data in 20.2%. Compared to non-randomised studies, randomised studies were more frequently multicentre (85.5% vs. 65.5%) and international (58.2% vs. 28.5%). The type of studies supporting recommendations varied as per the LOE of the recommendation. For LOE-A recommendations, the breakdown of supporting recommendations was: 18.5% meta-analyses, 56.6% randomised studies, 16.6% non-randomised studies and 8.3% 'other' papers; for LOE-B this breakdown was 9%, 39.8%, 38.2%, and 12.9%; and for LOE-C; 4.6%, 19.3%, 30.3%, and 45.9% | ||
| 520 | |a CONCLUSIONS: The references supporting the ACC/AHA and ESC guidelines on STEMI and NSTE-ACS consisted of non-randomised studies in ~ 45% of cases, with less than a third of the references consisting of meta-analyses and randomised studies. The type of studies supporting guideline recommendations varied widely by the LOE of the recommendation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute coronary syndrome | |
| 650 | 4 | |a Clinical Practice Guidelines | |
| 650 | 4 | |a Evidence-based medicine | |
| 650 | 4 | |a Recommendations | |
| 700 | 1 | |a Mas-Llado, Caterina |e verfasserin |4 aut | |
| 700 | 1 | |a Blaya-Peña, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Siquier-Padilla, Joan |e verfasserin |4 aut | |
| 700 | 1 | |a Coughlan, J J |e verfasserin |4 aut | |
| 700 | 1 | |a Peral, Vicente |e verfasserin |4 aut | |
| 700 | 1 | |a Rossello, Xavier |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical research in cardiology : official journal of the German Cardiac Society |d 2006 |g 113(2024), 4 vom: 20. März, Seite 546-560 |w (DE-627)NLM161855350 |x 1861-0692 |7 nnns |
| 773 | 1 | 8 | |g volume:113 |g year:2024 |g number:4 |g day:20 |g month:03 |g pages:546-560 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00392-023-02262-9 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 113 |j 2024 |e 4 |b 20 |c 03 |h 546-560 | ||