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Levels of evidence in cardiovascular clinical practice guidelines.
Can J Cardiol. 2000 Oct; 16(10):1249-54.CJ

Abstract

BACKGROUND

Clinical practice guidelines (CPGs) can be helpful in distilling the medical research literature for clinicians; however, the guidelines should acknowledge the variable methodological quality used in clinical research by tempering their recommendations with a 'levels of evidence' scale.

OBJECTIVE

To evaluate the proportion of English-language cardiovascular CPGs that provide the user with recommendations graded according to a defined levels of evidence scale. In addition, to evaluate other key aspects important in the critical appraisal of CPGs.

METHODS

CPGs for atrial fibrillation, congestive heart failure and myocardial infarction were identified by searching MEDLINE, a reference text of CPGs and the Internet. Each CPG was evaluated using a priori-defined criteria based on the Evidence-Based Medicine Working Group's paper on critical appraisal of CPGs, including use of a reproducible search strategy, method of obtaining consensus, peer review and testing in practice.

RESULTS

A total of 95 CPGs were evaluated. Only 13% graded their recommendations using a defined levels of evidence scale. In addition, few CPGs documented a reproducible search strategy or peer review process, and none had been formally tested in practice.

CONCLUSIONS

Reporting the levels of evidence for recommendations is an important component of CPGs, yet this system is not widely used.

Authors+Show Affiliations

University of Alberta Hospital, Edmonton, Canada. mackman@cha.ab.caNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

11064299

Citation

Ackman, M L., et al. "Levels of Evidence in Cardiovascular Clinical Practice Guidelines." The Canadian Journal of Cardiology, vol. 16, no. 10, 2000, pp. 1249-54.
Ackman ML, Druteika D, Tsuyuki RT. Levels of evidence in cardiovascular clinical practice guidelines. Can J Cardiol. 2000;16(10):1249-54.
Ackman, M. L., Druteika, D., & Tsuyuki, R. T. (2000). Levels of evidence in cardiovascular clinical practice guidelines. The Canadian Journal of Cardiology, 16(10), 1249-54.
Ackman ML, Druteika D, Tsuyuki RT. Levels of Evidence in Cardiovascular Clinical Practice Guidelines. Can J Cardiol. 2000;16(10):1249-54. PubMed PMID: 11064299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Levels of evidence in cardiovascular clinical practice guidelines. AU - Ackman,M L, AU - Druteika,D, AU - Tsuyuki,R T, PY - 2000/11/7/pubmed PY - 2001/2/28/medline PY - 2000/11/7/entrez SP - 1249 EP - 54 JF - The Canadian journal of cardiology JO - Can J Cardiol VL - 16 IS - 10 N2 - BACKGROUND: Clinical practice guidelines (CPGs) can be helpful in distilling the medical research literature for clinicians; however, the guidelines should acknowledge the variable methodological quality used in clinical research by tempering their recommendations with a 'levels of evidence' scale. OBJECTIVE: To evaluate the proportion of English-language cardiovascular CPGs that provide the user with recommendations graded according to a defined levels of evidence scale. In addition, to evaluate other key aspects important in the critical appraisal of CPGs. METHODS: CPGs for atrial fibrillation, congestive heart failure and myocardial infarction were identified by searching MEDLINE, a reference text of CPGs and the Internet. Each CPG was evaluated using a priori-defined criteria based on the Evidence-Based Medicine Working Group's paper on critical appraisal of CPGs, including use of a reproducible search strategy, method of obtaining consensus, peer review and testing in practice. RESULTS: A total of 95 CPGs were evaluated. Only 13% graded their recommendations using a defined levels of evidence scale. In addition, few CPGs documented a reproducible search strategy or peer review process, and none had been formally tested in practice. CONCLUSIONS: Reporting the levels of evidence for recommendations is an important component of CPGs, yet this system is not widely used. SN - 0828-282X UR - https://www.unboundmedicine.com/medline/citation/11064299/Levels_of_evidence_in_cardiovascular_clinical_practice_guidelines_ DB - PRIME DP - Unbound Medicine ER -