Class I ACC/AHA Recommendations Vary Over Time

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Class I ACC/AHA Recommendations Vary Over Time
Class I ACC/AHA Recommendations Vary Over Time

(HealthDay News) — The durability of class I American College of Cardiology/American Heart Association (ACC/AHA) guidelines varies, according to research published in the May 28 issue of the Journal of the American Medical Association.

Mark D. Neuman, MD, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues conducted a textual analysis of 11 class I ACC/AHA guidelines published between 1998–2007 and revised from 2006–2013. Variations in the durability were characterized.

The researchers found that 80.0% of the 619 index recommendations were retained in the subsequent guideline version; 9.2% were downgraded or reversed; and 10.8% were omitted. Across guidelines, there was variation in the percentage of recommendations retained, from 15.4 to 94.1%. The percentage of recommendations with available information on level of evidence that were retained was 90.5% for recommendations supported by multiple randomized studies, compared with 81.0% for those supported by one randomized trial or observational data and 73.7% for those supported by opinion. Recommendations based on opinion or on one trial or observational data had a significantly higher probability of being downgraded, reversed, or omitted, compared with those based on multiple trials (odds ratios, 3.14 and 3.49, respectively).

"The durability of class I cardiology guideline recommendations for procedures and treatments promulgated by the ACC/AHA varied across individual guidelines and levels of evidence," the authors write.

One author disclosed financial ties to the pharmaceutical and health insurance industries.

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