Same evidence different recommendations: a methodological assessment of transatlantic guidelines for the management of valvular heart disease.

Select Content Type
Clinical Guidelines
Authored By
Milojevic M, Sousa-Uva M, Marin-Cuartas M, Kaul S, Nikolic A, Mandrola J, Sádaba JR, Myers PO
Authored On
Interests
Cardiology
Internal/Family Medicine
Speciality
Cardiology
Internal/Family Medicine
Book Detail
volume
65
ISSN
1873-734X
Publication Date
Actions
Download in App
Event Data
{"article_title":"Same evidence different recommendations: a methodological assessment of transatlantic guidelines for the management of valvular heart disease.","author":"\"Milojevic, Milan , Sousa-Uva, Miguel , Marin-Cuartas, Mateo , Kaul, Sanjay , Nikolic, Aleksandar , Mandrola, John , S\u00e1daba, J Rafael , Myers, Patrick O\"","journal_title":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","issn":"1873-734X ; Electronic","isbn":"","publication_date":"20240503","volume":"65","issue":"5","first_page":"","page_count":"","accession_number":"38733575","doi":"10.1093\/ejcts\/ezae184","publisher":"Oxford University Press","doctype":"Journal Article","subjects":"Cardiology ","interest_area":["Cardiology"," Internal\/Family Medicine"],"abstract":"The aim of this study was to identify methodological variations leading to varied recommendations between the American College of Cardiology (ACC)\/American Heart Association (AHA) and the European Society of Cardiology (ESC)\/European Association for Cardio-Thoracic Surgery (EACTS) valvular heart disease guidelines and to suggest foundational steps towards standardizing guideline development.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=38733575&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Milojevic M, Sousa-Uva M, Marin-Cuartas M, Kaul S, Nikolic A, Mandrola J, S\u00e1daba JR, Myers PO","Journal_Info":"Publisher: Oxford University Press Country of Publication: Germany NLM ID: 8804069 Publication Model: Print Cited Medium: Internet ISSN: 1873-734X (Electronic) Linking ISSN: 10107940 NLM ISO Abbreviation: Eur J Cardiothorac Surg Subsets: MEDLINE","Publication_Type":"Journal Article","Published_Date":"2024-05-03","Source":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2024 May 03; Vol. 65 (5).","Languages":"English","Electronic_ISSN":"1873-734X","MeSH_Terms":"Heart Valve Diseases*\/surgery , Heart Valve Diseases*\/therapy , Practice Guidelines as Topic*\/standards, Humans ; Evidence-Based Medicine\/standards ; Europe ; Societies, Medical\/standards ; United States ; Cardiology\/standards","Subjects":"Humans, Evidence-Based Medicine standards, Europe, Societies, Medical standards, United States, Cardiology standards, Heart Valve Diseases surgery, Heart Valve Diseases therapy, Practice Guidelines as Topic standards","Title_Abbreviations":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","Volume":"65"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"38733575","RelevancyScore":"914","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"914.4599609375"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=38733575&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=38733575&authtype=shib&custid=ns346513&group=main&profile=eds"}
ISSN
1873-734X ; Electronic
IS_Ebsco
true
Upload Link
https://search.ebscohost.com/login.aspx?direct=true&db=mdl&AN=38733575&authtype=shib&custid=ns346513
Additional Info
["Milojevic M, Sousa-Uva M, Marin-Cuartas M, Kaul S, Nikolic A, Mandrola J, S\u00e1daba JR, Myers PO","Publisher: Oxford University Press Country of Publication: Germany NLM ID: 8804069 Publication Model: Print Cited Medium: Internet ISSN: 1873-734X (Electronic) Linking ISSN: 10107940 NLM ISO Abbreviation: Eur J Cardiothorac Surg Subsets: MEDLINE","Journal Article","2024-05-03","European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2024 May 03; Vol. 65 (5).","English","1873-734X","Heart Valve Diseases*\/surgery , Heart Valve Diseases*\/therapy , Practice Guidelines as Topic*\/standards, Humans ; Evidence-Based Medicine\/standards ; Europe ; Societies, Medical\/standards ; United States ; Cardiology\/standards","Humans, Evidence-Based Medicine standards, Europe, Societies, Medical standards, United States, Cardiology standards, Heart Valve Diseases surgery, Heart Valve Diseases therapy, Practice Guidelines as Topic standards","European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","65"]
Description
Objectives: The aim of this study was to identify methodological variations leading to varied recommendations between the American College of Cardiology (ACC)/American Heart Association (AHA) and the European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) valvular heart disease guidelines and to suggest foundational steps towards standardizing guideline development.<br />Methods: An in-depth analysis was conducted to evaluate the methodologies used in developing the transatlantic guidelines for managing valvular heart disease. The evaluation was benchmarked against the standards proposed by the Institute of Medicine.<br />Results: Substantial discrepancies were noted in the methodologies utilized in development processes, including Writing Committee composition, evidence evaluation, conflict of interest management and voting processes. Furthermore, despite their mutual differences, both methodologies demonstrate notable deviations from the Institute of Medicine standards in several essential areas, including literature review and evidence grading. These dual variances likely influenced divergent treatment recommendations. For example, the ESC/EACTS recommends transcatheter edge-to-edge repair for patients with chronic severe mitral regurgitation ineligible for mitral valve surgery, while the ACC/AHA recommends transcatheter edge-to-edge repair based on anatomy, regardless of surgical risk. ESC/EACTS guidelines recommend a mechanical aortic prosthesis for patients under 60, while ACC/AHA guidelines recommend it for patients under 50. Notably, the ACC/AHA and ESC/EACTS guidelines have differing age cut-offs for surgical over transcatheter aortic valve replacement (&lt;65 and &lt;75 years, respectively).<br />Conclusions: Variations in methodologies for developing clinical practice guidelines have resulted in different treatment recommendations that may significantly impact global practice patterns. Standardization of essential processes is vital to increase the uniformity and credibility of clinical practice guidelines, ultimately improving healthcare quality, reducing variability and enhancing trust in modern medicine.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Published Date