The ACC/American Heart Association (AHA) guideline recommendations are becoming increasingly more evidence-based, according to a study published June 22 in the Journal of the American College of Cardiology.

Led by Henry Han, BS, of the VA North Texas Healthcare System and University of Texas Southwestern Medical Center at Dallas, Dallas, TX, researchers assessed changes in the ACC/AHA guidelines issues between 2008 and 2014, noting developments in class of recommendations and level of evidence. Han and his team reviewed nine disease-based and two interventional procedure-based guidelines. The time interval between versions of guidelines was approximately 6.5 years.

The historical review of the guidelines revealed that the total number of recommendations decreased from 2,067 to 1,869, and the Level of Evidence: C recommendations decreased from 937 to 639. The authors note that this demonstrates a shift toward support from scientific evidence rather than just support from expert opinion. The study further showed that between 2008 and 2014, 859 recommendations were introduced, 1,339 were dropped, 129 were revised, and 881 were unchanged in their class of recommendation and level of evidence.

The authors of study note that "the numerous changes in guideline recommendations highlight the significant effort that went into their development."

"Regardless of future directions in [clinical practice guideline] evolution, the overall goal of enhancing the quality of care and improving outcomes of patients with cardiovascular disease must remain," stated Jeffery L. Anderson, MD, FACC, in an accompanying editorial review. "As [clinical practice guidelines] continue to evolve, interval 'audits' ... will serve as useful landmarks along the way, to be correlated with and judged by trends in cardiovascular disease incidence and outcomes."

Keywords: American Heart Association, Expert Testimony, Goals, Incidence, Morbidity, Research Personnel, Science

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