The Pharmaceutical Journal
Vol 279 No 7464 p144
11 August 2007

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Clinical guidance questioned

The results of randomised controlled trials used to formulate clinical guidelines may not always be applicable for the patients or interventions the guidelines are for, a Canadian study suggests (PLoS Medicine 2007;4:e250).

In a review of nine cardiovascular guidelines from Canada, the US and Europe, researchers found that less than a third of treatment recommendations were based on high-quality evidence.

For the development of future guidelines, the authors recommend wider implementation of “evidence-ranking schemes” that consider the strengths and weaknesses of the evidence for particular clinical scenarios and not just the studies’ internal validity.