Evidence map›Paper›PMID 37920978›Full record

ArticleCirculation. Cardiovascular quality and outcomes2023

Evolution of Value in American College of Cardiology/American Heart Association Clinical Practice Guidelines.

Andrea Luviano, Ankur Pandya

Abstract read
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Andrea LuvianoHarvard University, Ph.D. Program in Health Policy, Cambridge, MA (A.L.).ORCID 0000-0002-2624-4850
Ankur PandyaDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).ORCID 0000-0002-6130-2286

Funding

Development, Validation, and Application of a Stroke Policy Simulation ModelR01NS104143 · NINDS · HARVARD SCHOOL OF PUBLIC HEALTH · PI PANDYA, ANKUR · 2018 to 2022
$2.3M
NINDS NIH HHS R01 NS104143
6 · The paper itself

Abstract

backgroundIn January 2014, the American College of Cardiology/American Heart Association released a policy statement arguing for the inclusion of cost-effectiveness analysis (CEA) and value assessments in clinical practice guidelines. It is unclear whether subsequent guidelines changed how they incorporated such concepts.

methodsWe analyzed guidelines of cardiovascular disease subconditions with a guideline released before and after 2014. We counted the words (total and per page) for 8 selected value- or CEA-related terms and compared counts and rates of terms per page in the guidelines before and after 2014. We counted the number of recommendations with at least 1 reference to a CEA or a CEA-related article to compare the ratios of such recommendations to all recommendations before and after 2014. We looked for the inclusion of the value assessment system recommended by the writing committee of the American College of Cardiology/American Heart Association policy statement of 2014.

resultsWe analyzed 20 guidelines of 10 different cardiovascular disease subconditions. Seven of the 10 cardiovascular disease subconditions had guidelines with a greater term per page rate after 2014 than before 2014. Across all 20 guidelines, the proportion of recommendations with at least 1 reference to a CEA changed from 0.44% to 1.99% (

conclusionsThe proportion of recommendations with at least 1 reference to a CEA or CEA-related article was low before and after 2014 for most of the subconditions, however, with substantial variation in this finding across the guidelines included in our analysis. There is a need to organize existing CEA information better and produce more policy-relevant CEAs so guideline writers can more easily make recommendations that incentivize high-value care and caution against using low-value care.

Indexed as

CardiologyCardiovascular DiseasesAmerican Heart AssociationHumansUnited StatesAmerican Heart Associationatrial fibrillationcardiovascular diseaseheart failureischemic stroke

Identifiers

PMID37920978
PMCPMC10842500

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.