Evidence map›Paper›PMID 41467181›Full record

ArticleiScience2025

Evolution and regional disparities in guideline recommendations and evidence levels for structural heart disease.

Yuxiang Tang, Aijin Xie, Yiming Yan, Guangzhi Zhao, Yi Sun, Fengwen Zhang, Shouzheng Wang, Cheng Wang, Fang Fang, Chuangshi Wang and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in iScience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Yuxiang TangNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Aijin XieNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Yiming YanDepartment of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Guangzhi ZhaoDepartment of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Yi SunInstitute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China.
Fengwen ZhangDepartment of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Shouzheng WangDepartment of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Cheng WangDepartment of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Fang FangDepartment of Structural Heart Disease, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Chuangshi WangNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Xiangbin PanNational Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Significant advances have been made in the field of structural heart disease (SHD), yet guideline characteristics and evolution across regions remain uncertain. This study aims to analyze the distribution of class of recommendation and level of evidence (LOE) of SHD guidelines across American College of Cardiology/American Heart Association (ACC/AHA), European Society of Cardiology (ESC), and Chinese cardiovascular societies. We evaluated 1,867 recommendations from prior and current guidelines. In current guidelines, strong recommendations (Class I/III) constituted 53.2%, yet only 8.1% (38/470) were supported by highest-quality evidence (LOE A). Regional variations existed, with ACC/AHA showing predominant LOE B recommendations (56.3%) while ESC and Chinese guidelines featured mainly LOE C (79.4% and 69.5%, respectively). Longitudinal analysis revealed overall evidence improvement. These findings highlight persistent challenges in aligning recommendation strength with evidence quality across healthcare systems. Additionally, the disparity across regions underlines the importance of establishing international collaborative mechanisms to coordinate guideline development processes.

Indexed as

Cardiovascular medicinePublic health

Identifiers

PMID41467181
PMCPMC12744249

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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.