Dr. Donna K. Arnett, dean and professor of epidemiology at the University of Kentucky College of Public Health, is first and corresponding author of “Tracing and Assessing the Evolution of Clinical Guidelines”, published in the Journal of the American Heart Association. Mr. Steven A. Claas, UK CPH Office of Scientific Writing, is co-author. The article provides a reponse to the article by Ms. Victoria DuBose‐Briski and colleagues, “Evolution of the American College of Cardiology and American Heart Association Cardiology Clinical Practice Guidelines: A 10‐Year Assessment”.
Ms. DuBose-Briski and colleagues conclude that “there has been a decrease in American College of Cardiology/American Heart Association guidelines recommendations, driven by removal of recommendations based on lower quality of evidence, although there was no corresponding increase in the highest quality of evidence.” Dr. Arnett and Mr. Claas highlight several strengths of the DuBose-Briski et al study; they also note what they contend are shortcomings of the study design.
Dr. Arnett and Mr. Claas further discuss the history of clinical guidelines developed by the AHA and ACC. They conclude that the study by Ms. DuBose-Briski et al, although it has shortcomings, “suggest[s] something important about assessments of clinical guidelines: [s]imple counts and longitudinal comparisons of changes in a large sample of recommendations and their associated [classes of recommendation] and [levels of evidence] do not provide a nuanced view of the evolutionary trends in clinical guidelines. Instead, a close reading of the guidelines and a careful dissection of the changes that have occurred over time would be most informative.”Friday Letter Submission, Publish on October 18