Copyright © 2003 by the European Society of Cardiology.
Current opinion
Medical Practice Guidelines
Separating science from economics
* Correspondence to: Silvia G Priori, MD,PhD, Molecular Cardiology, Maugeri Foundation, Via Ferrata 8, 27100 Pavia Italy. Tel: +39-0382-592050; fax: +39-0382-592059
E-mail address: spriori@fsm.it
Received 16 June 2003; accepted 17 July 2003
| The first 150 words of the full text of this article appear below. |
1. Introduction
Over the past twenty years, practice guidelines have become an increasingly popular tool for synthesis of clinical information.
The objectives of guidelines are to enhance the appropriateness of practice, improve quality of cardiovascular care, lead to better patient outcomes, improve cost-effectiveness, help authorities to decide on the approval of drugs and devices and identify areas of research needed. Guidelines may also be used as quality measurement for the health insurance.
Evidence-based medicine is a relatively recent concept: indeed, it is only within the past two decades that prospective, randomized clinical trials have become widely accepted, creating the foundation for modern clinical research. Thanks to the evidence coming from these trials, physicians have been forced to abandon some concepts that were previously considered ‘logical’ or ‘good common sense’ and which had provided the rationale for what was in fact empirical treatment. The scientific community has been adopting the new concepts introduced
1.1. Credibility of the evidence
1.2. Compelling magnitude of treatment effect
2. Guidelines and conflict of interest
2.1. From evidence based guidelines to clinical practice
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