To quantify the proportion of articles published between successive ESC guideline editions that were cited in the subsequent edition and to assess indirect links through citation networks.
Approach:
Study Setting and Data Sources: Examined eight ESC guideline topics with two successive editions, focusing on thematic continuity, specificity, and recency.
Outcomes and Definitions: Primary outcome was the percentage of relevant publications cited in subsequent guidelines, with sensitivity analyses for different publication cohorts.
Statistical Analysis: Calculated overall inclusion rates for direct, second-degree, and third-degree incorporation, and performed logistic regression for clinical trials.
Key Findings:
Only 15.5% of recommendations in ESC guidelines are supported by level of evidence A.
Over 80% of basic research studies had not been cited in clinical research articles.
Citation-network tools allow evaluation of both direct and indirect research-to-guideline pathways.
Interpretation:
The study highlights the limited direct incorporation of high-level evidence into clinical guidelines despite the growth of cardiovascular research.
Limitations:
The analysis is limited to eight specific ESC guideline topics.
Indirect influences of basic research may not be fully captured.
Conclusion:
The findings suggest a need for improved integration of high-quality research into clinical practice guidelines.
