Takeaway
- Clinical practice guidelines for assessing and managing hypertension have a “high rate of inconsistency”, according to findings from this cross-sectional study.
- These authors say that no single source underlies areas of inconsistency among the 8 guidelines they examined.
Why this matters
- These authors say that these guidelines are “poor proxies for a universally accepted source of truth.”
- They say that the focus should be on classifying consistency across guidelines as a signpost for clinical practice.
Key results
- Among the 8 guidelines evaluated:
- 22 (32%) recommendations were consistent with each other for both strength and direction.
- 18 (26%) were consistent for direction but not strength (e.g., when to use ambulatory BP monitoring).
- 28 (41%) were inconsistent for direction (e.g., cutoffs for hypertension).
- 17 of 48 (35%) recommendations considered of high importance showed inconsistency of direction.
- Various analyses excluding recommendations with specific evidence ratings did not pinpoint a sole source of inconsistency.
Study design
- 8 guidelines included, from the United States, Australia, Canada, Europe, the UK.
- 71 recommendations were evaluated.
- Funding: EBSCO Information Services.
Limitations
- The authors had to create a method for evaluating consistency.
- They dichotomised strength ratings.
References
References
