The American Heart Association (AHA) and the American College of Cardiology (ACC) periodically issue guidelines for treatment and diagnosis of heart disease and other cardiovascular diseases, such as stroke, high blood pressure and so on.
These guidelines are treated like the word of God by the practicing cardiologists and other medical specialists.
Based on these guidelines, doctors make clinical decisions and give specific recommendations to their patients about medications (what drugs to use and for how long), surgery (bypass vs.
angioplasty), diet and lifestyle.
It turns out that most of these recommendations are made up.
They are not based on any real scientific evidence.
A recent study published in the Journal of American Medical Association in February of 2009 examined 2,711 current recommendations issued by AHA and ACC.
The authors of the study described 3 kinds of evidence on which the recommendations were based.
The best evidence comes from multiple randomized double blind medical studies.
They are considered to be the most effective in determining which treatment works and which does not.
"Randomized" means that patients are randomly assigned into a treatment group, the one that gets the real treatment, or the placebo group, which only appears to receive the treatment.
"Double blind" means that the participants do not know whether they receive the real treatment or not and neither do the doctors who observe and monitor them.
This kind of evidence is the most reliable and it is called Category A.
Category B is based on evidence that comes from either a single randomized trial (not multiple) or non-randomized studies.
It is not nearly as reliable as Category A and may be very inaccurate.
Category C is based on the opinion of experts or on the current standard of care.
For example, many people are using aspirin to prevent heart attacks, so this is considered the standard of care, even though no studies have shown it to be beneficial.
(See my other article called Aspirin Useless For Heart Health and Stroke Prevention and Causes Major Complications) In other words, Category C it is not based on any evidence whatsoever.
After examining 2,711 recommendations, the researchers found that 1,246 of them (48%) were in category C.
In other words, almost half of the recommendations were based not on evidence, but on guesswork.
In fact, only 314 (11%) were in category A, which means that only about 1 in ten recommendations were based on real scientific evidence.
As I mentioned, doctors follow these recommendations very closely when making decisions about patient's health, so each recommendation has a major impact on how heart disease is treated in the US.
According to the study authors, these recommendations are viewed as "established guidance for management of cardiovascular disease.
" And in almost 9 cases out of 10 they are based on the guesswork of some "experts" from AHA and ACC.
The fact is that the experts do not know what works and what does not if there are no studies to support a particular treatment or intervention.
If there are no studies comparing bypass surgery vs.
angioplasty, how would an expert decide which treatment is the best? The truth is that they often decide in favor of more expensive drugs or procedures because they have financial incentives to do so.
Each of the "experts" has ties to the industry and receives major financial support from it.
The authors of the study point out that experts are the ones who receive "honoraria, consulting fees, or research support from the industry", so they have a clear conflict of interests.
Next time your doctor suggests an expensive drug or a procedure, keep that in mind.
These guidelines are treated like the word of God by the practicing cardiologists and other medical specialists.
Based on these guidelines, doctors make clinical decisions and give specific recommendations to their patients about medications (what drugs to use and for how long), surgery (bypass vs.
angioplasty), diet and lifestyle.
It turns out that most of these recommendations are made up.
They are not based on any real scientific evidence.
A recent study published in the Journal of American Medical Association in February of 2009 examined 2,711 current recommendations issued by AHA and ACC.
The authors of the study described 3 kinds of evidence on which the recommendations were based.
The best evidence comes from multiple randomized double blind medical studies.
They are considered to be the most effective in determining which treatment works and which does not.
"Randomized" means that patients are randomly assigned into a treatment group, the one that gets the real treatment, or the placebo group, which only appears to receive the treatment.
"Double blind" means that the participants do not know whether they receive the real treatment or not and neither do the doctors who observe and monitor them.
This kind of evidence is the most reliable and it is called Category A.
Category B is based on evidence that comes from either a single randomized trial (not multiple) or non-randomized studies.
It is not nearly as reliable as Category A and may be very inaccurate.
Category C is based on the opinion of experts or on the current standard of care.
For example, many people are using aspirin to prevent heart attacks, so this is considered the standard of care, even though no studies have shown it to be beneficial.
(See my other article called Aspirin Useless For Heart Health and Stroke Prevention and Causes Major Complications) In other words, Category C it is not based on any evidence whatsoever.
After examining 2,711 recommendations, the researchers found that 1,246 of them (48%) were in category C.
In other words, almost half of the recommendations were based not on evidence, but on guesswork.
In fact, only 314 (11%) were in category A, which means that only about 1 in ten recommendations were based on real scientific evidence.
As I mentioned, doctors follow these recommendations very closely when making decisions about patient's health, so each recommendation has a major impact on how heart disease is treated in the US.
According to the study authors, these recommendations are viewed as "established guidance for management of cardiovascular disease.
" And in almost 9 cases out of 10 they are based on the guesswork of some "experts" from AHA and ACC.
The fact is that the experts do not know what works and what does not if there are no studies to support a particular treatment or intervention.
If there are no studies comparing bypass surgery vs.
angioplasty, how would an expert decide which treatment is the best? The truth is that they often decide in favor of more expensive drugs or procedures because they have financial incentives to do so.
Each of the "experts" has ties to the industry and receives major financial support from it.
The authors of the study point out that experts are the ones who receive "honoraria, consulting fees, or research support from the industry", so they have a clear conflict of interests.
Next time your doctor suggests an expensive drug or a procedure, keep that in mind.