A small and unimproving percentage of major cardiovascular guideline recommendations are supported by high-quality RCT evidence.
Recommendations warrant cautious application given sparse RCT support; leaves open the need for more large trials to strengthen future guidelines.
Among recommendations in major cardiovascular society guidelines, only a small percentage were supported by evidence from multiple RCTs or a single, large RCT. This pattern does not appear to have meaningfully improved from 2008 to 2018.
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Fanaroff et al. (2019) studied this question.
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