美國家庭醫生協會,American Academy of Family Physicians (AAFP),認為ACC/AHA新版高血壓指南所推薦的新低診治標準依據不足。
摘錄:
There were a number of reasons the AAFP decided to not endorse the AHA/ACC guideline, including that the bulk of the guideline wasn't based on a systematic evidence review.
Although the AHA/ACC guideline's recommendation statements were graded according to strength of evidence, assessments of the quality of individual studies or systematic reviews weren't provided.
For example, the new guideline offered a strong recommendation for using the unvalidated atherosclerotic cardiovascular disease risk assessment tool previously developed by AHA and ACC to determine whether medications should be initiated for BP control. However, this recommendation wasn't based on evidence that using the tool in this way improves outcomes.
Finally, the AAFP's CHPS voiced concerns related to the use of the SPRINT trial in the AHA/ACC guideline. First, the guideline gave the SPRINT trial considerable weight while minimizing results from other trials.
"The SPRINT trial was an important trial, but needs to be considered in the context of the totality of the evidence," the CHPS said.
Additionally, the commission said conflict of interest is a major concern in judging the trustworthiness of guidelines and plays a key role in the AAFP's assessment of guidelines.
鏈接:
一位家庭醫生Kenneth W. Lin, MD, MPH的看法:
New Hypertension Guideline: A Case of Guideline Creep?