Evidence in cardiology

Question 1

Classes of recommendations:

Class I
- describe
[ - recommended - ]

Class II
- describe

–> Class IIa: describe
[ - should be considered - ]
–> Class IIb: describe
[ - may be considered - ]

Class III
- describe
[ - not recommended - ]

Answer 1

Classes of recommendations:

Class I
- evidence treatment is beneficial/useful/effective
[ - recommended - ]

Class II
- conflicting evidence about usefulness/efficacy treatment

–> Class IIa: weight of evidence in favour of usefulness/efficacy
[ - should be considered - ]
–> Class IIb: evidence for usefulness/efficacy less well established
[ - may be considered - ]

Class III
- evidence that treatment is not useful/effective, and sometimes may be harmful
[ - not recommended - ]

Question 2

Levels of evidence

• Level A
  > data from multiple ___ or ___-______
• Level B
  > data from single ___ or ___ ___-_______ studies
• Level C
  >c_______ of o____ by e_____ or s____ s____ or clinical data registries

Answer 2

Levels of evidence

• Level A
  > data from multiple RCTs or meta-analysis
• Level B
  > data from single RCT or large non-randomised studies
• Level C
  >consensus of opinion by experts or small studies or clinical data registries

Question 3

What is a clinical trial?

Answer 3

A clinical trial is an evaluation of a new therapeutic intervention (drug, device, procedure/surgery) in human volunteers

• human volunteers may be healthy or patients with a disease

Question 4

Effect size of trials

• is it clinically meaningful? check the ___
• is it statistically robust?
  check the _ _____ and __% ________ _______

Answer 4

Effect size of trials

• is it clinically meaningful? check the NNT (number needed to treat)
• is it statistically robust?
  check the p value and 95% confidence interval