In a new editorial commentary published today by the American Heart Association , John B. O'Connell MD points out that the AHA's new guidelines for managing heart failure patients are "eminence-based," not evidence-based. Nice turn of phrase, that.
It turns out that the guidelines include 24 recommendations. Only one is level of evidence A. O'Connell continues:
Although some have called such recommendations "eminence-based," until there are randomized controlled clinical trials to justify the recommendations, the quality of expertise on the panel and their collective experience justifies consensus recommendations.
The increased focus on quality of evidence underlying recommendations is refreshing, even if it reminds us of just how uncertain are the foundations of many "consensus" recommendations. Certainly salt reduction falls in that category.
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