European guidelines must be changed now to protect patients

摘要

We were pleased to see that the European Society of Cardiology partially corrected its erroneous 2009 recommendations on perioperative p blockade. However, the Joint Task Force still included the widely discredited study of Mangano et al, even though its major flaw (failure to analyse mortality on an intention to treat basis) was highlighted in the article.The JointTask Force also used meta-analyses that included the thoroughly discredited DECREASE studies. Cole and Francis confirm thatthere is now even less evidence to support the class lib treatment recommendation (usefulness/efficacy is less well established) of the European Society of Cardiology. We therefore again assertthatthe European Society guidelines must be corrected immediately, which is in line with the conclusions of Cole and Francis. We also remind the task force that failure to modify its current guidelines is likely to contribute to an incalculable number of unnecessary deaths of patients not only in the NHS but across Europe. As one of us (SNB) has said elsewhere, "no institution, particularly in healthcare, can everafford to lose sight of its patients."