Vascular viewpoint: an evidence-based approach to vascular medicine

Abstract

Given the large number of peer review articles that are published in the medical literature each week (e.g. 3000 new postings on MEDLINE per week!), and the easy accessibility of these papers using internet databases, clinicians and researchers are inundated with materials to digest and process in order to keep up with the latest therapeutic interventions they can use to treat their patients. To assist in the interpretation of this huge volume of information, clinicians and researchers need to develop skills that will enable them to assess the validity of clinical research, and to understand when enough evidence has been accumulated for a therapeutic intervention for it to become ‘clearly’ indicated. Although this evidence-based approach to assessing the medical literature is not new, we believe a greater emphasis should be placed on critical appraisal in the area of vascular medicine, and an ideal forum for this is the quarterly publication of Vascular Medicine. Thus, we are introducing a new feature called ‘Vascular viewpoint’, which is intended to assist the reader in synthesizing and evaluating clinical studies related to the treatment of vascular diseases. To avoid complicated ranking scales of levels of evidence, we will use understandable ‘at a glance’ terminology to categorize studies. The type of study will be labeled as Randomized—large ‐ meaning a randomized trial of adequate sample size; Randomized—small ‐ meaning a randomized study of small size; Systematic overview ‐ a quantitative review of randomized and non-randomized studies; Nonrandomized studies such as cohort, case‐control, cross-sectional, and case series; and Investigational studies ‐ referring to physiologic investigations (see Table 1). Study methods will be classified as being high, moderate or low quality, and the validity of the conclusions will be classified