Underrepresentation of Women, Elderly Patients, and Racial Minorities in the Randomized Trials Used for Cardiovascular Guidelines

JAMA Intern Med, November 2014

The American College of Cardiology/American Heart Association (ACC/AHA) guidelines are frequently used to guide cardiovascular care. Randomized controlled trials (RCTs) are considered to be the highest level of evidence and are cited in these guidelines whenever available. However, RCTs can have limited external validity. To examine their generalizability, we examined the percentage of enrollment and reporting of sexes, races, geographic distribution, and age groups in the RCTs cited in the ACC/AHA guidelines for atrial fibrillation (AF), and unstable angina/non–ST-segment elevation myocardial infarction (acute coronary syndromes [ACS]). Read more.