2023 ESC Guidelines for the management of endocarditis, engl.

Year of publication: 2023

Classification: -

Registration number: ESCGuidelines

Editing medical society(ies):
European Society of Cardiology (ESC)

Other medical societies involved: 3

Evaluation by Leitlinienwatch






The conflict of interest declaration (https://www.escardio.org/static-file/Escardio/Guidelines/DOI/2023%20DOIs/DOI_Summary_2023%20Endocarditis-26.05.2023.pdf), like the previous version, lists conflicts of interest in detail. Despite various recommendations there is no evidence in this edition of an assessment or consequences at coordinator level or by an external committee (https://www.escardio.org/The-ESC/About/Policies/esc-declaration-and-management-of-conflict-of -interest policy).


Composition of the Guideline Working Group

The declaration of conflict of interest only lists "task force" members, reviewers and other participants in a summarized form; the respective influence on the guidelines/recommendations is not apparent. In the “task force” area, which is comparable to an author group, 20 out of 25 members indicate multiple relevant conflicts of interest. In some cases, these authors are financed by dozens of pharmaceutical and medical device companies that directly benefit from the guideline recommendations (as ad board members, paid speakers, ...). In addition, there are 98 reviewers, of which only around a third (32) do not have coi.


Independence of the Coordinators/Chairs/Lead AuthorsUnabhängigkeit der Vorsitzenden/federführenden Autoren

Both lead authors (as well as both coordinators) also receive funding from various companies whose products they should independently assess.


Abstention from Voting

An abstention rule is not documented or apparent in the recommendations.


External Review of the Guideline

Quote from the long version: "ESC Guidelines undergo extensive review by the CPG Committee and external experts, including members from across the whole of the ESC region and from relevant ESC Subspecialty Communities and National Cardiac Societies. After appropriate revisions, the guidelines are signed off by all the experts involved in the Task Force." Since this is not a public review, we do not award any points for this criterion, but do award a bonus point (see below).


Bonus Points

Bonus point for the broad non-public review. Conflict of interest declarations are also available for these reviewers. However, it is not documented how this group was recruited or what influence the reviewers' numerous conflicts of interest had on the guideline process.

Explanations to the evaluation criteria

Overall score


Good! (11-18)

Warning! (6-10)

Needs reform! (0-5)


The ESC guidelines also apply to Germany, as the German Society for Cardiology adopts the ESC guidelines. In this new edition of the guidelines, most authors also state massive financial conflicts of interest. A standard guideline report, which shows abstention rules, methods of study assessment, recruitment of the guideline group, and the review process, is not accessible. There is no methodological improvement compared to the previous version.

Note: This evaluation was conducted with due care on the basis of the published guideline. Should you still discover an error, please contact us at info@leitlinienwatch.de.