2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, engl.

Evaluation by Leitlinienwatch

12.07.24

PTs.	Criterion
2	Transparency The handling of conflicts of interest at the ESC and also at this guideline is defined in the document "ESC Declaration and Management of Conflict of Interest Policy", last updated April 2023 (https://www.escardio.org/static-file/Escardio/Web/Documents/ESC-Declaration-and-Management-of-COI-Policy.pdf). Guideline authors who have received more than 10,000 euros in direct annual payments from industry are to be excluded from the development of guidelines from 2022 or 2024 (p.17), but this does not yet apply to this guideline. Currently, the amount of the grants is not yet recorded.
0	Composition of the Guideline Working Group Out of 31 task force members, only 4 had no conflicts of interest.
0	Independence of the Coordinators/Chairs/Lead AuthorsUnabhängigkeit der Vorsitzenden/federführenden Autoren Both chairmen receive money from the manufacturers of the drugs, which they are supposed to evaluate neutrally.
0	Abstention from Voting
0	External Review of the Guideline
1	Bonus Points Bonus point for internal review by selected reviewers who have also submitted a conflict of interest declaration (ESC Committee for Practice Guidelines).

Explanations to the evaluation criteria

Comment

The ESC guidelines also apply to Germany, as the German Society of Cardiology (DGK) simply links the ESC guidelines. This guideline, which has now been updated again after 2016, also appears as the first guideline on the DGK website, but the methodologically higher-quality National Care Guideline for Heart Failure, which is valid for Germany, is searched in vain. The German guideline has also not found its way into the DGK's "pocket guideline" on heart failure, it is only based on ESC content. The authors of the ESC guideline state financial conflicts of interest for the most part, as do the lead authors and also the reviewers. This may explain the relevant differences between the treatment pathways of the German and the ESC guideline: While the ESC guideline often only makes recommendations for new drug combinations based on expert consensus, the much more restrained drug recommendations of the German care guideline are based on systematic literature research and evaluation. The first steps now planned by the ESC to regulate conflicts of interest of future guideline authors are to be welcomed. However, the exclusion of authors with more than €10,000 in industry payments per year leaves unreasonable scope for cumulative payments by a company to individual authors over several years. In addition, there is no clear rule for abstentions when voting on recommendations, but only a general expectation that participants with IC should abstain (Principle 3, p.2, https://www.escardio.org/static-file/Escardio/Web/Documents/ESC-Declaration-and-Management-of-COI-Policy.pdf).