Only 8.5% of cardiology guidelines rest on solid randomized evidence. The rest lean on weaker data or expert opinion. And that number hasn't moved in a decade. This is the shape of clinical medicine.
A 2019 study in JAMA looked at ten years of cardiology guideline updates. The finding is striking.
8.5% of major cardiology recommendations rest on solid randomized evidence.
The remaining 90%+ lean on weaker data, observational studies, or expert opinion — and that proportion held steady across a full decade of updates.
Cardiology, it's worth noting, is one of the best-evidenced specialties in medicine. If anything, this is an optimistic picture of where clinical evidence stands.
Most of what we recommend to patients has never been rigorously tested — and the questions that matter pile up faster than we generate answers.
The bottleneck is not data. The data to answer many of these questions already exists — in electronic health records, in registries, in the datasets that accumulate quietly across health systems every day.
What is scarce is the capacity to turn that data into evidence: the methodology, the data work, the analysis infrastructure.
WHAT THE GAP COSTS US
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Powering a randomized controlled trial for every unanswered clinical question is not realistic. It never was. But we can do far better at leveraging the data that already exists.
Most of what we recommend to patients has never been rigorously tested — and the questions that matter pile up faster than we generate answers.
That is the problem Augura was built to solve.
