{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:12:46Z","timestamp":1779167566356,"version":"3.51.4"},"reference-count":63,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:00:00Z","timestamp":1733443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"abstract":"ABSTRACT<\/jats:title>Introduction<\/jats:title>Evidence\u2010based clinical practice guidelines drive optimal patient care and facilitate access to high\u2010quality treatment. Creating guidelines for rare diseases such as haemophilia, where evidence does not often come from randomized controlled trials but from non\u2010randomized and well\u2010designed observational studies and real\u2010world data, is challenging. The methodology used for assessing available evidence should consider this critical fact. In formulating guidelines, it is essential to include treatment goals and patient preference.<\/jats:p><\/jats:sec>Aim<\/jats:title>This paper comprehensively critiques, against this background, the recommendations of the ISTH clinical practice guidelines for the treatment of haemophilia.<\/jats:p><\/jats:sec>Methods<\/jats:title>Each recommendation was critically reviewed against available evidence as well as existing guidelines and commented upon for its scientific validity, impact on clinical practice and access to care globally. The validity of the way in which the GRADE methodology was applied to existing evidence was also assessed.<\/jats:p><\/jats:sec>Results<\/jats:title>The critique provided shows that these recommendations have major limitations: they did not state treatment goals and contradict existing guidelines; opportunities for providing access to innovation were missed when the therapeutic benefits of the products approved in the last decades were not included. A major reason for this is the inappropriate adoption of the GRADE methodology without adaptations and without considering treatment goals and patient\u2010relevant outcomes.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>These recommendations may mislead healthcare professionals, payers and governments and therefore cannot serve the patient community well. They setback the advances made in haemophilia care because they overlook important available evidence and do not guide clinical practice to contemporary standards.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.15135","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T18:04:52Z","timestamp":1733508292000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["International Society on Thrombosis and Haemostasis Clinical Practice Guideline for Treatment of Congenital Haemophilia\u2014A Critical Appraisal"],"prefix":"10.1111","author":[{"given":"Manuela","family":"Albisetti","sequence":"first","affiliation":[{"name":"University Children's Hospital Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Ardila","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Imbanaco Quir\u00f3n Salud Hemophilia Center, IPS Especializada 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