We have read with great interest the article by Laserna et al., “Levels of Evidence Supporting the North American and European Perioperative Care Guidelines for Anesthesiologists between 2010 and 2020: A Systematic Review,” in the most recent issue of Anesthesiology. Without a doubt, this is an issue of great importance, and it is imperative to take actions against this problem. On the other hand, it is worth mentioning that this is not a new problem. In 1994 Altman mentioned the existence of low-quality medical research in his article “The Scandal of Poor Medical Research,” and a more recent article by Van Calster et al., “Methodology over Metrics: Current Scientific Standards Are a Disservice to Patients and Society,” also takes up this issue, arguing that the main problem is a paradox: “The methodology, the...

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