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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Clinical guidelines for acute stroke management: which recommendations should remain consensus-based?

Sandy Middleton¹, Julianne Rowley, Sharon Hillege

¹Nursing Research Institute- St Vincent's & Mater Health Sydney, Australian Catholic University, Sydney, Australia. sandy.middleton@acu.edu.au

Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing

|May 21, 2013

Summary

Many stroke clinical guideline recommendations can remain consensus-based, not requiring the highest evidence. Experts agreed that 70% of recommendations could stay consensus-based, guiding future research priorities.

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Area of Science:

Neurology
Clinical Practice Guidelines
Evidence-Based Medicine

Background:

Clinical practice guidelines aim for evidence-based recommendations.
However, some recommendations may appropriately remain consensus-based.
This study explores expert opinions on consensus-based recommendations in stroke management.

Purpose of the Study:

To determine which consensus-based recommendations from the Australian National Stroke Foundation Clinical Guidelines for Acute Stroke Management (2007) should remain consensus-based.
To identify factors influencing expert opinions on the appropriateness of consensus-based recommendations.

Main Methods:

A self-administered questionnaire was used to survey stroke clinicians and academics.
Participants were asked to evaluate 50 consensus-based recommendations.
Statistical analysis, including multivariable analysis, was performed to identify influencing factors.

Main Results:

70% of participants believed 35 out of 50 recommendations should remain consensus-based.
Recommendations perceived to impact patient outcomes were less likely to be considered appropriate for remaining consensus-based (OR=0.16).
Female respondents, those with higher education, and those from nursing/medicine disciplines were more likely to support consensus-based recommendations.

Conclusions:

There is expert agreement that a proportion of clinical guideline recommendations can appropriately remain consensus-based.
Expert opinions vary based on perceived impact, education level, and professional discipline.
Identifying areas for robust research evidence is crucial for prioritizing and allocating research resources effectively.