Scribd Logo
Upload

Welcome to Scribd!

  • The European Stroke Organisation Guidelines 2014

    Uploaded by

    Anonymous omvOqGHX2F
    5 views2 pages
    jurnal

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    jurnal

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    5 views2 pages

    The European Stroke Organisation Guidelines 2014

    Uploaded by

    Anonymous omvOqGHX2F
    jurnal

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 2
    Editorial The European Stroke Organisation (ESO) guidelines T. Steiner’, R. Al-Shahi Salman’, and G. Ntaios* "Department of Neurology, Kina Frankfurt Hochst, Frank, Germany ‘Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany ‘Divison of Clinical Neurosciences, Centre for Clinical Brain Sciences University of Edinburgh, Edinburgh, UK ‘Department of Medicine, Lass University Hospital, School of Medicine, University of Thessaly, Lavi, Greece ‘In 2008, the European Stroke Organisation (ESO) updated the European Stroke Initiative (EUSI) recommendations for the ‘management of ischemic stroke and transient ischemic attack, {italy published in 2000 and updated in 2003 (1-8). Since then, the ESO has begun the process of implementing a new standard. ‘ved system for the production and presentation of evidence- ‘based clinical guidelines. The ESO guidelines committee agreed ‘on two msjor developments use ofthe Grading of Recommen- dations Assessment, Development and Evaluation (GRADE) system (4-7); and the transition to a model in which several ‘psideline documents deal with specific topics of interest called ‘modules rather than a single document on a large topic. ‘The GRADE system has a series of advantages over other systems that include lear separation betwecn quality of evidence and strength of recommendation, explicit comprehensive criteria for downgrading and upgrading quality of evidence ratings, ‘ransparent process of moving from evidence to recommends: ‘tions, explicit evaluation ofthe importance of outcomes of alter ative management strategies, explicit acknowledgment of values and preferences, and clear pragmatic interpretation of strong ‘versus weak recommendations for clinicians, patients, and policy makers (4-7) In summary, the GRADE approach stars with the {formulation ofthe PICO (population, intervention, comparator, and outcome) questions. The selected outcomes are rated using a S-degree scale (79: critical 46 important) 1-3: of limited ‘mportance) anda search strategy i formulated. After a thorough | literature search leading tothe identification ofall available evi- dence, eligible studies are then selected and their data are ‘earacted and analyzed. The results can be imported into the [GRADEPro software (8), allowing for eficient quality grading of the available evidence foreach outcome and each clinical ques- tion, Then we determine the direction (either ‘against’ or Yor’) and strength of the recommendation (ether ‘strong’ or ‘weak’, and finaly the recommendation is formulated using a standard- {ved language (4-7). “The second major development in the ESO guidelines policy ‘was to move from the clasical model ofa single guideline docu- ment on a major topic ~ eg. management of ischemic stoke, transient ichemic attack, and hemorthagic stroke to aubdivi sion of the major topic into focused modules. This enables the 'BSO Guidlines Committe to react quickly when new develop- ‘ments in a specific area of stroke medicine occur, and update secommendations on the selated module with speed. With the Dok: 10.11117.12369 Previous approach of a single large guideline document, an entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines for use in lint cal practice. For each module the FSO Gisidelines Commitee invites an 50 member to organize working group that follows the afore- nvionedroed map to prepare te guidelines fortis specific toodile, Porto anbesiion for publication, each guideline document is submitted for review tothe ESO Guidelines Com- mittee, the ESO Exzetive Commitee, and two external review: ta. tomaparene, all enthora and reviewera pert their potential conics of interest. The fit ESO guideline document using this new approach is the management of sponteneses fntrasrehea.hemarchage (ICH), published in the present issue of the International Journal of Siroke (pp. 840-855). Tn this guideline, a mltidixplinary group of cinkcal researchers addrewed 20 PICO questions. In summary, the concusions provide evidence-based support for acute stroke nit care, intersive bloodpressure lowering within schoors of onset, intermittent preumatic compression in immobile patients with ICH, and secondary prevention with blood pressure lowering fr ICH survivors. Another result of the comprehensive literature search and assessment wa to Sein how tnany ates there i nly lite to no evidence fom randomized controlled tials oF meta-analyses. However, becuse clinicians often wish for guidance in the absence of high-quality RCTs in diseases with such high marbidty and mortality as ICH, there i further guidance on wht to do in the ‘edition information section, based on observational data and views within the weting group. Other modules which are currently in progress include prehos- pital soke management: organization of acute endovascular treatment in acute scheme stoke; the management of tempera ture, gheemia and mass eet in acute ischemic stroke; preven- tion of venous thromboembolism in troke patients investigation of stroke and transient ischemic attacks secondary stroke peven- tion; management of intracrarial venous snus thrombosis; and others The ESO Guidelines Commitee is supported by two leading stroke conferenes the recently announced annual ESO Confer ence (ESOC) hel forthe first time in Glasgow om Api 17-19, 2015, and thereafter moving around Europe (9). ESO guidelines wal be presented and dicused at a speci guidelines sesion during PSOC. In ation, the sational biannval Karolinska ‘Stroke Update Conference is joining forces with the ESO and. B38 Voi, Ociober 2014, 638-838 © 701d Word Sroke Organon Ee Editorial | continues atthe ESO Karolinska Stroke Update from Noveraber 1M to 16, 2014 in Stockholm. These Karolinska meetings have ‘been a valuable tool for in-depth discussion and recommenda- tions on stroke practice since 1996 (10). This meeting will con- tinue to provide an excellent opportunity to present, discuss, and

    You might also like