national-clinical-guidelines-for-stroke-fourth-edition

National clinical guideline for stroke
The guideline is set within the context of the current legal framework within the UK
governing the provision of services, for example concerning community care or social
services care management. This guideline is not intended to overrule such regulations.
It should be considered in conjunction with them. Hopefully they will facilitate practice
not only in health services but also in social services and other organisations. (‘Social
services’ are currently termed ‘adult services’ in much of the UK.)
Feedback is always welcome. This guideline is only as good as it is because hundreds of
people have contributed their comments to drafts and editions since 2000 for which we
are grateful. We also wish to acknowledge other guideline developers from around the
world who have published since our last edition, particularly the Canadian and
Australian guidelines. We had access to these documents during their development phase
and shamelessly used the information within them to contribute to the development of
this guideline. Hopefully in due course international stroke guideline developers will have
access to a common database so that the work can be shared routinely, avoiding
duplication of effort.
1.6 Methodology of guideline development
The guideline was developed by the Intercollegiate Stroke Working Party (ICSWP) and
coordinated by the Clinical Effectiveness and Evaluation Unit (CEEU) of the Royal College
of Physicians (RCP) in London. The current members of the working party, listed on pages
viii–ix, were nominated by professional organisations and societies to give wide
representation from all disciplines, including the views of patients and their families.
Members were required to liaise with their professional bodies and with other experts in the
field as they felt appropriate throughout the process. Most members have a longstanding
personal interest and expertise in the field of stroke management. We are very grateful to all
members of the working party, who gave their time and expertise freely to produce the
guideline. Searches, selection of studies, and reviews of studies were undertaken by a large
number of people. We are extremely grateful to each and every one of them and the
guideline would not exist without their hard work. They are acknowledged in appendix 1.
1.6.1 Development of scope
See section 1.1 for details of the content of the scope. This led to the generation of 260
questions (see the RCP website for full search strategies) to be searched initially.
Agreement was made that topics to be covered in the ongoing NICE guideline for stroke
rehabilitation would not be considered by us. However, when the publication date for this
guideline was delayed, we expanded our scope to include most of these topics for
completeness. There was insufficient time to do full searches on all of these topics but we
took guidance from the work already completed by the guideline development group at
the National Clinical Guideline Centre.
1.6.2 Searching the scientific literature
The searches consisted of systematic searching of computerised databases including:
Medline, AMED, CINAHL, Psychinfo and Embase. The Cochrane Collaboration database
was used extensively, and other national guidelines were reviewed including those of the
Scottish Intercollegiate Guidelines Network (SIGN) and NICE. Health Technology
6 © Royal College of Physicians 2012