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Clinical guidelines for acute stroke management : Which recommendations should remain consensus-based?
Middleton, Sandy Rowley, Julianne Hillege, Sharon Hill, Kelvin Churilov, Leonid Allnutt, Nissa
Middleton, Sandy
Rowley, Julianne
Hillege, Sharon
Hill, Kelvin
Churilov, Leonid
Allnutt, Nissa
Abstract
Although guideline recommendations should be based on the highest levels of evidence available, it may be appropriate for some recommendations to remain consensus-based. This study investigated stroke clinicians' and academics' opinions about which consensus-based recommendations from the Australian National Stroke Foundation Clinical Guidelines for Acute Stroke Management (2007) should remain as such, using a self-administered questionnaire. In the study, 43 people participated (62% response rate). Of the 50 recommendations presented, at least half the participants believed that 35 (70%) of these should remain consensus-based. In an adjusted multivariable analysis, recommendations perceived to be “highly likely” or “likely” to have an impact on patient outcomes were less likely to be perceived by respondents as appropriate to remain consensus-based (OR = 0.16 [95% CI 0.13–0.19], P < .001). Further, although females were less likely to state that recommendations should remain consensus-based (OR = 0.26 for female gender, [95% CI 0.08–0.88], P = .031), those with higher level of educational qualifications (OR = 1.45 per an incremental unit increase in education level [95% CI 1.04–2.03], P = .028) and those from nursing and medicine disciplines in comparison with allied health (OR = 25.2 for medical, nursing, and “other” disciplines in comparison with allied health [95% CI 1.54–413.1], P = .024) were more likely to state that a recommendations should remain consensus-based. The results indicated there was agreement that it may be appropriate that a proportion of recommendations in clinical guidelines remain consensus-based. Assessing the views of what areas require more robust research evidence according to academic and clinical experts may allow for prioritization and optimal allocation of scarce research resources.
Keywords
Date
2013
Type
Journal article
Journal
Journal of Vascular Nursing
Book
Volume
31
Issue
2
Page Range
72-83
Article Number
ACU Department
Nursing Research Institute
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled