People With Lived Experience at the Centre of Canadian Stroke Best Practice Recommendations: A Model for Guideline Developers

Lindsay, M. Patrice; Gierman, Natalie; Harris, Jocelyn E.; Arthur, Gavin; Teed, Moira; Mountain, Anita; Gubitz, Gordon; Smith, Eric E.; Dowlatshahi, Dar; Jong, Andrea de; Botly, Leigh C.P.

doi:10.1177/2374373520956538

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…A broad interdisciplinary group of experts was convened and participated in reviewing, drafting, and revising all recommendation statements, and a panel of people with lived experience participated in a parallel review process. 6 Evidence levels were assigned based on the quality of available evidence and expert opinion. These guidelines have undergone extensive internal and objective external review and consensus was achieved for all content.…”

Section: Guideline Development Methodologymentioning

confidence: 99%

Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020

Gladstone

Lindsay

Douketis

et al. 2021

Can. J. Neurol. Sci.

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113

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The 2020 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for the Secondary Prevention of Stroke includes current evidence-based recommendations and expert opinions intended for use by clinicians across a broad range of settings. They provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations address triage, diagnostic testing, lifestyle behaviors, vaping, hypertension, hyperlipidemia, diabetes, atrial fibrillation, other cardiac conditions, antiplatelet and anticoagulant therapies, and carotid and vertebral artery disease. This update of the previous 2017 guideline contains several new or revised recommendations. Recommendations regarding triage and initial assessment of acute transient ischemic attack (TIA) and minor stroke have been simplified, and selected aspects of the etiological stroke workup are revised. Updated treatment recommendations based on new evidence have been made for dual antiplatelet therapy for TIA and minor stroke; anticoagulant therapy for atrial fibrillation; embolic strokes of undetermined source; low-density lipoprotein lowering; hypertriglyceridemia; diabetes treatment; and patent foramen ovale management. A new section has been added to provide practical guidance regarding temporary interruption of antithrombotic therapy for surgical procedures. Cancer-associated ischemic stroke is addressed. A section on virtual care delivery of secondary stroke prevention services in included to highlight a shifting paradigm of care delivery made more urgent by the global pandemic. In addition, where appropriate, sex differences as they pertain to treatments have been addressed. The CSBPR include supporting materials such as implementation resources to facilitate the adoption of evidence into practice and performance measures to enable monitoring of uptake and effectiveness of recommendations.

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Section: Guideline Development Methodologymentioning

confidence: 99%

Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020

Gladstone

Lindsay

Douketis

et al. 2021

Can. J. Neurol. Sci.

Self Cite

113

View full text Add to dashboard Cite

show abstract

“…78 Involving individuals with lived experience in guideline development ensures that recommendations are supported by their experiences and areas that are important to them are prioritised. 79 This also aligns with the World Health Organization's vision of centring people and communities in health services and empowering and engaging individuals and families, communities, and disadvantaged populations. 78…”

Section: Discussionmentioning

confidence: 68%

Equity considerations in clinical practice guidelines for traumatic brain injury and homelessness: a systematic review

Chan,

Estrella,

Hanafy

et al. 2023

eClinicalMedicine

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“…were not been sought. During the development of CPGs, patients and a variety of stakeholders, such as clinicians of all types, insurance payers and funders, health policy decision makers, and experts should be involved in the development of CPGs to set priorities, ensure feasibility, and promote distribution and compliance ( 6 , 40 , 41 ).…”

Section: Discussionmentioning

confidence: 99%

Quality appraisal of clinical practice guidelines for the management of Dysphagia after acute stroke

Gao,

Liu,

Han

et al. 2023

Front. Neurol.

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ObjectivesDysphagia is a common complication in stroke patients, widely affecting recovery and quality of life after stroke. The objective of this systematic review is to identify the gaps that between evidence and practice by critically assessing the quality of clinical practice guidelines (CPGs) for management of dysphagia in stroke.MethodsWe systematically searched academic databases and guideline repositories between January 1, 2014, and August 1, 2023. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used by two authors to independently assess CPG quality.ResultsIn a total of 14 CPGs included, we identified that three CPGs obtained a final evaluation of “high quality,” nine CPGs achieved “moderate quality” and two CPGs received “low quality.” The domain of “scope and purpose” achieved the highest mean score (91.1%) and the highest median (IQR) of 91.7% (86.1, 94.4%), while the domain of “applicability” received the lowest mean score (55.8%) and the lowest median (IQR) of 55.4% (43.2, 75.5%).ConclusionThe CPG development group should pay more attention to improving the methodological quality according to the AGREE II instrument, especially in the domain of “applicability” and “stakeholder involvement;” and each item should be refined as much as possible.

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People With Lived Experience at the Centre of Canadian Stroke Best Practice Recommendations: A Model for Guideline Developers

Cited by 10 publications

References 14 publications

Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020

Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020

Equity considerations in clinical practice guidelines for traumatic brain injury and homelessness: a systematic review

Quality appraisal of clinical practice guidelines for the management of Dysphagia after acute stroke

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