Ghozy Sherief, Kobeissi Hassan, Amoukhteh Melika, Kadirvel Ramanathan, Brinjikji Waleed, Rabinstein Alejandro A, Carpenter Christopher R, Kallmes David F
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Brain Sci. 2024 Jul 20;14(7):728. doi: 10.3390/brainsci14070728.
Stroke guideline statements are important references for clinicians due to the rapidly evolving nature of treatments. Guideline statements should be informed by up-to-date systematic reviews (SRs) and meta-analyses (MAs) because they provide the highest level of evidence. To investigate the utilization of SRs/MAs in stroke management guidelines, we conducted a literature review of guidelines and extracted relevant information regarding SRs/MAs.
A literature review was conducted in PubMed with supplementation using the Trip medical database with the term "stroke" as the target population, followed by using the filter "guidelines". We extracted the number of included SRs/MAs, the years of publication, the country of origin, and other characteristics of interest. Descriptive statistics were generated using the R software version 4.2.1.
We included 27 guideline statements. The median number of overall SRs or MAs within the guidelines was 4.0 (interquartile range [IQR] = 2-9). For MAs only, the median number included in the guidelines was 3.0 (IQR = 2.0-5.5). Canadian guidelines had the oldest citations, with a median gap of 12.0 (IQR = 5.2-18.0) years for the oldest citation, followed by European (median = 12; IQR = 9.5-13.5) and US (median = 10.0; IQR = 5.2-16) guidelines.
Stroke guideline writing groups and issuing bodies should devote greater effort to the inclusion of up-to-date SRs/MAs in their guideline statements so that clinicians can reference recent data with the highest level of evidence.
由于治疗方法迅速发展，卒中指南声明对临床医生来说是重要的参考依据。指南声明应以最新的系统评价（SRs）和荟萃分析（MAs）为依据，因为它们提供了最高级别的证据。为了调查SRs/MAs在卒中管理指南中的应用情况，我们对指南进行了文献综述，并提取了有关SRs/MAs的相关信息。
在PubMed中进行文献综述，并使用Trip医学数据库进行补充，以“卒中”为目标人群，随后使用“指南”过滤器。我们提取了纳入的SRs/MAs数量、发表年份、原产国以及其他感兴趣的特征。使用R软件版本4.2.1进行描述性统计。
我们纳入了27份指南声明。指南中总体SRs或MAs的中位数为4.0（四分位间距[IQR]=2-9）。仅对于MAs，指南中纳入的中位数为3.0（IQR=2.0-5.5）。加拿大指南的引用年份最久，最旧引用的中位数差距为12.0（IQR=5.2-18.0）年，其次是欧洲（中位数=12；IQR=9.5-13.5）和美国（中位数=10.0；IQR=5.2-16）指南。
卒中指南编写组和发布机构应更加努力地在其指南声明中纳入最新的SRs/MAs，以便临床医生能够参考具有最高级别证据的最新数据。
