Unless YOU get involved you will never get protocols instead of useless guidelines.
Living clinical guidelines for stroke: updates, challenges and opportunities: Australia
Published online: 16 May 2022
The Australian and New Zealand living stroke management guidelines provide timely, evidence‐based updates to recommendations
Continued growth in the number of published clinical studies has necessitated changes to the way evidence‐based resources such as clinical guidelines are developed and updated. The Australian and New Zealand Clinical Guidelines for Stroke Management (https://informme.org.au/guidelines/clinical‐guidelines‐for‐stroke‐management) are based on continual evidence surveillance and timely updates to recommendations as new research is published. In this article, we outline the main updates to recommendations since the guidelines moved into a living mode in 2018, and discuss key challenges and benefits of living guidelines.
Background
Stroke is a leading cause of adult disability in Australia, with an estimated 27 428 incident strokes occurring each year, or one every 19 minutes.1 Compared with urban areas, the incidence of stroke is 17% higher in rural communities, where access to specialist stroke care is less likely.1 This makes the need for easily accessible, up‐to‐date, evidenced‐based clinical practice guidelines for stroke care essential.
The first Australian clinical guidelines for stroke were published in 2003 (acute) and 2005 (post‐acute). These were updated in 2007, 2010 and most recently in 2017 following traditional methods, including endorsement by the National Health and Medical Research Council (NHMRC). In 2017, the guidelines moved from being published in a static (pdf) format, to being published online using the Making GRADE the Irresistible Choice (MAGICapp) platform (https://magicevidence.org).2
Traditional cycles of guideline updates which involve recommendations based on the best available evidence at the time of publication are problematic because new evidence can mean that recommendations quickly become outdated. In 2018, the Stroke Foundation and Cochrane Australia were awarded funding to test a model of living guidelines for stroke management. These were the first Australian living clinical guidelines and are the first and only living stroke guidelines worldwide. Subsequent living guidelines include those for diabetes,3 maternal and perinatal health,4 and COVID‐19.5 The stroke guidelines are published online at https://informme.org.au/guidelines/clinical‐guidelines‐for‐stroke‐management, to guide day‐to‐day stroke care in Australia and New Zealand.
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