Development of clinical guidelines

NSF develops the Clinical Guidelines for Stroke Management following these steps:

Question formulation – The EWG agrees on specific clinical questions addressing interventions relevant to stroke care. These questions provide direction for a literature search of relevant evidence.

Literature search – NSF conducts a systematic identification of relevant studies using electronic databases such as EMBASE, Medline and Cochrane, CINAHL and PsychINFO.

Summarising and synthesising the evidence – NSF summarise relevant studies using a standard NHMRC grading process. We provide the EWG with draft recommendations, which are discussed and agreed by the EWG. The NHMRC grading matrix is used to guide the strength or grading of the recommendation.

Guidelines document – Once the EWG agrees on the recommendations, NSF begins drafting the guidelines. The guidelines include a brief discussion of the evidence and other relevant factors such as the current gaps in practice identified in the National Stroke Audit results or considerations for implementation. We then circulate a draft for EWG comment and incorporate amendments before releasing the guidelines for public consultation.

Consultation – Public consultation on the draft guidelines is wide and takes place over one month. The EWG reviews the feedback and we incorporate recommended amendments.

International peer review – Following public consultation, international experts in the field of stroke and guidelines development peer review the draft guidelines. NSF integrates the peer review feedback and circulates the final draft of the guidelines to the EWG for approval.

Submission to the NHMRC – NSF submits the guidelines and evidence tables to the NHMRC for approval. This process can take a few months and may include ongoing communication with the NHMRC.

For more information contact:

Leah Wright, National Guidelines Coordinator -