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Guidelines in Cerebrovascular Neurosurgery

Guidelines in Cerebrovascular Neurosurgery. Resident Session December 2000. Guideline Methodology. systematic review of the literature relating to a disease or specific treatment condition categorization according to “levels of evidence” development of “grades of recommendation”

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Guidelines in Cerebrovascular Neurosurgery

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  1. Guidelines in Cerebrovascular Neurosurgery Resident Session December 2000

  2. Guideline Methodology • systematic review of the literature relating to a disease or specific treatment condition • categorization according to “levels of evidence” • development of “grades of recommendation” • generally a consensus process

  3. Levels of evidence for rating studies of treatment or prevention

  4. Grading System for Recommendation

  5. Categories for Strength of Recommendation

  6. … Still more terms … • “Standard of care”: • handful (Nimodipine, NASCET >70%, NASCIS) • “Recommendations” • “Options”

  7. Guidelines “Cookbook medicine”?

  8. How to use Guidelines • assess quality of guideline construction • ensure applicability to your patient • If there is high-level evidence (standard of care): • follow it! OR • delineate (and document) rationale for not following it • If the evidence is poor: • decide based on (evidence & experience)

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