Hernán Bayona1, Mayowa Owolabi2, Wuwei Feng3, Paul Olowoyo2, Joseph Yaria2, Rufus Akinyemi2, James R Sawers4, Bruce Ovbiagele4. 1. Department of Neurology, Medical University of South Carolina, Charleston, USA; Department of Neurology, Fundación Santa Fe de Bogotá Hospital, Andes University, Bogota, Colombia. 2. Department of Medicine, University of Ibadan, and University College Hospital, Ibadan, Nigeria. 3. Department of Neurology, Medical University of South Carolina, Charleston, USA. Electronic address: feng@musc.edu. 4. Department of Neurology, Medical University of South Carolina, Charleston, USA.
Abstract
BACKGROUND AND PURPOSE: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. However, key quality characteristics of guidelines issued in LMICs compared with those in High-Income Countries (HICs) have not been systematically studied. We aimed to compare important features of stroke prevention guidelines issued in these groups. METHODS: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: "Stroke" and "Guidelines". We critically appraised the articles for evidence level, issuance frequency, translatability to clinical practice, and ethical considerations. We followed the PRISMA guidelines for the elaboration process. RESULTS: Among 36 stroke prevention guidelines published, 22 (61%) met eligibility criteria: 8 from LMICs (36%) and 14 from HICs (64%). LMIC-issued guidelines were less likely to have articulation of recommendations (62% vs. 100%, p=0.03), involve high quality systematic reviews (21% vs. 79%, p=0.006), have a good dissemination channels (12% vs 71%, p=0.02) and have an external reviewer (12% vs 57%, p=0.07). The patient views and preferences were the most significant stakeholder considerations in HIC (57%, p=0.01) compared with LMICs. The most frequent evidence grading system was American Heart Association (AHA) used in 22% of the guidelines. The Class I/III and Level (A) recommendations were homogenous among LMICs. CONCLUSIONS: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.
BACKGROUND AND PURPOSE: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. However, key quality characteristics of guidelines issued in LMICs compared with those in High-Income Countries (HICs) have not been systematically studied. We aimed to compare important features of stroke prevention guidelines issued in these groups. METHODS: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: "Stroke" and "Guidelines". We critically appraised the articles for evidence level, issuance frequency, translatability to clinical practice, and ethical considerations. We followed the PRISMA guidelines for the elaboration process. RESULTS: Among 36 stroke prevention guidelines published, 22 (61%) met eligibility criteria: 8 from LMICs (36%) and 14 from HICs (64%). LMIC-issued guidelines were less likely to have articulation of recommendations (62% vs. 100%, p=0.03), involve high quality systematic reviews (21% vs. 79%, p=0.006), have a good dissemination channels (12% vs 71%, p=0.02) and have an external reviewer (12% vs 57%, p=0.07). The patient views and preferences were the most significant stakeholder considerations in HIC (57%, p=0.01) compared with LMICs. The most frequent evidence grading system was American Heart Association (AHA) used in 22% of the guidelines. The Class I/III and Level (A) recommendations were homogenous among LMICs. CONCLUSIONS: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.
Authors: David Moher; Laura Weeks; Mary Ocampo; Dugald Seely; Margaret Sampson; Douglas G Altman; Kenneth F Schulz; Donald Miller; Iveta Simera; Jeremy Grimshaw; John Hoey Journal: J Clin Epidemiol Date: 2011-01-08 Impact factor: 6.437
Authors: Béatrice Fervers; Jako S Burgers; Margaret C Haugh; Jean Latreille; Najoua Mlika-Cabanne; Louise Paquet; Martin Coulombe; Mireille Poirier; Bernard Burnand Journal: Int J Qual Health Care Date: 2006-06 Impact factor: 2.038
Authors: George Ntaios; Natan M Bornstein; Valeria Caso; Hanne Christensen; Jacques De Keyser; Hans-Christoph Diener; Exuperio Diez-Tejedor; Jose M Ferro; Gary A Ford; Armin Grau; Emanuella Keller; Didier Leys; David Russell; Danilo Toni; Guillaume Turc; Bart Van der Worp; Nils Wahlgren; Thorsten Steiner Journal: Int J Stroke Date: 2015-07-06 Impact factor: 5.266
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: Hypertension Date: 2003-12-01 Impact factor: 10.190
Authors: Valery L Feigin; George A Mensah; Bo Norrving; Christopher J L Murray; Gregory A Roth Journal: Neuroepidemiology Date: 2015-10-28 Impact factor: 3.282
Authors: Aizhamal Tabyshova; John R Hurst; Joan B Soriano; William Checkley; Erick Wan-Chun Huang; Antigona C Trofor; Oscar Flores-Flores; Patricia Alupo; Gonzalo Gianella; Tarana Ferdous; David Meharg; Jennifer Alison; Jaime Correia de Sousa; Maarten J Postma; Niels H Chavannes; Job F M van Boven Journal: Chest Date: 2020-10-08 Impact factor: 9.410
Authors: Mayowa O Owolabi; Amanda G Thrift; Ajay Mahal; Marie Ishida; Sheila Martins; Walter D Johnson; Jeyaraj Pandian; Foad Abd-Allah; Joseph Yaria; Hoang T Phan; Greg Roth; Seana L Gall; Richard Beare; Thanh G Phan; Robert Mikulik; Rufus O Akinyemi; Bo Norrving; Michael Brainin; Valery L Feigin Journal: Lancet Public Health Date: 2021-10-29
Authors: Tanja Kovačević; Davorka Vrdoljak; Slavica Jurić Petričević; Ivan Buljan; Dario Sambunjak; Željko Krznarić; Ana Marušić; Ana Jerončić Journal: Int J Environ Res Public Health Date: 2022-08-03 Impact factor: 4.614
Authors: Michał J Kubisa; Mateusz P Jezewski; Aleksandra Gasecka; Jolanta M Siller-Matula; Marek Postuła Journal: Ther Clin Risk Manag Date: 2018-01-17 Impact factor: 2.423
Authors: Rajesh N Kalaria; Mayowa O Owolabi; Rufus O Akinyemi; Bruce Ovbiagele; Olaleye A Adeniji; Fred S Sarfo; Foad Abd-Allah; Thierry Adoukonou; Okechukwu S Ogah; Pamela Naidoo; Albertino Damasceno; Richard W Walker; Adesola Ogunniyi Journal: Nat Rev Neurol Date: 2021-09-15 Impact factor: 42.937