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Guidelines in Cerebrovascular Neurosurgery

Understand the systematic review process, levels of evidence, and grading system for recommendations in cerebrovascular neurosurgery. Learn how to evaluate guidelines and apply them to patient care effectively.

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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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