Systematic Review of Existing Stroke Guidelines: Case for a Change.
Tissa WijeratneCarmela SalesChanith WijeratneLeila KarimiMihajlo Michael JakovljevicPublished in: BioMed research international (2022)
This systematic review has identified a significant evidence-practice gap in all existing national stroke guidelines published in English medium as of October 2020. These guidelines included the only current "living stroke guidelines," stroke guidelines from Australia with a real opportunity to modernize the living stroke guidelines with systems biology approach, and provide 2020 vision towards better stroke care globally. Investigation of complex disease such as stroke is best served through a systems biology approach. One of the easiest places to start is simple blood tests such as total white cell count and NLR. Systems biology approach point us towards simple tools such immune-inflammatory index (SII) and serial systemic immune inflammatory indices (SSIIi) which should pave the way for the stroke physician community address the challenges in systems biology approach in stroke care. These challenges include translating bench research to the bedside, managing big data (continuous pulse, blood pressure, sleep, oxygen saturation, progressive changes in NLR, SII, SSIIi, etc.). Working with an interdisciplinary team also provides a distinct advantage. Recent adoption of historic WHO-IGAP calls for immediate action. The 2022 World Brain Day campaign on Brain Health for All is the perfect opportunity to raise awareness and start the process.
Keyphrases
- atrial fibrillation
- systematic review
- healthcare
- blood pressure
- big data
- cerebral ischemia
- clinical practice
- quality improvement
- primary care
- palliative care
- oxidative stress
- randomized controlled trial
- meta analyses
- machine learning
- public health
- adipose tissue
- mesenchymal stem cells
- physical activity
- pain management
- insulin resistance
- skeletal muscle
- peripheral blood
- health insurance
- drug induced
- glycemic control