Developing a National Guideline for Diagnosis, Treatment and Follow-up of Stroke

Background and purpose: Lack of clear boundaries and standard reference about the diagnosis of stroke, necessary evaluations and interventions, effective treatments, and referral of stroke patients resulted in various inconsistent services. Therefore, this study aimed at developing practical national strategies for stroke in Iran. Clinical guidelines about diagnosis and management of stroke were extracted from different guidelines. Three guidelines were selected according to AGREE scoring system after quality assessment and evaluation of clinical guidelines. In order to adapt the guidelines, recommendations of the three clinical guidelines were recorded in the form of clinical questions. Evidence supporting each recommendation was identified based on references and compared in terms of initial outcomes. Cost of interventions, the side effects, and clinical benefits were also studied. Finally, the national guideline for management of stroke was developed. The results of this investigation were presented as clinical recommendations for diagnosis and management of stroke (2016). For example, strict control of blood glucose level and fever in patients with aneurysmal subarachnoid hemorrhage was recommended in the guideline. The current indigenous stroke guide for the Iranian population is believed to be of great benefit in screening, referral, diagnosis, treatment, and follow-up of stroke.