Are NICE stroke guidelines scientific or political?

doi:10.1136/bmj.a1339

Published 18 August 2008, doi:10.1136/bmj.a1339
Cite this as: BMJ 2008;337:a1339

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NICE on stroke care

Are NICE stroke guidelines scientific or political?

The first 150 words of the full text of this article appear below.

The BBC and other media organisations were provided with additionalinformation from the press conference at which the NationalInstitute for Health and Clinical Excellence (NICE) and theRoyal College of Physicians released their joint press statementon their stroke guidelines.¹ The first line was: "Approx 4500people could be prevented from being disabled through strokeif they were thrombolysed." This figure is unbelievable, giventhe Department of Health’s estimate of a 13.1% absolutebenefit of recovery to independence (131 per 1000 treated) asit means that some 34 351 patients would have to be given thrombolysis.The Department of Health’s December 2007 impact assessmentindicated that 549 would recover to independence, with a rangeof 307 to 792.

The "extra points" from the conference continued: "Further thousandsof lives could be saved if all patients were admitted directlyto an acute stroke unit (but we do not have a . . . [Full text of this article]

Nigel Dudley, consultant in elderly/stroke medicine¹

¹ St James’s University Hospital, Leeds LS9 7TF

nigel.dudley@leedsth.nhs.uk

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