Published 24 July 2008, doi:10.1136/bmj.a833
Cite this as: BMJ 2008;337:a833

Practice

Commentary: Controversies in NICE guidance on acute stroke and transient ischaemic attack

¹ School of Clinical Medical Sciences, Newcastle University, The Medical School, Newcastle upon Tyne NE2 4HH, ² North Tyneside General Hospital, North Shields NE29 8NH

doi: 10.1136/bmj.a786

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

The guidelines from the National Institute for Health and Clinical Excellence (NICE) are a thorough and helpful summary of evidence in acute management of stroke and transient ischaemic attack.¹ They are a welcome contribution to increasing understanding of stroke as a major cause of death and disability and to improving the structure and funding of services to tackle the problem.

Controversy is likely to centre on:

• The selective remit for the guidelines given by the Department of Health
  
• The conflict between evidence based recommendations from NICE and recent statements from the Department of Health and the Healthcare Commission
  
• The consensus guidance in areas where evidence is scant.
  

NICE guidance carries considerable influence over funding for services. It is therefore worrying that the Department of Health instructed NICE to examine only the first few days of treatment for a condition that often requires prolonged rehabilitation and long term support. Given fixed . . . [Full text of this article]

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