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

BMJ 2008; 337 doi: (Published 24 July 2008) Cite this as: BMJ 2008;337:a833
  1. Helen Rodgers, professor of stroke care 12,
  2. Mark Sudlow, honorary senior lecturer and consultant stroke physician12
  1. 1School of Clinical Medical Sciences, Newcastle University, The Medical School, Newcastle upon Tyne NE2 4HH
  2. 2North Tyneside General Hospital, North Shields NE29 8NH
  1. Correspondence to: H Rodgers helen.rodgers{at}

    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.

    Focus on initial management

    NICE guidance carries considerable influence over funding for services. It …

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