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Int J Stroke. 2015 Oct;10 Suppl A100:128-35. doi: 10.1111/ijs.12583. Epub 2015 Jul 6.

The European Stroke Organisation Guidelines: a standard operating procedure.

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Department of Medicine, University of Thessaly, Larissa, Greece.
Comprehensive Stroke Center, Department of Neurology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Stroke Unit, Department of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
University of Copenhagen and Bispebjerg Hospital, Copenhagen, Denmark.
Department of Neurology, University Hospital Brussels, Center for Neurosciences Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Department of Neurology, UMCG, Groningen, The Netherlands.
Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Department of Neurology and Stroke Centre, Neurosciences Area - IdiPAZ (Health Research Institute), La Paz University Hospital, Autónoma University of Madrid, Madrid, Spain.
Department of Neurosciences, Hospital Santa Maria, University of Lisbon, Lisbon, Portugal.
Division of Medical Sciences, University of Oxford, Oxford, UK.
Neurology Department, Klinikum Ludwigshafen, Ludwigshafen, Germany.
Neurointensive Care Unit, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
INSERM U1171, University of Lille, Lille, France.
Department of Neurology, Oslo University Hospital, Oslo, Norway.
Department of Neurology and Psychiatry, Hospital Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Department of Neurology, Sainte-Anne Hospital, Paris, France.
Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
Department of Neurology, Klinikum Frankfurt Höchst, Frankfurt, Germany.
Department of Neurology, Heidelberg University, Heidelberg, Germany.


In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations on the related module rather swiftly; with the previous approach of a single large Guideline Document, its entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines. After discussion within the European Stroke Organisation Guidelines Committee and significant input from European Stroke Organisation members as well as methodologists and analysts, this document presents the official standard operating procedure for the development of the Guideline Documents of the European Stroke Organisation.


European Stroke Organisation; guidelines; standard operating procedure

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