Diagnosis and therapy for the acute stage of ischemic cerebrovascular accident: A clinical practice guideline from Peruvian Social Security (EsSalud)

  • Joel Mario Sequeiros-Chirinos Hospital Nacional Alberto Sabogal Sologuren. Seguro Social de Salud. Lima, Perú.
  • Carlos A. Alva-Díaz Instituto de Evaluación de Tecnologías en Salud e Investigación. Seguro Social de Salud. Lima, Perú
  • Kevin Pacheco-Barrios Instituto de Evaluación de Tecnologías en Salud e Investigación. Seguro Social de Salud. Lima, Perú
  • Jorge Huaringa-Marcelo Instituto de Evaluación de Tecnologías en Salud e Investigación. Seguro Social de Salud. Lima, Perú
  • Charles Huamaní Hospital Nacional Adolfo Guevara Velasco. Seguro Social de Salud. Cusco, Perú.
  • Carla E. Camarena-Flores Hospital Nacional Guillermo Almenara Irigoyen. Seguro Social de Salud. Lima, Perú.
  • Walter S. Durand-Castro Hospital Nacional Guillermo Almenara Irigoyen. Seguro Social de Salud. Lima, Perú.
  • Ana María Valencia-Chávez Instituto Nacional de Ciencias Neurológicas. Ministerio de Salud. Lima, Perú.
  • Rosa L. Ecos-Quispe Instituto Nacional de Ciencias Neurológicas. Ministerio de Salud. Lima, Perú.
  • Paula I. Estupinan-Valdez Hospital Nacional Alberto Sabogal Sologuren. Seguro Social de Salud. Lima, Perú.
  • Marla Gallo-Guerrero Hospital Nacional Guillermo Almenara Irigoyen. Seguro Social de Salud. Lima, Perú.
  • Marlene Doris Huamaní-Mendoza Hospital Nacional Edgardo Rebagliati Martins. Seguro Social de Salud. Lima, Perú.
  • Evelyn Vanessa Mariños-Sánchez Hospital Nacional Edgardo Rebagliati Martins. Seguro Social de Salud. Lima, Perú.
  • María Elizabeth Morón-Cabrera Hospital Nacional Edgardo Rebagliati Martins. Seguro Social de Salud. Lima, Perú.
  • Elena Pulachet-Contreras Hospital Nacional Edgardo Rebagliati Martins. Seguro Social de Salud). Lima, Perú.
  • Alfredo Ramos-Auccasi Hospital Nacional Edgardo Rebagliati Martins. Seguro Social de Salud. Lima, Perú.
  • Liliana Rodríguez-Kadota Hospital Nacional Edgardo Rebagliati Martins. Seguro Social de Salud. Lima, Perú.
  • César Saavedra-Rocha Hospital Nacional Edgardo Rebagliati Martins. Seguro Social de Salud. Lima, Perú.
  • Lesly Chávez-Rimache Instituto de Evaluación de Tecnologías en Salud e Investigación. Seguro Social de Salud. Lima, Perú.
  • Raúl Timaná Ruíz Instituto de Evaluación de Tecnologías en Salud e Investigación. Seguro Social de Salud. Lima, Perú
Keywords: Stroke, Practice guidelines as topic, GRADE approach, Evidence-based medicine

Abstract

Objective: to provide evidence based clinical recommendations for the diagnosis and therapy of the acute stage of ischemic cerebrovascular accident in EsSalud. Materials and methods: a group for producing the guideline was conveyed, including specialized physicians and methodologists. The group prepared 8 clinical questions to be answered by the guideline. Systematic searches of previous reviews were performed, and – when it was deemed necessary – primary studies in Medline and the Cochrane Controlled Registry of Trials for 2018 were reviewed. Evidence was selected aiming to respond each one of the proposed clinical questions. Certainty of the evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work sessions, the group used GRADE methodology for reviewing the evidence and generated recommendations, good clinical practice items, and designed flow charts for both diagnosis and therapy. Finally, the guide was approved with the decree N° 128-IETSI-ESSALUD-2019. Results: this clinical practice guideline focused in 8 clinical questions, which were divided into four topics: screening, diagnosis, therapy, support and rehabilitation. On the basis of these questions, 28 recommendations were formulated (8 strong and 20 conditional), 38 items for good clinical practice, 1 implementation note, and 2 flow charts. Conclusion: this paper summarizes both evidence based methodology and conclusions from a new clinical practice guide for diagnosis and therapy of the acute stage of a cerebrovascular accident in EsSalud.

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Published
2020-03-31
How to Cite
1.
Sequeiros-Chirinos JM, Alva-Díaz CA, Pacheco-Barrios K, Huaringa-Marcelo J, Huamaní C, Camarena-Flores CE, Durand-Castro WS, Valencia-Chávez AM, Ecos-Quispe RL, Estupinan-Valdez PI, Gallo-Guerrero M, Huamaní-Mendoza MD, Mariños-Sánchez EV, Morón-Cabrera ME, Pulachet-Contreras E, Ramos-Auccasi A, Rodríguez-Kadota L, Saavedra-Rocha C, Chávez-Rimache L, Timaná Ruíz R. Diagnosis and therapy for the acute stage of ischemic cerebrovascular accident: A clinical practice guideline from Peruvian Social Security (EsSalud). Acta Med Peru [Internet]. 2020Mar.31 [cited 2020Aug.6];37(1). Available from: https://amp.cmp.org.pe/index.php/AMP/article/view/869