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Guideline Opportunities

We are seeking volunteer, multidisciplinary, multispecialty health professionals and consumer representatives to help with a new guideline on stroke prevention.

This guideline is being produced under the auspices of the International Union of Angiology (IUA). It is focusing on disease of the main brain artery (the carotid artery) with implications for optimising all arterial disease prevention.

The aim is to produce the world’s first ‘evidence-true’ guideline for carotid arterial disease management by correcting the errors in existing guidelines (see Abbott et al, Stroke, 2015: DOI: 10.1161/STROKEAHA.115.003390). Therefore, in this new guideline:

  • Endorsements for interventions will be limited to subgroups that benefited in relevant trials and subgroups included and not included in such trials will be clearly distinguished.
  • Recommendations for patient subgroups (such as men and women) will not be the same if the evidence clearly shows significantly different outcomes for such subgroups with the same treatment.
  • Outdated trials will be acknowledged, including all past trials of carotid endarterectomy.
  • Interventions causing excess harm, such as carotid stenting, will be acknowledged.
  • Recommendations for proven, effective non-invasive interventions will be included.
  • Randomised trial data will not be automatically ranked as the best for informing patient management decisions, even when that data is outdated, biased or not required.

This project involves systematic reviews of guidelines and studies regarding how to best define and modify arterial disease risk factors (including hypertension, lipids, physical inactivity and tobacco smoking) for primary and secondary prevention of clinical manifestations of arterial disease.

Consumers, in particular, can assist by helping make the guideline understandable, relevant and accessible.

All work is being performed via email and videoconferencing. There is no need for meeting participation. People of all career stages are welcome and variable time contributions can be accommodated.

If interested, please email a summary of why and how you would like to help to A/Prof Anne Abbott: Anne.L.Abbott@gmail.com


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Research Opportunities (the CASCOM Study)

Carotid Stenosis Management During the COVID-19 Era with Best Medical Intervention Alone (CASCOM Study)

CASCOM is a prospective cohort study of patients with advanced carotid arterial disease (narrowing or stenosis) receiving current best medical intervention alone (lifestyle coaching and medication) for stroke prevention.

CASCOM is also a multi-national, multi-specialty, collaborative, quality assurance and evaluation project being conducted under the auspices of the International Union of Angiology.

CASCOM will include patients with or without prior stroke or transient ischaemic attack who do not undergo a carotid procedure for any reason, including lack of proven procedural benefit and where procedural use is considered unethical.

We will expect stroke rates in CASCOM will be at least 50% lower than those seen in past randomised trials of medical intervention and carotid endarterectomy (surgery). We expect CASCOM will provide new evidence that past randomised trials are outdated and set new improved standards for prevention of stroke and other arterial disease complications.

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