Response to Letter by Hart
We are grateful to Dr Hart for his comments. The Stroke Council Scientific Statements Oversight Committee (SOC) fully concurs that guidelines are improved by having a variety of perspectives represented on writing panels. Stroke Council Guidelines have historically had broad specialty representation, including neurology, neurosurgery, vascular surgery, neuroradiology, cardiology, internal medicine, emergency medicine, and additional physician specialty representatives as may be appropriate. Steps are being taken to further increase the contribution of primary care practitioners, including formal guideline affirmation and endorsement arrangements with other relevant professional societies.
SOC supports the goal of incorporating patient values and preferences in guideline formulation. The Stroke Council recently developed and released a formal Guideline Development Manual to guide writing committees.1 The Manual recommends that Stroke Council–sponsored guidelines include data reflecting patient preferences whenever possible. Integrating patient values in guidelines is challenging because data on patient preferences is often not available or of variable quality, and interpretation of preference data are complicated by adjustment to disease bias and other confounds. Guidelines, nonetheless, are optimized by encompassing available findings regarding patient preferences among poststroke health outcome states.
Stroke Council Guideline Development Manual v 1.0. Available at: http://www.americanheart.org/presenter.jhtml?identifier=3039361. Accessed 5-5-06.