Critical Issues That Need to Be Addressed to Improve Outcomes for Patients with Carotid Stenosis

Research output: Contribution to journalReview ArticleOtherpeer-review

9 Citations (Scopus)


Significant improvement in outcomes for patients with carotid stenosis requires liberation from the historic fixation with randomization and a procedurally based, late-stage, reactive approach to medical care. We require a multipronged and multidisciplinary approach that includes all of the following: (i) removal of overreliance on, and biased use of, randomized trial data; (ii) using accurate ways to rank evidence quality and relevance; (iii) improved research reporting standards; (iv) building quality assurance and other research capability into routine practice; (v) producing evidence-true rather than evidence-based guidelines; (vi) bringing current optimal medical treatment to the community and measuring its effectiveness; (vii) funding only interventions known to help patients when and where they are treated and use the savings to fund vital research, including quality assurance in routine practice; and (viii) recognize that making the indication for carotid procedures obsolete is a good thing.

Original languageEnglish
Pages (from-to)420-426
Number of pages7
Issue number5
Publication statusPublished - 2016


  • carotid angioplasty/stenting
  • carotid endarterectomy
  • carotid stenosis
  • guidelines
  • quality assurance
  • stroke prevention

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