Abstract
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 language | English |
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Pages (from-to) | 420-426 |
Number of pages | 7 |
Journal | Angiology |
Volume | 67 |
Issue number | 5 |
DOIs | |
Publication status | Published - 2016 |
Keywords
- carotid angioplasty/stenting
- carotid endarterectomy
- carotid stenosis
- guidelines
- quality assurance
- stroke prevention