SynthesisBulletin of the World Health Organization2021
Quality of stroke guidelines in low- and middle-income countries: a systematic review.
Synthesis in Bulletin of the World Health Organization, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Tertiary prevention interventions for patients with stroke in African countries: a systematic review.BMJ open · 2025Pooled it
- Stroke Rehabilitation Clinical Practice Guidelines in Low- and Middle-Income Countries: A Systematic Review of Quality and Unique Features.Cerebrovascular diseases (Basel, Switzerland) · 2025Pooled it
- Pooled it
- A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization.International journal of stroke : official journal of the International Stroke Society · 2023Pooled it
- Quality of stroke guidelines in low- and middle-income countries: a systematic review.Bulletin of the World Health Organization · 2021Pooled it
- Refining the Stroke Risk Screening Scales (SRSS) Through Two-Round Cognitive Interviews with Stroke Survivors and Healthcare Providers in Thailand.Vascular health and risk management · 2026Article
- Challenges in the Management of Stroke in Intensive Care Units in Low- and Middle-Income Countries.Neurocritical care · 2025Review
- Improving Access to Primordial and Primary Stroke Prevention: Global Considerations.Journal of the American Heart Association · 2025Review
- Article
- Article
- Epidemiological trends of subarachnoid hemorrhage at global, regional, and national level: a trend analysis study from 1990 to 2021.Military Medical Research · 2024Article
- Thrombectomy outcomes for acute ischemic stroke in lower-middle income countries: A systematic review and analysis.World neurosurgery: X · 2024Review
- Addressing disparities in the global epidemiology of stroke.Nature reviews. Neurology · 2024Review
- Diagnosis and management of subarachnoid haemorrhage.Nature communications · 2024Review
- Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization-Lancet Neurology Commission.The Lancet. Neurology · 2023Review
- Global synergistic actions to improve brain health for human development.Nature reviews. Neurology · 2023Article
- Article
- Two-Stage Clinical Model for Screening the Suspected Cases of Acute Ischemic Stroke in Need of Imaging in Emergency Department; a Cross-sectional Study.Archives of academic emergency medicine · 2023Article
- Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: A scoping review.Frontiers in rehabilitation sciences · 2023Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
30 authors.
Funding
Abstract
objectiveTo identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries.
methodsWe systematically searched medical databases and websites of medical societies and contacted international organizations. Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation). We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of guidelines and plans for dissemination to target audiences.
findingsWe reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries. Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development; breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines encompassed detailed implementation plans and socioeconomic considerations.
conclusionGuidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.