Stroke PSP Question Verification Form

The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.

The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking.

Name of the PSP

Stroke PSP

Please describe the scope of the PSP

The scope of the Stroke PSP is to identify uncertainties relating to all aspects of the stroke pathway, including clinical pathway or the experience of people affected by stroke, and includes causes, diagnosis, prevention (primary and secondary) and care/treatment (pre-hospital, acute, post-acute, long-term and end-of-life).

All types of stroke (i.e. ischaemic, intracerebral haemorrhage, subarachnoid haemorrhage - SAH), and transient ischaemic attack (TIA) Including questions relating to:

• long-term impacts of holistic care, including quality of life and emotional/psychological effects
• stroke in association with other conditions
• access to services
• public awareness and perception of stroke

(Excluded: stroke services & care outside of UK; childhood stroke i.e. stroke experienced by those under 16.

Please provide a brief overview of your approach to checking whether the questions were unanswered

1. A search for up-to-date Cochrane Systematic Reviews was carried out in order to check whether the questions were unanswered by existing research. Assistance was provided by Cochrane Editors and the Cochrane Information Specialist.

2. Signposting to selected Guidance, ongoing trials that might address a question, and other up-to-date evidence was sought from Steering Group members and Stroke Association Lecturers.

NB. (1) Up-to-date was defined as 3 years in the main, with some leeway to 5 years. (2) Steering Group advice was followed where there was any uncertainty.

Please list the type(s) of evidence you used to verify your questions as unanswered

Clinical Guidance

Systematic Reviews

Please list the sources that you searched in order to identify that evidence

1. The following searches were conducted: Cochrane Stroke Database - CDSR (for uncertainties relating to interventions)

2. Signposting was sought within these Clinical Guidelines:

• NICE Guidance
• European Stroke Guidelines
• Subarachnoid Haemorrhage Guidelines
• Australian Guidelines

NB. (1) SIGN, American, Australian and Canadian Guidelines had been included following discussion at Steering Group meeting #4 in February 2020, and removed at meeting #5 in March 2020. Australian Guidelines were added back following meeting #11 in November 2020. (2) The original intention was to also search PubMed. However, a pilot exercise conducted with the assistance of Stroke Association Fellows concluded that the time this would require did not make it feasible (estimated at ~1000 hours).

What search terms did you use?

CDSR Stroke MeSH and Free text searching AND key words from indicative questions (include key words as searching Stroke Mesh and Free text retrieves 1300+ hits)

PubMed Stroke MeSH and Free text searching AND key words from indicative questions (include key words from indicative as searching Stroke Mesh and Free text with SR Limit retrieves 2600+ hits)

Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

No limits placed in NICE, and other Guidelines Limit placed for Systematic Reviews in CDSR and PubMed – 3 years

Names of individuals who undertook the evidence checking

Ann Daly, Information Specialist

On what date was the question verification process completed?

February 2021