How are diagnostic guidelines for stroke/related vascular disorders updated/created?

[someqsaboutstuff]

I was curious if any of the societies related to stroke (AHA/ANA/endovascular neurosurgeons etc) have a specified process for the adjustment of diagnostic guidelines. For example, if I were to publish a study suggesting that it is highly efficient to (1) use a Super Accurate clinical algorithm to determine risk for intracranial atherosclerosis (2) do imaging/other relevant diagnostic testing to confirm ICAS if risk score is high enough (3) use another Super Accurate algorithm to determine risk for stroke, and (4) do interventional procedure if stroke risk is high enough, do any of the societies have a procedure for turning the process proposed by that study into the newest set of clinical guidelines?

I imagine it would take an entire career to publish separately on steps 1-4 as well as do the politicking necessary to get them endorsed by whatever relevant society, but I would like to read more about the latter part. What is the specific bureaucratic process for updating clinical guidelines for stroke, and what quality of evidence is required by these bureaucratic processes?

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[deathmerchant]

Depends on the complexity/impact of your recommendations. For the above mentioned recs, you have to be a somewhat of a leader/senior member in that field/society and have at least Level 4, ideally Level 5 evidence for your recommendations. For which you probably have to have few multi-center, RCTs.

 

[Hank Rearden]

The formula is pretty simple. Perform a multicenter, phase III RCT that proves that your intervention is superior to the standard of care. Unless your intervention is exorbitantly expensive or provides only marginal benefit it will be adopted as standard of care and written into the guidelines.