Making difficult decisions about the benefits and risks of thrombolysis treatment

Dr Aoife De Brun is a Research Associate at the Institute of Health & Society at Newcastle Universityshutterstock_114405178

An online survey investigating factors that influence clinical decision-making regarding intravenous thrombolysis for patients with acute ischaemic stroke has been launched. The project is funded by the NIHR Health Service and Delivery Research Programme and is led by researchers from Newcastle University.

We are recruiting clinicians who are involved in making the final decision regarding thrombolysis for patients with acute ischemic stroke.  By understanding how clinicians make difficult trade-offs between the potential benefits and risks of thrombolysis, we can design strategies to better support risk communication, consent and decision-making with patients in clinical practice. Continue reading

Atrial Fibrillation: The real story behind the new NICE guidelines

Richard Bogle is a Consultant Cardiologist based in London and Surrey. He specialises in the assessment and treatment of patients with all types of heart and vascular disease. He tweets at @richardbogleshutterstock_180215222

If you watched the news this week you might have thought that the only recommendation in the NICE Atrial Fibrillation Guideline was that doctors should not prescribe aspirin to prevent strokes. In fact most cardiologists and geriatricians stopped using aspirin for this condition several years ago and the NICE recommendation simply reaffirms those issued previously by other professional societies such as the European Society of Cardiology.

The real story behind the guidelines was, in my opinion, nothing to do with medication or rate versus rhythm but rather the importance of delivering a personalised package of care for patients with atrial fibrillation (AF). Recognising that AF is a long term health condition there is emphasis on the importance of shared decision making processes particularly around anticoagulation. Alongside the guideline NICE published a Patient Decision Aid to assist with this process.  Continue reading