The National Stroke Foundation (NSF) is responsible for coordinating and publishing the Clinical Guidelines for Stroke Management 2010 that were approved by the National Health and Medical Research Council (NHMRC). We agree with Phan et al that evidence continues to evolve rapidly, which ideally should be reflected in national clinical guidelines in a timely fashion. We would also welcome a review of the NHMRC process for guideline development in Australia to allow recommendations to reflect current evidence in a timely manner. However, there are significant barriers to continuous appraisal, especially given the volunteer nature of most of the members of the Expert Working Group. The current NHMRC methodology is rigorous and regarded highly internationally, and while evidence may become outdated, the systematic processes ensure that the guidelines are robust but clearly 'date-stamped'.
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