Since "Chinese Guidelines for Diagnosis and Treatment of Acute Ischemic Stroke 2010"[1](New Guidelines for short) has attracted the attention of doctors all over the country since it was published in the Chinese Journal of Neurology in February last year. During the one-year promotion and use process, we collected a lot of feedback, most of which were positive affirmations and constructive comments that helped to improve and improve, and there were also questions about some contents of the guide or feedback that did not understand[2,3,4,5]。 After carefully reading and summarizing the feedback from all parties, several basic and practical issues need to be explained and discussed: Should the development of guidelines be standardized? How to deal with the following seemingly opposite but must be unified problems, namely evidence-based and consensus, international standards and local characteristics, high-end standards and basic requirements, research progress and practical application, clear definition and vague description, and how to use guidelines? Standardization and individualization. These issues must be considered in the development and use of guidelines, and many inconsistencies are related to these issues. Understanding them helps to understand the development and use of new guidelines and other evidence-based guidelines. In fact, it is very difficult for the guide to deal with the above problems perfectly, and it is easy to go from one extreme to the other. Because people tend to ask questions based on one angle or one aspect, and may ignore other equally important aspects. However, the guideline-developing team should take into account as many aspects as possible and capture the main and key aspects in an effort to make the guidelines both scientific and practical.
