1. Perceived conflicts of interest resulting in blind spot bias exist among stroke opinion leaders and the authors of the ACEP tPA Clinical Policy.
2. For Clinical Guidelines to be trustworthy, they must: 1) have transparent methodology, 2) manage conflicts of interest, 3) have a balanced guideline development group composition, and 4) have undergone adequate balanced external review.
3. It is unlikely that the revised ACEP tPA Clinical Policy will substantially impact current perspectives related to the use of IV tPA for stroke