[The Japanese Guidelines for the Management of Stroke 2007 and medical professionalism].

In 2004, we published the first Japanese Guidelines for the Management of Stroke which were evidence-based and took into consideration of the differences in races and therapeutic agents between Japan and other countries, and also, employed the detailed, lots of evidences from Japan. For the renewal of this Guideline, the new Joint Committee on Guidelines for the Management of Stroke was established (Chairperson: Yukito Shinohara, Vice-Chairpersons: Akira Ogawa, Yasuo Katayama, Norihiro Suzuki, Akio Kimura, Clinical Epidemiology: Hideki Origasa, Secretariat-General: Masao Nagayama). Approximately 120 representative authorities were selected from five stroke-related societies in Japan. The committee is composed of seven groups which take charge of stroke general, cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, asymptomatic cerebrovascular diseases, other cerebrovascular diseases, or rehabilitation, respectively. On the other hands, in recent years, medical professionalism has been faced a crisis and scrutinized by physicians, patients, and the media. Because the author is also involved in the activity of the committee for the medical professionalism by the Fellows' Association of the Japanese Society of Internal Medicine, recent concepts regarding the relationship between medical professionalism and guideline were reviewed, and the critical roles of a physician in the process of consensus development for clinical guideline determination were emphasized.