{
  "abstract": "Introduction Intracranial atherosclerotic stenosis (ICAS) is a leading cause of ischaemic stroke, particularly among Asian populations, and continues to impose a significant burden across the region. Despite this, evidence from Asia remains fragmented. Findings from our previously conducted scoping review revealed an absence of standardised diagnostic criteria and imaging protocols. This resulted in marked methodological inconsistencies in regional ICAS research, thereby limiting the validity and interpretability of existing data. To address this, we have initiated a consensus process that aims to establish standardised definitions, develop harmonised diagnostic protocols and outline research standards and priorities for ICAS across Asia.Methods and analysis A modified Delphi approach will be employed to formulate consensus-based recommendations through a structured, iterative, multistage process. Draft Delphi statements will be informed by targeted literature reviews and formatted into five-point Likert scale questionnaires with fields allowing for qualitative feedback. An expert core group was selected based on their established clinical and research expertise in intracranial atherosclerosis, cerebrovascular imaging and stroke, with deliberate consideration for geographic and disciplinary diversity. This group will serve as the formal voting panel. The process will comprise three to four anonymous online rounds, with a predefined consensus threshold of ≥80% agreement. Statements that do not reach consensus will be revised based on aggregated feedback and re-evaluated in subsequent rounds. A non-voting hybrid conference, open to the public, will follow the second round to facilitate broader engagement and discussion; relevant points will be incorporated into the subsequent round. Consensus on research standards and priorities will follow the finalisation of recommendations on standardised definitions and harmonised diagnostic protocols to ensure alignment with preceding outcomes.Ethics and dissemination This consensus was granted exemption by the Jose R. Reyes Memorial Medical Center Institutional Review Board (No. 2025–221). Resulting recommendations will be disseminated through peer-reviewed publication and presentation at scientific fora.Registration number https://doi.org/10.17605/OSF.IO/MB6GP.",
  "authors": [
    {
      "affiliations": [
        "Section of Stroke and Vascular Neurology, Department of Neurology, Jose R Reyes Memorial Medical Center, Manila, Philippines",
        "Department of Neuroscience and Behavioral Medicine, University of Santo Tomas Hospital, Manila, Philippines"
      ],
      "name": "Jose C Navarro"
    },
    {
      "affiliations": [
        "Section of Stroke and Vascular Neurology, Department of Neurology, Jose R Reyes Memorial Medical Center, Manila, Philippines"
      ],
      "name": "Bonifacio C Pedregosa II"
    },
    {
      "affiliations": [
        "Philippine Academy of Vascular and Interventional Neurology, Manila, Philippines"
      ],
      "name": "Allan A Belen"
    },
    {
      "affiliations": [
        "Independent Author, Antipolo, Philippines"
      ],
      "name": "Robert N Gan"
    }
  ],
  "title": "Protocol for the development of the Asian consensus recommendations on the standardised diagnosis and imaging of intracranial atherosclerotic stenosis applying a modified Delphi approach",
  "uid": "392813a6-23a1-54d4-964b-2deb0bbc4db1"
}