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A population-based study of thrombolysis for acute stroke in South Australia

Tim Kleinig, James M Leyden, Andrew Lee and Jim Jannes
Med J Aust 2011; 194 (8): 431-432.

In reply: To a carpenter, everything looks like a nail, and to a stroke thrombolysis sceptic, every study seems to confirm their opinion. A result cannot be “clinically important” yet statistically not so. We found no difference in symptomatic intracranial haemorrhage rates between our study and others using the same definition.

Tim Kleinig, Neurologist1
James M Leyden, Neurologist2
Andrew Lee, Director of Stroke Medicine3
Jim Jannes, Head, Stroke Unit2
1 Royal Adelaide Hospital, Adelaide, SA.
2 Queen Elizabeth Hospital, Adelaide, SA.
3 Comprehensive Stroke Centre, Flinders Medical Centre, Adelaide, SA.
Article References: 
Reference Text: 
Saver JL. Number needed to treat estimates incorporating effects over the entire range of clinical outcomes: novel derivation method and application to thrombolytic therapy for acute stroke. Arch Neurol 2004; 61: 1066-1070.<eMJA full text>
Reference Order: 
1
PubMed ID: 
15262737
Reference Text: 
Mishra NK, Ahmed N, Andersen G, et al. Thrombolysis in very elderly people: controlled comparison of SITS International Stroke Thrombolysis Registry and Virtual International Stroke Trials Archive. BMJ 2010; 341: c6046.
Reference Order: 
2
PubMed ID: 
21098614
Reference Text: 
Lees KR, Bluhmki E, von Kummer R, et al. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet 2010; 375: 1695-1703.
Reference Order: 
3
PubMed ID: 
20472172
Reference Text: 
Wardlaw JM, Murray V, Berge E, Del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev 2009; (4): CD000213.
Reference Order: 
4
PubMed ID: 
19821269

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