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.
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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.
Tim Kleinig, Neurologist1
James M Leyden, Neurologist2
Andrew Lee, Director of Stroke Medicine3
Jim Jannes, Head, Stroke Unit2
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>
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.
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.
Wardlaw JM, Murray V, Berge E, Del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev 2009; (4): CD000213.
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