Department of Medicine Publications

Document Type

Article

Publication Date

1-1-1982

Journal

Stroke

Volume

13

Issue

1

First Page

94

Last Page

99

URL with Digital Object Identifier

10.1161/01.STR.13.1.94

Abstract

Critical evaluation of the literature was use to identify remediable flaws in the design of clinical trials of stroke treatment. Trials of dexamethasone, dextran, and glycerol were reviewed. Available studies have in common major weaknesses in case selection (failure to exclude arteriolar strokes due to hemorrhage or lacunar infarction), and failure to estimate required sample size. Problems of case selection can be avoided with computerized tomography; the sample size required to show superiority of active treatment over placebo can be estimated using standard formulas. Prognostic stratification is suggested as a method of overcoming problems of unbalanced allocation. Further studies with improved design are required to evaluate the prospects for medical limitation of cerebral infarct size. © 1982 American Heart Association, Inc.

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