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Comment & Response |

Stroke Care Within the Golden Hour

Kyle Fischer, MD, MPH1; Vince McDonough, MD2
[+] Author Affiliations
1Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore
2Abrazo Health System, Phoenix, Arizona
JAMA Neurol. 2015;72(4):475-476. doi:10.1001/jamaneurol.2014.4571.
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To the Editor In a study published in JAMA Neurology, Ebinger et al1 assessed the efficacy of prehospital thrombolytic therapy during the golden hour for acute ischemic stroke. The authors concluded that prehospital “thrombolysis entails no risk to the patients’ safety and is associated with better short-term outcomes.” However, limitations in the study’s methods create uncertainty in this assertion. The issue at hand is noted by the authors in the following statement, “Patients with stroke mimics who received [tissue plasminogen activator] were not included in this evaluation of treatment effects.” Thus, the data were not calculated under an intention-to-treat analysis, the current standard for research in a randomized clinical trial.

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April 1, 2015
Li Min Li, BBA, MD, PhD; Sharon Johnson, PhD
1Department of Neurology, University of Campinas, São Paulo, Brazil2Foisie School of Business, Worcester Polytechnic Institute, Worcester, Massachusetts3Healthcare Delivery Institute, Worcester Polytechnic Institute, Worcester, Massachusetts
2Foisie School of Business, Worcester Polytechnic Institute, Worcester, Massachusetts3Healthcare Delivery Institute, Worcester Polytechnic Institute, Worcester, Massachusetts
JAMA Neurol. 2015;72(4):475. doi:10.1001/jamaneurol.2014.4568.
April 1, 2015
Martin Ebinger, MD; Heinrich J. Audebert, MD
1Department of Neurology, Center for Stroke Research Berlin, Berlin, Germany
JAMA Neurol. 2015;72(4):476-477. doi:10.1001/jamaneurol.2014.4574.
January 1, 2015
Martin Ebinger, MD; Alexander Kunz, MD; Matthias Wendt, MD; Michal Rozanski, MD; Benjamin Winter, MD; Carolin Waldschmidt, MD; Joachim Weber, MD; Kersten Villringer, MD; Jochen B. Fiebach, MD; Heinrich J. Audebert, MD
1Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany2Center for Stroke Research Berlin, Charité–Universitätsmedizin Berlin, Berlin, Germany
1Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany
JAMA Neurol. 2015;72(1):25-30. doi:10.1001/jamaneurol.2014.3188.
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