Editorial

In this edition of IJS we continue our policy of introducing a limited number of research articles of high quality which will be of interest to our readers, on this occasion Gray et al. for the University of Nottingham, address one of the most important issue in the conduct of clinical trials today, the issue of sample size. We are all to familiar with the history of underpowered trials which have been either negative or positive and have therefore slowed the progress of either rejection or acceptance of an important stroke intervention. Our authors show evidence that by adopting a statistical analysis plan with ordinal rather than binary measures, samples sizes may be reduced by up to 30% for a given statistical power. This is certainly food for thought given the escalating cost of trial conduct. I am sure that this will not be the last word on this controversial subject!

Another area of contention is also addressed in this issue; there have been a trickle of reports from both the cardiac and stroke literature of outcomes being poorer in patients who have had statins discontinued. These are interesting findings for which there may be a number of possible explanations as nicely outlined by Castillo et al., in their Leading opinion. While these are hypothesis generating findings and ideas, they do need to be more formally tested since the sample sizes of the studies to date have been unacceptably small. The evidence to date does not seem to be enough to alter clinical practice and we wait with interest more definitive information.

We have other articles of interest ranging from a nice piece on the polly pill by David Spence, a potential new form of therapy with near infrared light therapy and our usual attention to clinical guidelines with contributions from the National Stroke Foundation of Australia and the investigators for the interventional management of stroke (IMS)III Trial.

The content of the journal continues to be topical and interesting, and should be on the reading list of every stroke practitioner worldwide. Together with our outstanding editorial board we will continue to develop and enhance your journal in editions to come.