Apply science, not politics

doi:10.1136/bmj.39325.444491.3A

BMJ 2007;335:464 (8 September), doi:10.1136/bmj.39325.444491.3A

Letters

Improving stroke outcome

Apply science, not politics

The first 150 words of the full text of this article appear below.

Markus leaps from a discussion about outcomes to a plea to reorganiseacute stroke care to improve access to thrombolysis.¹ Not onepatient received thrombolytic treatment in the studies he quotes,but such subtleties will be lost in the political hubbub aboutthe NHS letting us all down yet again. It is frustrating thatafter 25 years' research, we have only one drug treatment, alteplase,which seems to work, and we only manage to give it to 2% ofour patients, but we should not put all our eggs in this basket.

About 1 in 8 patients would expect to obtain major benefit fromthrombolytic treatment, so even if we could increase the proportiontreated to 20%, about 1 in 40 patients would benefit overall.To achieve this, Markus suggests that patients receive "rapidambulance assessment" and perhaps half would be transferredto "specialised stroke centres," some distance away.¹ What . . . [Full text of this article]

David Barer, professor in stroke medicine

Queen Elizabeth Hospital, Gateshead, Tyne and Wear NE9 6SX

d.h.barer@ncl.ac.uk