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Efficacy of Carotid Endarterectomy Translates to Being Efficacious With Appropriate Surgical Skill
Arch Neurol. 2002;59:1866-1868.
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SURGICAL INITIATIVE and hematological and pharmaceutical research have achieved substantial measures of success in the prevention and treatment of ischemic stroke. The key to this progress has been the conduct of large randomized trials. For none of the strategies shown to have efficacy (benefit) has the dialogue stopped with the publication of the primary results. The results may be presented in such a way as to appear beneficial, but closer scrutiny must examine the efficaciousness or practicality of transferring the results to clinical practice. Questions may also arise about the clinical significance of a statistically significant result.
Efficacy of a treatment can be assured for some patients and may exist for others, but the information remains buried within large generically defined populations. In addition, claims of efficacy have been confused by speculative assumptions made as a prelude to analyses. For example, in the CAPRIE (clopidrogel vs aspirin in patients at . . . [Full Text of this Article]
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