{"id":3540,"date":"2016-08-08T08:30:01","date_gmt":"2016-08-08T15:30:01","guid":{"rendered":"http:\/\/www.emlitofnote.com\/?p=3540"},"modified":"2016-08-07T21:35:02","modified_gmt":"2016-08-08T04:35:02","slug":"when-the-headline-isnt-enough","status":"publish","type":"post","link":"https:\/\/www.emlitofnote.com\/?p=3540","title":{"rendered":"Don&#8217;t Stop at the Headline"},"content":{"rendered":"<p>The verdict is in: \u201cAspiration Thrombectomy No Help for Large-Clot Strokes\u201d, <a href=\"http:\/\/www.medpagetoday.com\/cardiology\/strokes\/59530\">reports MedPage Today<\/a>.<\/p>\n<p>Except, they\u2019re not precisely correct \u2013 in a way, you could even say they\u2019re wrong.<\/p>\n<p>This is THERAPY, an endovascular trial in acute stroke featuring the Penumbra aspiration device. \u00a0This is somewhat unique, as the technology differs from the otherwise popularized Solitaire retrieval system. This trial is also\u00a0different from the most contemporary comparators,\u00a0as its imaging criteria did not rely on perfusion imaging, but, rather, simply large-vessel occlusion with a clot length of 8mm or greater.<\/p>\n<p>The results of the trial, as you might have picked up from the lay press headline, were negative \u2013 that is to say, they did not reach statistical significance. Their primary endpoint for modified Rankin Scale of 0-2 was achieved in 38% receiving endovascular treatment and 30% receiving intravenous thrombolysis alone, and this 8% absolute difference produced\u00a0a <em>p<\/em>-value of only 0.52. However, the trial was initially scheduled to enroll 692 patients to be powered to\u00a0detect a 10.6% difference, but stopped enrollment after 108 based on the publication of other positive endovascular trials.<\/p>\n<p>So, simply put, this trial tells us hardly anything. Is the Penumbra system just as good as Solitare? Probably, but perhaps we\u2019ll never know for certain. Does the 8% difference seen in this trial reflect the lower magnitude of effect of treatment relating to lack of perfusion imaging? Probably, as well, based on the the larger evidentiary context.<\/p>\n<p>But, at the minimum, the medical reporting has simply gone off course with their headline.<\/p>\n<p>\u201cAspiration Thrombectomy After Intravenous Alteplase Versus Intravenous Alteplase Alone\u201d<br \/>\n<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27486173\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27486173<\/a><\/p>\n\n<div class=\"twitter-share\"><a href=\"https:\/\/twitter.com\/intent\/tweet?via=emlitofnote\" class=\"twitter-share-button\">Tweet<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>The verdict is in: \u201cAspiration Thrombectomy No Help for Large-Clot Strokes\u201d, reports MedPage Today. Except, they\u2019re not precisely correct \u2013 in a way, you could even say they\u2019re wrong. This is THERAPY, an endovascular trial in acute stroke featuring the Penumbra aspiration device. \u00a0This is somewhat unique, as the technology differs from the otherwise popularized &hellip; <a href=\"https:\/\/www.emlitofnote.com\/?p=3540\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Don&#8217;t Stop at the Headline&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[14,15],"tags":[],"class_list":["post-3540","post","type-post","status-publish","format-standard","hentry","category-neurology","category-stroke"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7KesJ-V6","jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3540","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3540"}],"version-history":[{"count":3,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3540\/revisions"}],"predecessor-version":[{"id":3543,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=\/wp\/v2\/posts\/3540\/revisions\/3543"}],"wp:attachment":[{"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3540"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3540"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.emlitofnote.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3540"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}