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I am grateful for the opportunity to reply to the letter by Dr Kaye regarding my Best Evidence Topic review.1
Dr Kaye refers to the Cochrane systematic review and meta-analysis by Wardlaw et al and quotes the authors' conclusions that there is a net reduction in the proportion of patients ‘dead or dependent’ among those patients who received thrombolysis for their acute ischaemic stroke.2 The authors also point out in their discussion that the statistical significance of the results of some of the trials depends on the precise definition of a ‘poor functional outcome’, becoming non-significant if this is defined as a Rankin 3-6 instead of a Rankin 2-6. Indeed, the authors also state that the effect of thrombolysis on death or dependency is no longer statistically significant if a random …