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January 6, 1999

Reducing Treatment Delay and Improving Diagnostic Accuracy for Patients With Acute Stroke

Author Affiliations

Margaret A.Winker, MDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor

JAMA. 1999;281(1):31-34. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-1-jbk0106

To the Editor: Dr Schriger and colleagues1 have done a major disservice by incorrectly concluding that board-certified general radiologists are incapable of identifying intracranial hemorrhage on cranial CT and therefore are unable to determine eligibility for thrombolytic therapy.

Their sample of 36 board-certified general radiologists is flawed. There is no documentation to indicate that those chosen to participate represent an appropriate sample of the type of general radiologist that would be responsible for interpreting emergency cranial CTs in most clinical situations. Their data are therefore suspect, and the authors are correct in stating that "our convenience sampling method is the main threat to the external validity of the study." More than a threat, this limitation destroys any credibility to their conclusion.

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