The STICH trial: Misguided conclusions

The significance of crossovers after randomization in the STICH trial.

INTRODUCTION Of all forms of stroke, spontaneous intracerebral haemorrhage (ICH) causes the highest morbidity and mortality. The Surgical Trial in Intracerebral Haemorrhage (STICH) found no difference in outcomes between patients randomized to surgical or conservative treatment. PATIENTS AND METHODS Of 530 patients randomized to initial conservative treatment, 140 crossed over to surgery. Thi...

Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II) Protocol

BACKGROUND Within the spectrum of spontaneous intracerebral haemorrhage there are some patients with large or space occupying haemorrhage who require surgery for neurological deterioration and others with small haematomas who should be managed conservatively. There is equipoise about the management of patients between these two extremes. In particular there is some evidence that patients with l...

STICH (Surgical Treatment for Ischemic Heart Failure) trial enrollment.

OBJECTIVES The aim of this study was to assess the influence of enrolling site location and enrollment performance on the generalizability of STICH (Surgical Treatment for Ischemic Heart Failure) trial results. BACKGROUND The international STICH trial seeks to define the role of cardiac surgery for patients with ischemic cardiomyopathy. METHODS Baseline characteristics of 2,136 randomized S...

Misguided Policy?

Altruism by Stephen Stich

1. Philosophical Background People sometimes behave in ways that benefit others, and they sometimes do this while knowing that their helpful behavior will be costly, unpleasant, or dangerous. But at least since Plato’s classic discussion in the second book of the Republic, debate has raged over why people behave in these ways. Are their motives altruistic, or is their behavior ultimately motiva...