Emergency stroke care in Spain's "stroke Belt".

I have carefully read the comments on the article ‘‘Impact of introducing neurology into a local hospital in Andalusia’’. When evaluating this article, we must be mindful that it is neither a clinical trial nor a prospective study. It simply describes retrospective data gathering for the purpose of studying a specific situation that is very common in Andalusia: stroke care in hospitals which do not have and have never had neurologists on staff. We felt this provided an excellent opportunity to compare data from the first year a neurologist was working in one such hospital, keeping in mind that the situation probably resembled that before the neurologist was present. The situation may have evolved in later years as specialists in internal medicine expanded their knowledge due to contact with the neurologist. Our intention was to gain an understanding of the true situation of stroke patients in hospitals without neurologists. While it is true that a retrospective observational study has less validity than a prospective study or clinical trial, there was probably no other way to perform this particular