How to Improve the Quality of a Clinical Trial on Traditional Chinese Medicine for Stroke

To the Editor:In the August issue of Stroke , Zhang and colleagues1 took on the tremendous task to present a systematic review of the efficacy of complex Traditional Chinese Medicine (TCM) for stroke. The authors have included 34 randomized, controlled trials and quasi-randomized, controlled trials, which had assessed the effect of complex TCM on motor dysfunction after a stroke. In a quite appropriate way, they have chosen death, activities of daily living, functional recovery, and quality of life as outcome criteria. They correctly stress the poor methodological quality of almost all the trials selected for the review. The participants involved in these trials were patients who had either an ischemic or hemorrhagic stroke. The time from stroke onset to the trial inclusion was highly variable. The heterogenous interventions included complex TCM, acupuncture, herbal medicine, Western medicine, and physical exercise. “Effective rate” was defined as a primary outcome measure in almost all the trials. All trials …