Does the sliding dichotomy result in higher powered clinical trials for stroke and traumatic brain injury research?

Abstract

Background Recent research has proposed a new method for defining a favorable outcome in traumatic brain injury and stroke research. Purpose This new method is called the sliding dichotomy, and it is suggested as a potential solution to the problem of underpowered clinical trials. Methods We present a brief simulation study and graphical comparison of the power of each method to detect varying treatment effect sizes. Results Simulations of a patient population similar to the National Acute Brain Injury Study: Hypothermia (NABISH) study indicate that the sliding dichotomy method does not result in higher power than traditional methods. Conclusions Although the sliding dichotomy may present gains in power in some cases, several aspects of the patient population need to be considered in choosing between sliding dichotomy and traditional definitions of favorable outcomes.