Was the International Randomized Trial of Extracranial-Intracranial Arterial Bypass Representative of the Population at Risk?

The international, multicenter, randomized trial of extracranial–intracranial arterial anastomoses (EC–IC bypass)1 , 2 has been applauded and cited as a standard for future studies of this type.3 The eminence of the primary investigators, the multiple statistical analyses to which the data were submitted, and the eloquence of the presentation have virtually muted responsible criticism. During preparation for a formal critique of this work at a meeting of the American Association of Neurological Surgeons held in Denver in April 1986, some information was disclosed that should be shared with the readers of the Journal.I am neither an epidemiologist nor a biostatistician . . .