BMJ  2004;329:1404 (11 December), doi:10.1136/bmj.329.7479.1404

Letter

The PROGRESS trial three years later

Clear and accurate interpretations of studies are needed

The first 150 words of the full text of this article appear below.

EDITOR—Like Wennberg and Zimmermann, I am troubled by the interpretation of the results of PROGRESS published in the original Lancet article and reiterated by others; by the amalgamation of the perindopril and perindopril-indapamide arms under the rubric "perindopril based therapy"; and by the chief conclusions about such treatment attributed by the trialists.^{1 2}

Interestingly, this has affected my own work. A neurologist referee of a recent article on secondary stroke prevention I published with Kapral in the Canadian Journal of Neurological Sciences strongly criticised our paper for simply noting the difference in efficacy between the two active treatment arms of PROGRESS³; this anonymous reviewer adamantly stated that the trial was not sufficiently powered to show a distinction. Perhaps the best way to look at PROGRESS is that it is really two parallel but different randomised trials with the same control group. Therefore, combining these two very different treatment . . . [Full text of this article]

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Institute for Clinical Evaluative Sciences, Division of Clinical Pharmacology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Canada M4N 3M5 danhackam@cogeco.ca

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