Intended for healthcare professionals

Letters Speech therapy after stroke

Authors’ reply to Enderby, Meteyard, and Thornton

BMJ 2012; 345 doi: (Published 10 September 2012) Cite this as: BMJ 2012;345:e6023
  1. Audrey Bowen, senior lecturer in psychology1,
  2. Anne Hesketh, clinical senior lecturer in speech and language therapy1,
  3. Emma Patchick, trial manager1,
  4. Alys Young, professor of social work education and research2,
  5. Linda Davies, professor of health economics3,
  6. Andy Vail, senior lecturer in biostatistics4,
  7. Andrew F Long, professor of health systems research5,
  8. Caroline Watkins, professor of stroke and older people’s care, chair of UK Forum for Stroke Training6,
  9. Mo Wilkinson, visitor monitor1,
  10. Gill Pearl, speech and language therapist7,
  11. Matthew A Lambon Ralph, professor of cognitive neuroscience8,
  12. Pippa Tyrrell, professor of stroke medicine9
  1. 1HCD, Ellen Wilkinson Building, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester M13 9PL, UK
  2. 2Jean McFarlane Building, University of Manchester MAHSC
  3. 3Manchester Health Sciences Research Group: Health Economics, Jean MacFarlane Building, University of Manchester MAHSC
  4. 4University of Manchester MAHSC, R&D Support Unit, Salford Royal NHS Foundation Trust, Salford, UK
  5. 5School of Healthcare, University of Leeds, Leeds, UK
  6. 6Clinical Practice Research Unit, University of Central Lancashire, Preston, UK
  7. 7Speakeasy, c/o 2 Purbeck Drive, Bolton, UK
  8. 8NARU, University of Manchester MAHSC
  9. 9University of Manchester MAHSC, Salford Royal NHS Foundation Trust
  1. audrey.bowen{at}

It is encouraging to see the Royal College of Speech and Language Therapists supporting randomised controlled trials (RCTs).1 2 Meteyard worries that RCTs will not cope with the complexity inherent after stroke.3 However, many RCTs have demonstrated the effectiveness of a range of complex interventions for heterogeneous populations (for example, stroke unit care, occupational therapy).

As Enderby notes, the Cochrane review finds …

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