In reply: Dickson argues for exclusion of randomised controlled trials (RCTs) if treatments have changed, but treatments are constantly changing so, following this rule, meta-analysis would be impossible. Similarly, diagnosis has changed — stroke was a clinical diagnosis, then computed tomography was required, and now magnetic resonance imaging is needed. Equipoise is not a requirement for inclusion in a meta-analysis.
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I work in a hospital and a HITH unit.