Dear Editor,We read with interest the article published by Ganjiwale et al.[1] To study the association of quality of life of caregivers and the degree of functional independence and the quality of life of their patients with a history of stroke, is a very important issue, especially in specific non-Western populations, where there has been little research.[1] It is known that a lot of people with stroke live with certain functional limitations in their activities of daily living,[2] so they need a caretaker, who suffers physical and mental stress.[3] However, we have some concerns regarding the study design.The parameters considered for sample size calculation are incomplete; also, did the researchers calculate the power? was the “design effect” taken into account given the fact that the observations are not independent, but correlated? The patient-caregiver pair could be considered as a cluster; the “design effect” is directly proportional to the Intraclass Correlation Coefficient (ICC);[4] thus, if ICC and “design effect” were not taken into account, the study may not have adequate power.[5] Furthermore, power calculation has been made for a difference in proportions, however, the analysis was based on the correlation. In the methods section, data analysis plan was not shown; was the normality assumption evaluated in order to apply Pearson correlation? also, it is not known if Cronbach's alpha of the scales was computed, and if a factorial analysis was performed.Finally, we found certain discrepancies between the main aim and the conclusions mentioned in the abstract. Definitely, this issue deserves further discussion and studies with more explicit designs.
Authors: M Knoflach; B Matosevic; M Rücker; M Furtner; A Mair; G Wille; A Zangerle; P Werner; J Ferrari; C Schmidauer; L Seyfang; S Kiechl; J Willeit Journal: Neurology Date: 2012-01-11 Impact factor: 9.910