Bench to bedside: the quest for quality in experimental stroke research

This whole article basically points out how badly stroke research needs to be improved,. I would say by starting with a damage diagnosis, at least then the starting point of research could be repeated.
http://www.nature.com/jcbfm/journal/v26/n12/full/9600298a.html#bib77

Over the past decades, great progress has been made in the prevention, diagnosis, and treatment of stroke (Cheng et al, 2004; Ward and Cohen, 2004; del Zoppo, 2004). At the same time, by modeling of stroke in animal experiments, our understanding of the pathophysiologic mechanisms by which focal cerebral ischemia kills brain cells has greatly improved (Lo et al, 2003; Dirnagl et al, 1999). In addition, experimental stroke studies have identified numerous therapeutic targets for stroke therapy (Dirnagl et al, 2003; Meisel et al, 2005; Endres, 2005; Lo et al, 2005; Lindvall and Kokaia, 2004). However, it is an overall failure to validate the efficacy of such treatment strategies, which is fuelling a debate concerning the general predictive value of experimental modeling of this complex disorder (Hoyte et al, 2004; Fisher and Tatlisumak, 2005; Kaste, 2005). Much of the discussion on why bench results get 'lost in translation' to the bedside has focused on issues such as species differences, side effects, hetereogeneity of strokes in humans, etc. (see below). Nevertheless, quality issues in experimental research that may impact on bench to bedside translation have recently been raised by a number of authors (Heard et al, 2005; Bebarta et al, 2003; Pound et al, 2004; Samsa and Matchar, 2001). More specifically, systematic reviews of experimental stroke research have exposed a number of important deficits in the quality of preclinical experimental stroke research, and a negative correlation between measured effect sizes and quality scores was demonstrated (see below, and Table 1). The discussion has been further sparked by research, which provocatively predicts that most published research findings are 'false' (Ioannidis, 2005), and that quality issues are important reasons for this shocking finding. In this article, I would like to explore whether translational experimental stroke research is affected by quality problems. The purpose of my critical approach is not to denounce experimental stroke research, but to initiate a discussion geared at improving the translation of basic research into successful clinical stroke therapy. It is important to note that animal experiments in other areas of medicine, such as neurosurgery (Heard et al, 2005), cardiology (Lee et al, 2003), cancer (Clarke, 1997), or intensive care (Bebarta et al, 2003; Roberts et al, 2002), are affected by similar quality issues (Pound et al, 2004). In addition, I would like to stress that quality issues are but one factor that may impact on the success of bench to bedside translation in stroke research: validity of models, species issues, clinical trial design, among many others, may be equally or even more relevant determinants.