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Clinical Medicine & Research
Volume 4, Number 1 : 12 -21
doi:
© 2006 Marshfield Clinic
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Original Research

The Siblings With Ischemic Stroke Study (SWISS): A Progress Report

James F. Meschia, MD, Brett M. Kissela, MD, Thomas G. Brott, MD, Robert D. Brown, Jr, MD, Bradford B. Worrall, MD, MSc, Jeanne Beck, PhD and Alexa N. Skarp, BS

James F. Meschia, MD, Thomas G. Brott, MD, and Alexa N. Skarp, BS, Department of Neurology, Mayo Clinic, Jacksonville, Florida
Brett M. Kissela, MD, Department of Neurology, University of Cincinnati, Cincinnati, Ohio
Robert D. Brown, Jr, MD, Department of Neurology, Rochester, Minnesota
Bradford B. Worrall, MD, MSc, Department of Neurology, University of Virginia, Charlottesville, Virginia
Jeanne Beck, PhD, Coriell Institute, Camden, New Jersey

Reprint Requests: James F. Meschia, MD, Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224. Email: meschia.james{at}mayo.edu

There is increasing evidence that genetic factors are associated with ischemic stroke, including multiple recent reports of association with the gene PDE4D, encoding phosphodiesterase 4D, on chromosome 5q12. Genetic studies of stroke are important but can be logistically difficult to perform. This article reviews the design of the Siblings With Ischemic Stroke Study (SWISS) and discusses problems in performing a sibling-based pedigree study where proband-initiated consent is used to enroll pedigree members. Proband-initiated enrollment optimizes privacy protections for family members, but it is associated with a substantial pedigree non-completion rate such that 3 to 4 probands must be identified to obtain one completed sibling pedigree. This report updates the progress of enrollment in the SWISS protocol, discusses barriers to pedigree completion and describes innovative approaches used by the SWISS investigators to enhance enrollment.

Key Words: Cerebral infarction • Ischemic stroke • Pedigree research • Proband • Recruitment • SWISS






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