Current software and textbooks present procedures to estimate power
and sample size for
sign tests that only apply to settings where positive (i.e., X=1)
or negative (i.e., X=-1), but
not neutral (i.e., X=0) outcomes occur. However, many studies analyzed
by sign tests
involve the more general setting where significant amounts of neutral
outcomes can
occur. This paper illustrates extension of existing power/sample size
approaches and
software that have been developed for matched binary responses
(McNemar's discordant pairs) to general sign tests with neutral outcomes
occurring. An application is made to a
recent study that the author collaborated on.