Kaplan-meier survival curve comparing patients with RVEF < 35% (n = 48) and RVEF≥ 35% (n = 61) undergoing CABG or valve procedures.

<p>The top curve corresponds to patients with RVEF <35% and the bottom curve to patients with RVEF≥ 35%. The number below each year indicates the number of patients at risk.</p

Patient Characteristics.

<p>Cerebral vascular accident, CVA, Pro-BNP, pro-brain natriuretic peptide; LDL, low-density lipoprotein; HDL, high density lipoprotein; RVEF, right ventricular ejection fraction; RVSP, right ventricular systolic pressure; mPAP, mean pulmonary artery pressure; LVEF, left ventricular ejection fraction. Measurements of RV and LV volumes, mass, regional wall motion abnormalities, and function were obtained by CMR; TR and PAP by echocardiography.</p><p>Patient Characteristics.</p

Analysis of early (≤ 30-d) and long-term (> 30-d) outcomes associated with RVEF <35% and RVEF ≥ 35%.

<p>ICU, intensive care unit; IQR, interquartile range; LFT, liver function test; postoperative complications (i.e. reoperations for bleeding, early valve reoperations, deep sternal infection, early stroke, early transient ischemic attack, pacemaker implantation, myocardial infarction, atrial fibrillation and renal insufficiency requiring dialysis).</p><p>Analysis of early (≤ 30-d) and long-term (> 30-d) outcomes associated with RVEF <35% and RVEF ≥ 35%.</p

Preoperative CMR.

<p>Short axis cine views traced right ventricle (A), left ventricle (B) and right ventricle from base to the apex (C) for ejection fraction measurements. Marked region of interest is demonstrated in green.</p

Analysis of early (≤ 30-d) and long-term (> 30-d) outcomes associated with primary CABG and valve procedures.

<p>Early complications within 30-d include reoperations for bleeding, early valve reoperations, deep sternal infection, early stroke, early transient ischemic attack, pacemaker implantation, myocardial infarction, atrial fibrillation, and renal insufficiency requiring dialysis.</p><p>Analysis of early (≤ 30-d) and long-term (> 30-d) outcomes associated with primary CABG and valve procedures.</p

Review and Analysis of Publication Trends over Three Decades in Three High Impact Medicine Journals

<div><p>Context</p><p>Over the past three decades, industry sponsored research expanded in the United States. Financial incentives can lead to potential conflicts of interest (COI) resulting in underreporting of negative study results.</p><p>Objective</p><p>We hypothesized that over the three decades, there would be an increase in: a) reporting of conflict of interest and source of funding; b) percentage of randomized control trials c) number of patients per study and d) industry funding.</p><p>Data sources and Study Selection</p><p>Original articles published in three calendar years (1988, 1998, and 2008) in The Lancet, New England Journal of Medicine and Journal of American Medical Association were collected.</p><p>Data Extraction</p><p>Studies were reviewed and investigational design categorized as prospective and retrospective clinical trials. Prospective trials were categorized into randomized or non-randomized and single-center or multi-center trials. Retrospective trials were categorized as registries, meta-analyses and other studies, mostly comprising of case reports or series. Study outcomes were categorized as positive or negative depending on whether the pre-specified hypothesis was met. Financial disclosures were researched for financial relationships and profit status, and accordingly categorized as government, non-profit or industry sponsored. Studies were assessed for reporting COI.</p><p>Results</p><p>1,671 original articles were included in this analysis. Total number of published studies decreased by 17% from 1988 to 2008. Over 20 year period, the proportion of prospective randomized trials increased from 22 to 46% (p < 0.0001); whereas the proportion of prospective non-randomized trials decreased from 59% to 27% (p < 0.001). There was an increase in the percentage of prospective randomized multi-center trials from 11% to 41% (p < 0.001). Conversely, there was a reduction in non-randomized single-center trials from 47% to 10% (p < 0.001). Proportion of government funded studies remained constant, whereas industry funded studies more than doubled (17% to 40%; p < 0.0001). The number of studies with negative results more than doubled (10% to 22%; p<0.0001). While lack of funding disclosure decreased from 35% to 7%, COI reporting increased from 2% to 84% (p < 0.0001).</p><p>Conclusion</p><p>Improved reporting of COI, clarity in financial sponsorship, increased publication of negative results in the setting of larger and better designed clinical trials represents a positive step forward in the scientific publications, despite the higher percentage of industry funded studies.</p></div

Study outcomes amongst all published articles within calendar years.

<p>Study outcomes amongst all published articles within calendar years.</p

Characteristics of the included studies.

<p>Characteristics of the included studies.</p

Important features of the multicenter randomized clinical trials.

<p>Important features of the multicenter randomized clinical trials.</p

Patterns in trial design.

<p>Patterns in trial design.</p