The full content of Annals is available to subscribers

Subscribe/Learn More  >
Academia and the Profession |

Diagnostic Heterogeneity in Clinical Trials for Congestive Heart Failure

Paul R. Marantz, MD, MPH; Michael H. Alderman, MD; and Jonathan N. Tobin, PhD
[+] Article, Author, and Disclosure Information

Presented in part on 18 November 1986, at the American Heart Association's fifty-ninth scientific session, Dallas, Texas.

Requests for Reprints: Paul Marantz, MD, MPH; Department of Epidemiology and Social Medicine, Montefiore Medical Center, 111 East 210th Street; Bronx, NY 10467.

Current Author Addresses: Dr. Marantz: Department of Epidemiology and Social Medicine, Montefiore Medical Center, Bronx, NY 10462. Drs. Alderman and Tobin: Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY 10461.

© 1988 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1988;109(1):55-61. doi:10.7326/0003-4819-109-1-55
Text Size: A A A

There are no uniform diagnostic criteria for congestive heart failure. To determine the pattern of diagnostic criteria used, reports of 51 randomized, double-blind, placebo-controlled, clinical drug trials published between 1977 and 1985 were reviewed. Only 23 (45%) of the trials specified objective diagnostic criteria beyond treatment history, clinical diagnosis, or functional class. Of these, there were two trials each for digoxin, hydralazine, amrinone, and metoprolol; for each pair, only one study showed therapy beneficial. Of the amrinone pair, the positive study required a lower ejection fraction ( < 30% compared with < 45%) and selected patients with more clinical severity. Conversely, for metoprolol, the positive study specified a higher ejection fraction ( < 49% compared with < 35%) and selected patients with clinically milder disease, suggesting that conflicting results may relate to differences in study population. Many studies of congestive heart failure are done without explicit diagnostic criteria. Criteria lack uniformity, and such discrepancies may explain conflicting results.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.