2. LVEF values after 6 cycles of Treatment
3. Treatment Efficacy (Overall Survival and Overall Response Rate)
4. Patient Characteristics
*LVEF is the fraction of the end-diastolic blood volume that is being pumped out by the left ventricle.
An LVEF value of 55% or higher is considered normal. Low LVEF values indicate cardio-pathologies
such as dilation cardiomyopathy and Myocardial Infarction (Guyton & Hall, 2006)
2.4. Quality Assessment
The quality of included studies was assessed by a quality assessment tool (Quality Assessment Tool…,
March 2014) developed by The National Heart, Lung, and Blood Institute (NHLBI) and Research
Triangle Institute International Jointly. It includes 14 points of criteria that need to be assessed. All of
the points referred to the internal validity of the tests, and hence the reliability of the results of each of
the four included studies was assessed based on their methodology. All of the criteria were scored
with either yes, no, Cannot Determine (CD), or Not Applicable (NA). A “yes” was given one point,
whereas a “no” was given a score of 0.
No standard for a good, moderate, or poor study was given. Hence, a study obtaining a score of 11/14
or higher was defined as a good quality study, meanwhile studies receiving a score of 7/14 or less
were defined as poor studies. A score between 7 and 11 out of 14 was defined as moderate.
Two reviewers independently analyzed the four included studies based on the quality assessment
criteria. If the ratings differed, the articles were discussed until a common consensus was reached.
3. Results
3.1. Research Findings
The initial search that was conducted yielded a total of 43 trials. After reading the titles, 29 results
were excluded as they did not fulfill the inclusion criteria, an d a further 4 trials were excluded after
reading the abstract. From the resulting 10 texts, 5 did not have a full available article, and 1 did not
assess the overall response rate (hence it did not assess treatment efficacy). Thus, a total of 4 resulting
clinical trials were used. This information can be seen in the flow chart below:
Figure 1: Flow chart of the Search Strategy