Published Online: November 18, 2009 (doi:10.1001/jama.2009.1731).
Author Contributions: Dr Tu had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Tu, Lee, Austin, Alter.
Acquisition of data: Tu, Donovan, Lee.
Analysis and interpretation of data: Tu, Lee, Wang, Austin, Alter, Ko.
Drafting of the manuscript: Tu, Lee, Ko.
Critical revision of the manuscript for important intellectual content: Donovan, Lee, Wang, Austin, Alter, Ko.
Statistical analysis: Wang, Austin.
Obtained funding: Tu, Lee, Alter.
Administrative, technical, or material support: Donovan, Lee.
Study supervision: Tu.
Financial Disclosures: Dr Alter reported being a scientific advisor for INTERxVENT Canada, a lifestyle and disease management company. None of the other authors reported financial disclosures.
Funding/Support: The EFFECT study was supported by a Canadian Institutes of Health Research team grant in cardiovascular outcomes research to the Canadian Cardiovascular Outcomes Research Team; it was initially funded by a Canadian Institutes of Health Research Interdisciplinary Health Research Team grant and a grant from the Heart and Stroke Foundation of Canada. The Institute for Clinical Evaluative Sciences is supported by an operating grant from the Ontario Ministry of Health and Long-Term Care. Dr Tu is supported by a Tier 1 Canada Research Chair in Health Services Research and a career investigator award from the Heart and Stroke Foundation of Ontario. Dr Lee is supported by a Clinician Scientist Award from the Canadian Institutes of Health Research. Drs Austin and Alter are supported by Career Investigator Awards from the Heart and Stroke Foundation of Ontario. Dr Ko is supported by a Clinician Scientist Award from the Heart and Stroke Foundation of Ontario.
Role of the Sponsors: The design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, and approval of the manuscript were conducted completely independently of the sponsors.
Disclaimer: The results and conclusions are those of the authors, and should not be attributed to any of the funding agencies.
Additional Contributions: We thank all of the clinicians, administrators, and health records departments at all of the hospitals from across Ontario who participated in the EFFECT study. We also thank the EFFECT study research nurses who collected the data, Tara O’Neill, BES, and Francine Duquette, BA, for administrative support, and Virginia Flintoft, MSc, BN, RN, for her role in helping coordinate the launch of the EFFECT study; each was employed by the study investigators. We also thank David Henry, MBCHB, MRCP, FRCP (Edin), and Merrick Zwarenstein, MBBCh, MSc, of Sunnybrook Health Science Centre, who were not financially compensated for helpful comments on early drafts of the manuscript.