Evidence map›Paper›PMID 27941066›Full record

SynthesisCirculation2017

Thrombus Aspiration in ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis: Thrombectomy Trialists Collaboration.

Sanjit S Jolly, Stefan James, Vladimír Džavík, John A Cairns, Karim D Mahmoud, Felix Zijlstra, Salim Yusuf, Goran K Olivecrona, Henrik Renlund, Peggy Gao and 6 more

4 registry-linked trialsOpen access · goldAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 137 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 6 pooled it
19.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02552407 completednot on this map

Thrombectomy in ST Elevation Myocardial Infarction, an Individual Patient Meta-analysis

TypeobservationalSponsorPopulation Health Research InstituteRan2015 to 2016Enrolled18,000ConditionsMyocardial Infarction, Acute Coronary SyndromesArmsManual Aspiration Thrombectomy
NCT04212494 narecruitingnot on this mapstarted 2020, after this paper: background citation

Thrombus Aspiration in Primary Percutaneous Coronary Intervention for STEMI Patients With High Thrombus Burden

TypeinterventionalSponsorGuangdong Provincial People's HospitalRan2020 to 2026Enrolled3,838ConditionsST-segment Elevation Myocardial Infarction (STEMI)ArmsThrombus aspiration, PCI Alone
NCT05307965 nacompletednot on this mapstarted 2022, after this paper: background citation

Stent Retriever Thrombectomy for Thrombus Burden Reduction in Patients With Acute Myocardial Infarction - RETRIEVE-AMI Study

TypeinterventionalSponsorOxford University Hospitals NHS TrustRan2022 to 2025Enrolled81ConditionsMyocardial Infarction, Thrombus, Coronary Artery DiseaseArmsRetriever Thrombectomy, Percutaneous Coronary Intervention, Thrombus Aspiration
NCT07551700 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Efficacy of Thrombus Aspiration in Patients With Acute ST-Segment Elevation Myocardial Infarction: A Prospective, Multicenter, Randomized, Controlled, Single-Blind Clinical Trial (TRAP-MI)

TypeinterventionalSponsorFirst Affiliated Hospital Xi'an Jiaotong UniversityRan2026 to 2028Enrolled6,760ConditionsST-segment Elevation Myocardial Infarction (STEMI)ArmsManual Thrombus Aspiration, Primary Percutaneous Coronary Intervention (PPCI)
3 · Its place in the literature

Who cites it

137 citing papers in PubMed, 6 syntheses or guidelines pooled it, 300 citations in OpenAlex.

  1. Pooled it
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  14. Article
  15. Mechanical Thrombus Aspiration for a Young STEMI Patient With Plaque Erosion: Time for a Stent-Free Approach?Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
    Article
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77 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 5 countries.

Sanjit S JollyFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.). sanjit.jolly@phri.ca.
Stefan JamesFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Vladimír DžavíkFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
John A CairnsFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Karim D MahmoudFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Felix ZijlstraFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Salim YusufFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Goran K OlivecronaFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Henrik RenlundFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Peggy GaoFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Bo LagerqvistFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Ashraf AlazzoniFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Sasko KedevFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Goran StankovicFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Brandi MeeksFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
Ole FrøbertFrom McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada (S.S.J., S.Y., P.G., A.A., B.M.); Department of Medical Science, Uppsala University and Uppsala Clinical Research Centre, Uppsala, Sweden (S.J., H.R., B.L.); Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada (V.D.); University of British Columbia, Vancouver, BC, Canada (J.A.C.); Department of Cardiology, Thorax Center, Erasmus Medical Centre, Rotterdam, the Netherlands (K.D.M., F.Z.); Skåne University Hospital-Lund/Lund University, Lund, Sweden (G.K.O.); University Clinic of Cardiology, Sts. Cyril and Methodius University, Skopje, Macedonia (S.K.); Clinical Center of Serbia and Department of Cardiology, Medical Faculty, University of Belgrade, Belgrade, Serbia (G.S.); and Örebro University, Faculty of Health, Department of Cardiology, Södra Grev Rosengatan, Örebro, Sweden (O.F.).
University of British Columbia · CAErasmus University Rotterdam · NLSs. Cyril and Methodius University in Skopje · MKUniversity of Belgrade · RSUppsala University · SEUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThrombus aspiration during percutaneous coronary intervention (PCI) for the treatment of ST-segment-elevation myocardial infarction (STEMI) has been widely used; however, recent trials have questioned its value and safety. In this meta-analysis, we, the trial investigators, aimed to pool the individual patient data from these trials to determine the benefits and risks of thrombus aspiration during PCI in patients with ST-segment-elevation myocardial infarction.

methodsIncluded were large (n≥1000), randomized, controlled trials comparing manual thrombectomy and PCI alone in patients with ST-segment-elevation myocardial infarction. Individual patient data were provided by the leadership of each trial. The prespecified primary efficacy outcome was cardiovascular mortality within 30 days, and the primary safety outcome was stroke or transient ischemic attack within 30 days.

resultsThe 3 eligible randomized trials (TAPAS [Thrombus Aspiration During Percutaneous Coronary Intervention in Acute Myocardial Infarction], TASTE [Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia], and TOTAL [Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI]) enrolled 19 047 patients, of whom 18 306 underwent PCI and were included in the primary analysis. Cardiovascular death at 30 days occurred in 221 of 9155 patients (2.4%) randomized to thrombus aspiration and 262 of 9151 (2.9%) randomized to PCI alone (hazard ratio, 0.84; 95% confidence interval, 0.70-1.01; P=0.06). Stroke or transient ischemic attack occurred in 66 (0.8%) randomized to thrombus aspiration and 46 (0.5%) randomized to PCI alone (odds ratio, 1.43; 95% confidence interval, 0.98-2.10; P=0.06). There were no significant differences in recurrent myocardial infarction, stent thrombosis, heart failure, or target vessel revascularization. In the subgroup with high thrombus burden (TIMI [Thrombolysis in Myocardial Infarction] thrombus grade ≥3), thrombus aspiration was associated with fewer cardiovascular deaths (170 [2.5%] versus 205 [3.1%]; hazard ratio, 0.80; 95% confidence interval, 0.65-0.98; P=0.03) and with more strokes or transient ischemic attacks (55 [0.9%] versus 34 [0.5%]; odds ratio, 1.56; 95% confidence interval, 1.02-2.42, P=0.04). However, the interaction P values were 0.32 and 0.34, respectively.

conclusionsRoutine thrombus aspiration during PCI for ST-segment-elevation myocardial infarction did not improve clinical outcomes. In the high thrombus burden group, the trends toward reduced cardiovascular death and increased stroke or transient ischemic attack provide a rationale for future trials of improved thrombus aspiration technologies in this high-risk subgroup. CLINICAL

trial registrationURLs: http://www.ClinicalTrials.gov http://www.crd.york.ac.uk/prospero/. Unique identifiers: NCT02552407 and CRD42015025936.

Indexed as

AdultAgedAged, 80 and overClinical Trials as TopicCoronary ThrombosisFemaleHeart FailureHumansIschemic Attack, TransientMaleMiddle AgedPercutaneous Coronary InterventionST Elevation Myocardial InfarctionStrokeThrombectomyThrombosismeta-analysis [publication type]myocardial infarctionthrombectomy

Identifiers

PMID27941066
OpenAlexW2586965858

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.