1. Systematic review of genuine versus spurious side-effects of beta-blockers in heart failure using placebo control: Recommendations for patient information 
Anthony J. Barron, Nabeela Zaman, Graham D. Cole, Roland Wensel, Darlington O. Okonko, Darrel P. Francis 
International Journal of Cardiology 
Volume 168, Issue 4, Pages (October 2013)
DOI: /j.ijcard
Copyright © 2013 The Authors Terms and Conditions

2. Fig. 1
An example of how the proportion of symptoms non-pharmacological has been calculated for a single listed side-effect on beta-blocker therapy. The square chart represents 100 patients with heart failure. The open circles show how many would expect to experience the side effect without the drug. The filled circles show how many additional patients would experience the side effect if all 100 took the drug. From this the physician and the patient can visualise the proportion of side effects that are non-pharmacological: it is the proportion of circles that are open. The spreadsheet that calculates these proportions, and automatically displays the square chart, operates on the free and open-source LibreOffice ( or the widely-available Microsoft Excel. It is downloadable as an Online Supplement of this article.
International Journal of Cardiology  , DOI: ( /j.ijcard )
Copyright © 2013 The Authors Terms and Conditions

3. Fig. 2 PRISMA flow diagram of the studies.
International Journal of Cardiology  , DOI: ( /j.ijcard )
Copyright © 2013 The Authors Terms and Conditions

4. Fig. 3
The proportions of patients where beta-blocker is causative (± confidence intervals) for 5 side-effects statistically more prevalent in the beta-blocker arm of RCTs.
International Journal of Cardiology  , DOI: ( /j.ijcard )
Copyright © 2013 The Authors Terms and Conditions

5. Fig. 4
Forest Plot of 5 frequently discussed perceived side-effects of beta-blocker use — fatigue, hypotension, hyperglycaemia, dizziness and bradycardia.
International Journal of Cardiology  , DOI: ( /j.ijcard )
Copyright © 2013 The Authors Terms and Conditions

6. Fig. 5
Forest Plot of drug withdrawal (A) and serious adverse events (B) amongst RCTs of double-blind beta-blocker versus placebo controlled trials. Overall there are more withdrawals and serious adverse events amongst participants in the placebo groups.
International Journal of Cardiology  , DOI: ( /j.ijcard )
Copyright © 2013 The Authors Terms and Conditions

7. Fig. 6
A rational side-effect note to give patients regarding beta blockers for heart failure. When advising patients to disregard regulatory notes because they are incorrect, it would be useful to have a replacement note whose content is supported by the blinded placebo-controlled studies. This proposed note is designed to show the available information simply for use by patients with heart failure.
International Journal of Cardiology  , DOI: ( /j.ijcard )
Copyright © 2013 The Authors Terms and Conditions

8. Supplementary Fig. 1
Funnel plots for 10 commonly reported side-effects. The y axis for all plots is the log odds ratio of a treatment effect (i.e. beta-blocker causing symptom to the right, alleviating symptom to the left), with the dark line the overall log odds ratio. The x axis is the standard error as a measure of the sample size. For most of these side-effects there is spread of values to either side of the overall log odds ratio, with smaller studies (larger standard error) generally diverging furthest from the overall log odds ratio, which does not suggest publication bias.
International Journal of Cardiology  , DOI: ( /j.ijcard )
Copyright © 2013 The Authors Terms and Conditions