A summary of our inclusion/exclusion criteria are in the online supplementary appendix 1. Information sources We will conduct a systematic search of the literature without language restrictions in MEDLINE, EMBASE, the Cumulative Index

Tipifarnib buy to Nursing and Allied Health Literature (CINAHL), and the Cochrane Central Register of Controlled Trials. We will also search unpublished or grey literature from other sources such as healthcare provider organisations (eg, the Canadian Cardiovascular Society, American Heart Association, American College of Cardiology and Heart Failure Society of America). Additionally, we will search the reference lists of included articles and identify other articles through contact with experts in cardiovascular medicine. Search strategy An experienced information specialist developed our search strategy in MEDLINE using the search terms: heart failure, cardiac failure, heart decompensation, myocardial failure; as well as a list of terms for QI strategies. We applied the validated search filters developed by Haynes et al12 to identify RCTs and systematic reviews.13 The search strategy was peer reviewed by another experienced information specialist using the PRESS checklist (ie, Peer Review of Electronic Search Strategies).14 The search strategy for MEDLINE is available in the online supplementary

appendix 2. This was adjusted for our other data sources (EMBASE, CINAHL and the Cochrane Library), which are available from the authors on request. Study selection Our study selection will involve performing an exercise to calibrate reviewers to ensure reliability of screening. Two reviewers will apply our eligibility criteria and independently screen a random sample of 25 citations using our online Synthesi.SR Tool

(a proprietary online systematic review software developed for our Knowledge Synthesis Center at St. Michael’s Hospital).15 We will calculate inter-rater agreement for applying the eligibility criteria (using per cent agreement), and we will repeat this exercise in two subsequent pilot screenings to reach 90% agreement. Once we attain this level of consistency, two reviewers will independently screen the titles and abstracts of the remainder of potentially relevant articles Carfilzomib in duplicate (level 1 screening). We will follow a similar calibration procedure during level 2 screening to identify potentially relevant articles in full text, which will also require two pilot calibration tests to attain a high level of consistency. Disagreements will be resolved through research team consensus for both levels of screening. Data collection process We will develop a standardised data abstraction form in Excel, which will be pilot tested on a random sample of 5–10 included studies to ensure agreement between data extractors.