Response to Commentary "Efficacy of inspiratory muscle training in chronic heart failure patients"

In their letter Plentz and colleagues attempt to highlight discrepancies between their review work and that of Smart et al. Plentz and colleagues suggest that the search by Smart et al. was too narrow. We challenge Plentz and colleagues to find omitted studies that were published in the stipulated time frame as, in addition to the stipulated search, extensive hand searching was conducted. The discrepancy between the previous works and the work of Smart et al. may be explained by the fact that we only recorded papers where we were required to read more than the title (e.g. abstracts or full manuscripts) in order to come to a decision to exclude a study. Second, Plentz and colleagues suggest our review included too many studies, which perhaps contradicts their comment above? We do however acknowledge that journal word limits permitting the inclusion of a sensitivity analysis (e.g. removal of studies of Winkelmann and Laoutaris) may have been helpful in teasing out any effects of heterogenic studies.