Topic Statement Places in a Manuscript
This example paper, published in Circulation (2002;106:672-678), nicely demonstrates where to position the
topic statement. In this manuscript, the authors demonstrate that a medication used to treat hypertension
(Valsartan) lowers a condition affecting diabetics, and that this effect is independent of blood pressure. These
results form the topic statement, which I have listed for each section of the manuscript. The authors do not write
exactly the same sentence in each section, but they emphasize the key feature of the study - that valsartan lowers
UAER independently of blood pressure. This distinction is important, as many investigators had speculated that
other hypertension medications could also lower UAER. This manuscript indicates that other medications do not
work as effectively as Valsartan.
Microalbuminuria Reduction With Valsartan in Patients With Type 2 Diabetes Mellitus:
A Blood Pressure–Independent Effect
For the same level of attained BP and the same degree of BP reduction, valsartan lowered urine albumin excretion
(UAER) more effectively than amlodipine in patients with type 2 diabetes and microalbuminuria, including the
subgroup with baseline normotension. This indicates a BP-independent antiproteinuric effect of valsartan.
The purpose of this study, therefore, was to investigate whether the effect of the highly selective AIIA, valsartan,
on UAER was independent of its BP-lowering properties.
Material and Methods
This was a multicenter, randomized, double-blind, active control, parallel group, 24-week study of 80 mg/d
valsartan versus 5 mg/d amlodipine. The study duration was based on the observation that inhibition of the RAS
[renin-angiotensin system] lowers albuminuria with full effect after 24 weeks.
Valsartan, in contrast to amlodipine, lowered UAER progressively over time to a nadir at 24 weeks
(Table 2 and Figure 1A). The UAER at 24 weeks with valsartan was 56% (95% CI, 49.6 to 63.0) of baseline,
equivalent to a 44% reduction. The UAER for amlodipine at week 24 was 92% (95% CI, 81.7 to 103.7) of
baseline, a reduction of only 8%. The treatment effect was highly significant (P,0.001; 95% CI for ratio, 0.520,
Discussion (first paragraph)
This study demonstrates that UAER was significantly reduced by valsartan in type 2 diabetic patients with
These results strongly support the notion that the albuminuria-lowering effects of valsartan are in addition to and,
to a large extent, divorced from its antihypertensive action.
Conclusion (end of discussion)
In conclusion, valsartan significantly reduces microalbuminuria in type 2 diabetic patients, an effect that appears to
be independent of its BP-lowering action.
Go To Step 2
The Title contains the TS,
but need not form a
Abstract concisely states
TS often written as study
goal in the Introduction
TS nicely inserted into
Part of the TS
Another part of the TS
Primary result in study
that supports the TS