The Lancet, the leading medical journal, announced the most voted paper of 2009 on February 20.    

The Lancet reported "2009 is the first time that the entire process of nominations and voting for paper of the year has been open to anyone with access to the internet," and "surprisingly, the big health story of 2009, pandemic Influenza A H1N1, was not even nominated."

The voting did elucidate the readership's choice for most interesting study, and based on popularity, the winner is "Prediction of mortality and major cardiac events by exercise echocardiography in patients with normal exercise electrocardiographic testing," published in Journal of the American College of Cardiology.

The Lancet commented, "improving prognostic accuracy for coronary artery disease has wide appeal to clinicians, patients, and those who organise and fund health services."

Alberto Bouzas-Mosquera, lead researcher on the study, pointed out, "the lower sensitivity of exercise electrocardiography for the detection of obstructive coronary artery disease when compared with exercise echocardiography may potentially translate into failure to identify some patients at risk."

This study could impact diagnostic practices of heart disease and is desperately needed since "cardiovascular disease is the leading cause of death worldwide."