April 8, 2011Heart
Quantifying the added value of BNP in suspected heart failure in general practice: an individual patient data meta-analysis
Why the study?
Does adding BNP to clinical assessment improve the diagnostic accuracy for suspected heart failure in primary care?
Population
582 patients with suspected heart failure referred to a rapid-access diagnostic outpatient clinic.
Comparison
B-type natriuretic peptide testing added to… vs Standard clinical information alone, or clinical…
Design
Meta-analysis
Authors
Discussion
Loading...
Member takes
Implication
Supports adding BNP to clinical assessment for suspected HF in primary care; extends prior models with superior discrimination in validation.
Structured PICO
Does adding BNP to clinical assessment improve the diagnostic accuracy for suspected heart failure in primary care?
P
Population
582 patients with suspected heart failure referred to a rapid-access diagnostic outpatient clinic (derivation cohort n=276 from Hillingdon and Rotterdam; validation cohort n=306 from UK Natriuretic Peptide Study).
I
Intervention
B-type natriuretic peptide (BNP) testing added to standard clinical information.
C
Comparator
Standard clinical information alone (encompassing age, gender, known coronary artery disease, diabetes, orthopnoea, elevated jugular venous pressure, crackles, pitting oedema and S3 gallop), or clinical information plus ECG, or clinical information plus chest x-ray.
O
Outcome
Diagnostic discrimination (measured by c-statistic) and calibration for heart failure diagnosis.surrogate
Adding BNP to standard clinical signs and symptoms significantly improves the diagnostic accuracy for suspected heart failure in primary care, though using BNP alone with current cut-offs is insufficient for a reliable diagnosis.
Cite This Study
Kelder et al. (2011) studied this question.