Evidence map›Paper›PMID 16638247›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2006

The diagnostic accuracy and utility of a B-type natriuretic peptide test in a community population of patients with suspected heart failure.

Ahmet Fuat, Jeremy J Murphy, A Pali S Hungin, Jane Curry, Ali A Mehrzad, Andrew Hetherington, Jennifer I Johnston, W Stuart A Smellie, Victoria Duffy, Patricia Cawley

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 5 pooled it
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 5 syntheses or guidelines pooled it, 131 citations in OpenAlex.

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  4. Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Ahmet FuatDepartment of Medicine, Darlington Memorial Hospital, Centre for Integrated Health Care Research, University of Durham, Darlington Primary Care Trust. ahmet@fuat.freeserve.co.uk
Jeremy J Murphy
A Pali S Hungin
Jane Curry
Ali A Mehrzad
Andrew Hetherington
Jennifer I Johnston
W Stuart A Smellie
Victoria Duffy
Patricia Cawley
Darlington Memorial Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNational guidelines suggest the use of natriuretic peptides in suspected heart failure but there have been no studies comparing assays in primary care.

aimTo test and compare the diagnostic accuracy and utility of B-type natriuretic peptide (BNP) and N-terminal B-type natriuretic peptide (NT proBNP) in diagnosing heart failure due to left ventricular systolic dysfunction in patients with suspected heart failure referred by GPs to one-stop diagnostic clinics. DESIGN OF STUDY: Community cohort, prospective, diagnostic accuracy study.

settingOne-stop diagnostic clinics in Darlington Memorial and Bishop Auckland General Hospitals and general practices in South Durham. SUBJECTS: Two hundred and ninety-seven consecutive patients with symptoms and signs suggestive of heart failure referred from general practice.

methodThe study measured sensitivity, specificity, positive and negative predictive values (PPV, NPV), and area under receiver operating characteristic curve for BNP (near patient assay) and NT proBNP (laboratory assay) in diagnosis of heart failure due to left ventricular systolic dysfunction. The NPV of both assays was determined as a potential method of reducing the number of referrals for echocardiography.

resultsOne hundred and fourteen of the 297 patients had left ventricular systolic dysfunction (38%). At the manufacturer's recommended cut-off of 100 pg/ml BNP gave a NPV of 82%. BNP performed better at a cut-off of 40 pg/ml with a NPV of 88%. At a cut-off of 150 pg/ml, NT proBNP gave a NPV of 92%. Using cut-offs of 40 pg/ml and 150 pg/ml for BNP and NT pro-BNP, respectively, could have prevented 24% and 25% of referrals to the clinic, respectively.

conclusionsIn this setting, NT pro-BNP performed marginally better than BNP, and would be easier to use practically in primary care. A satisfactory cut-off has been identified, which needs validating in general practice. NT pro-BNP could be used to select referrals to a heart failure clinic or for echocardiography. This process needs testing in real-life general practice.

Indexed as

AdultAgedAged, 80 and overBiomarkersCohort StudiesEchocardiographyFamily PracticeFemaleHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsPredictive Value of TestsProspective StudiesBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)

Identifiers

PMID16638247
PMCPMC1837840
OpenAlexW2152927765

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.