ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2011
Diagnostic triage and the role of natriuretic peptide testing and echocardiography for suspected heart failure: an appropriateness ratings evaluation by UK GPs.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- Age-adjusted natriuretic peptide thresholds for a diagnosis of heart failure in the community: Diagnostic accuracy study.ESC heart failure · 2025Article
- Use of Artificial Intelligence Applied to Electrocardiogram for Diagnosis of Left Ventricular Systolic Dysfunction.Arquivos brasileiros de cardiologia · 2025Article
- Respiratory infections in children: an appropriateness study of when parents should home care or seek medical help.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Guidance for post-discharge care following acute kidney injury: an appropriateness ratings evaluation.BJGP open · 2020Article
- Understanding the diagnosis of pre-diabetes in patients aged over 85 in English primary care: a qualitative study.BMC family practice · 2019Article
- Article
- Medical professionalism and pay-for-performance.The British journal of general practice : the journal of the Royal College of General Practitioners · 2012Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSome UK GPs are acquiring access to natriuretic peptide (NP) testing or echocardiography as diagnostic tests for heart failure. This study developed appropriateness ratings for the diagnostic application of these tests in routine general practice.
aimTo develop appropriateness ratings for the diagnostic application of NP testing or echocardiography for heart failure in general practice. DESIGN AND
settingAn appropriateness ratings evaluation in UK general practice.
methodFour presenting symptoms (cough, bilateral ankle swelling, dyspnoea, fatigue), three levels of risk of cardiovascular disease (low, intermediate, high), and dichotomous categorisations of cardiovascular/chest examination and electrocardiogram result, were used to create 540 appropriateness scenarios for patients in whom NP testing or echocardiography might be considered. These were rated by a 10-person expert panel, consisting of GPs and GPs with specialist interests in cardiology, in a two-round RAND Appropriateness Method.
resultsOnward referral for NP testing or echocardiography was rated as an appropriate next step in 217 (40.2%) of the 540 scenarios; in 194 (35.9%) it was rated inappropriate. The ratings also show where NP testing or echocardiography were ranked as equivalent next steps and when one test was seen as the more appropriate than the other.
conclusionNP testing should be the routine test for suspected heart failure where referral for diagnostic testing is considered appropriate. An abnormal electrocardiogram status makes referral to echocardiography an accompanying, or more appropriate, next step alongside NP testing, especially in the presence of dyspnoea. Abnormal NP testing should subsequently be followed up with referral for echocardiography.
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