Trial reportPloS one2013
Utility of biomarkers in the differential diagnosis of heart failure in older people: findings from the heart failure in care homes (HFinCH) diagnostic accuracy study.
Trial report in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
22 citing papers in PubMed, 6 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Diagnostic accuracy of natriuretic peptide screening for left ventricular systolic dysfunction in the community: systematic review and meta-analysis.ESC heart failure · 2023Pooled it
- Natriuretic peptides for heart failure screening in nursing homes: a systematic review.Heart failure reviews · 2021Pooled it
- Natriuretic peptides for the detection of diastolic dysfunction and heart failure with preserved ejection fraction-a systematic review and meta-analysis.BMC medicine · 2020Pooled it
- Risk of bias in studies investigating novel diagnostic biomarkers for heart failure with preserved ejection fraction. A systematic review.European journal of heart failure · 2020Pooled it
- Pooled it
- Predictive value of plasma copeptin level for the risk and mortality of heart failure: a meta-analysis.Journal of cellular and molecular medicine · 2017Pooled it
- Trial
- Feasibility of evidence-based diagnosis and management of heart failure in older people in care: a pilot randomised controlled trial.BMC geriatrics · 2012Trial
- Prognostic utility of mid-regional pro-adrenomedullin and growth differentiation factor 15 in patients undergoing transfemoral transcatheter aortic valve implantation.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Observational
- The Use of Brain Natriuretic Peptide in the Evaluation of Heart Failure in Geriatric Patients.Diagnostics (Basel, Switzerland) · 2023Review
- Nitric oxide metabolites: associations with cardiovascular biomarkers and clinical parameters in patients with HFpEF.ESC heart failure · 2022Article
- Copeptin as a Diagnostic and Prognostic Biomarker in Cardiovascular Diseases.Frontiers in cardiovascular medicine · 2022Review
- Using quantitative MRI to study brain responses to immune challenge with interferon-α.Brain, behavior, & immunity - health · 2021Article
- PET imaging shows no changes in TSPO brain density after IFN-α immune challenge in healthy human volunteers.Translational psychiatry · 2020Article
- Natriuretic Peptides in Chronic Heart Failure.Cardiac failure review · 2019Review
- Cardiopulmonary laboratory biomarkers in the evaluation of acute dyspnea.Open access emergency medicine : OAEM · 2016Review
- Central cardiac limit to aerobic capacity in patients with exertional pulmonary venous hypertension: implications for heart failure with preserved ejection fraction.Circulation. Heart failure · 2015Article
- Utility of NT-proBNP as a rule-out test for left ventricular dysfunction in very old people with limiting dyspnoea: the Newcastle 85+ Study.BMC cardiovascular disorders · 2014Article
- Utility of point-of-care testing of natriuretic peptides (brain natriuretic peptide and n-terminal pro-brain natriuretic peptide) in the emergency department.International journal of critical illness and injury science · 2014Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe performance of biomarkers for heart failure (HF) in older residents in long-term care is poorly understood and has not differentiated between left ventricular systolic dysfunction (LVSD) and HF with preserved ejection fraction (HFpEF).
methodsThis is the first diagnostic accuracy study in this population to assess the differential diagnostic performance and acceptability of a range of biomarkers against a clinical diagnosis using portable echocardiography. A total of 405 residents, aged 65-100 years (mean 84.2), in 33 UK long-term care facilities were enrolled between April 2009 and June 2010.
resultsFor undifferentiated HF, BNP or NT-proBNP were adequate rule-out tests but would miss one in three cases (BNP: sensitivity 67%, NPV 86%, cut-off 115 pg/ml; NT-proBNP: sensitivity 62%, NPV 87%, cut-off 760 pg/ml). Using higher test cut-offs, both biomarkers were more adequate tests of LVSD, but would still miss one in four cases (BNP: sensitivity 76%, NPV 97%, cut-off 145 pg/ml; NT-proBNP: sensitivity 73%, NPV 97%, cut-off 1000 pg/ml). At these thresholds one third of subjects would test positive and require an echocardiogram. Applying a stricter 'rule out' threshold (sensitivity 90%), only one in 10 cases would be missed, but two thirds of subjects would require further investigation. Biomarkers were less useful for HFpEF (BNP: sensitivity 63%, specificity 61%, cut-off 110 pg/ml; NT-proBNP: sensitivity 68%, specificity 56%, cut-off 477 pg/ml). Novel biomarkers (Copeptin, MR-proADM, and MR-proANP) and common signs and symptoms had little diagnostic utility.
conclusionsNo test, individually or in combination, adequately balanced case finding and rule-out for heart failure in this population; currently, in-situ echocardiography provides the only adequate diagnostic assessment.
trial registrationControlled-Trials.com ISRCTN19781227.
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Registered trials
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.