Evidence map›Paper›PMID 27855108›Full record

Observational studyBMJ open2016

Diagnostic rules and algorithms for the diagnosis of non-acute heart failure in patients 80 years of age and older: a diagnostic accuracy and validation study.

Miek Smeets, Jan Degryse, Stefan Janssens, Catharina Matheï, Pierre Wallemacq, Jean-Louis Vanoverschelde, Bert Aertgeerts, Bert Vaes

Open access · goldAbstract readComparative StudyObservational StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 21% 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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. NT-proBNP in the very old population: reference values and heart failure specificity from the AugUR-study.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  2. Review
  3. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Miek SmeetsDepartment of Public Health and Primary Care, KU Leuven (KUL), Leuven, Belgium.
Jan DegryseDepartment of Public Health and Primary Care, KU Leuven (KUL), Leuven, Belgium.
Stefan JanssensDepartment of Cardiovascular Diseases, Universitair Ziekenhuis Gasthuisberg, KU Leuven (KUL), Leuven, Belgium.
Catharina MatheïDepartment of Public Health and Primary Care, KU Leuven (KUL), Leuven, Belgium.
Pierre WallemacqLaboratory of Analytical Biochemistry, Cliniques Universitaires St Luc, Université Catholique de Louvain (UCL), Brussels, Belgium.
Jean-Louis VanoverscheldeDepartment of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium.
Bert AertgeertsDepartment of Public Health and Primary Care, KU Leuven (KUL), Leuven, Belgium.
Bert VaesDepartment of Public Health and Primary Care, KU Leuven (KUL), Leuven, Belgium.
KU Leuven · BECliniques Universitaires Saint-Luc · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDifferent diagnostic algorithms for non-acute heart failure (HF) exist. Our aim was to compare the ability of these algorithms to identify HF in symptomatic patients aged 80 years and older and identify those patients at highest risk for mortality.

designDiagnostic accuracy and validation study.

settingGeneral practice, Belgium.

participants365 patients with HF symptoms aged 80 years and older (BELFRAIL cohort). Participants underwent a full clinical assessment, including a detailed echocardiographic examination at home. OUTCOME MEASURES: The diagnostic accuracy of 4 different algorithms was compared using an intention-to-diagnose analysis. The European Society of Cardiology (ESC) definition of HF was used as the reference standard for HF diagnosis. Kaplan-Meier curves for 5-year all-cause mortality were plotted and HRs and corresponding 95% CIs were calculated to compare the mortality risk predicting abilities of the different algorithms. Net reclassification improvement (NRI) was calculated.

resultsThe prevalence of HF was 20% (n=74). The 2012 ESC algorithm yielded the highest sensitivity (92%, 95% CI 83% to 97%) as well as the highest referral rate (71%, n=259), whereas the Oudejans algorithm yielded the highest specificity (73%, 95% CI 68% to 78%) and the lowest referral rate (36%, n=133). These differences could be ascribed to differences in N-terminal probrain natriuretic peptide cut-off values (125 vs 400 pg/mL). The Kelder and Oudejans algorithms exhibited NRIs of 12% (95% CI 0.7% to 22%, p=0.04) and 22% (95% CI 9% to 32%, p<0.001), respectively, compared with the ESC algorithm. All algorithms detected patients at high risk for mortality (HR 1.9, 95% CI 1.4 to 2.5; Kelder) to 2.3 (95% CI 1.7 to 3.1; Oudejans). No significant differences were observed among the algorithms with respect to mortality risk predicting abilities.

conclusionsChoosing a diagnostic algorithm for non-acute HF in elderly patients represents a trade-off between sensitivity and specificity, mainly depending on differences between cut-off values for natriuretic peptides.

Indexed as

AlgorithmsEchocardiographyAged, 80 and overAge FactorsBelgiumFemaleHeart FailureHumansMaleNatriuretic Peptide, BrainPractice Guidelines as TopicPredictive Value of TestsProspective StudiesReproducibility of ResultsNatriuretic Peptide, BrainGERIATRIC MEDICINEPRIMARY CARE

Identifiers

PMID27855108
PMCPMC5073666
OpenAlexW2527903216

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.