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The purpose of this study is to systematically review the accuracy of …

Biology Articles » Medicine » Emergency Medicine » The utility of B-type natriuretic peptide in the diagnosis of heart failure in the emergency department: a systematic review » Tables

Tables
- The utility of B-type natriuretic peptide in the diagnosis of heart failure in the emergency department: a systematic review

Table 1
Characteristics of the studies included in the review
Study Year
 # subjects
 Age (mean +/- SD)
 % male
 History of HF (%)
 History of asthma or COPD (%)
 Patients admitted (%)
 BNP assay used
 Final diag-nosis HF (%)
 Cutoff (pg/ml)
 Sensi-tivity (%)
 Speci-ficity (%)
Jourdain 2002
 125
 72†
 *
 *
 *
 100
 Triage
 72
 300
 94
 86
Logeart 2002
 163
 67 ± 15
 67
 49
 *
 90
 Triage
 71
 100
 96
 31
Maisel 2002
 1,586
 64 ± 17
 56
 33
 41
 72
 Triage
 47
 100
 90
 76
Morrison 2002
 321
 *
 95
 42
 40
 43
 Triage
 42
 105
 86
 94
Villacorta 2002
 70
 72 ± 16
 47
 37
 44
 *
 Triage
 51
 200
 100
 97
Lainchbury 2003
 205
 70 ± 14
 49
 25
 42
 *
 Triage
 34
 100
 77
 84
Knudsen 2004
 155
 76†
 45
 *
 47
 *
 Triage
 48
 100
 90
 55
Ray 2004
 308
 80 ± 8
 50
 20
 25
 100
 Triage
 46
 100
 90
 59
Mueller 2005
 251
 73†
 93
 65
 *
 *
 AxSYM BNP
 55
 100
 96
 61
Alibay 2005
 160
 80 ± 14
 48
 38
 34
 58
 Triage
 38
 150
 94
 61
Sensitivity and Specificity are presented for the BNP value closest to 100 pg/ml from each study.
* Not reported † Standard deviation not reported
Table 2
Quality measures of included studies
Study, Year
 Were important inclusions and exclusions explained?
 Was patient spectrum clearly defined?*
 Was the diagnosis of HF determined without knowledge of the BNP result?
 Was agreement reported for the reference standard?
 Was selection bias present?
 Was verification bias present?
 Were withdrawals explained?
Jourdain 2002
 Yes
 No
 Yes
 No
 No
 No
 No
Logeart 2002
 Yes
 No
 Yes
 No
 No
 No
 Yes
Maisel 2002
 Yes
 Yes
 Yes
 No
 Possible
 No
 N/A†
Morrison 2002
 Yes
 No
 Yes
 No
 Yes
 No
 N/A†
Villacorta 2002
 Yes
 No
 Yes
 No
 No
 No
 N/A†
Lainchbury 2003
 No
 No
 Yes
 No
 Possible
 Possible
 N/A†
Knudsen 2004
 Yes
 No
 Yes
 No
 No
 Possible
 N/A†
Ray 2004
 Yes
 No
 Yes
 No
 Possible
 No
 Yes
Alibay 2005
 Yes
 No
 Yes
 No
 No
 No
 N/A†
Mueller 2005
 Yes
 No
 Yes
 No
 No
 No
 Yes
*Information available on age, gender, race, prevalence of a HF history and history of asthma and/or COPD, and the percentage of patients admitted to the hospital.
Table 3
Pooled LRs for BNP in emergency department settings
BNP cutoff (pg/ml)
 Number of studies/number of patients with information on this cutoff
 Positive LR
 Negative LR
50–80
 4/2109
 2.4
 .08
100–105
 7/2989
 3.4‡
 .14‡
150–199
 8/2944
 3.8
 .16
200–299
 6/1268
 4.6
 .16
300–400
 3/596
 7.6‡
 .17‡
‡LR from random effects model
Table 4
Impact of high and low BNP results on pre-test probabilities
Pre-test probability
 Post-test probability for BNP
Post-test probability for BNP > 300 pg/ml
10%
 2%
 46%
30%
 5%
 77%
50%
 12%
 88%
70%
 25%
 95%
90%
 56%
 99%

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