Evaluation of B-type Natriuretic Peptide for validation of a heart failure register in primary care

Bhatia, Gurbir; Sosin, Michael; Stubley, Jane; Patel, Jeetesh V.; Hughes, Elizabeth; Gibbs, R.; Davis, Russell

doi:10.1186/1471-2261-7-23

Cited by 5 publications

(7 citation statements)

References 21 publications

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“…It will also be important to show that biomarkers are reproducible not only within a highly specialized setting (tertiary or secondary referral center), but also in a primary care setting 117,118 . Poor reproducibility in primary care may be partly due to differences in pre-analytical factors, which may be more difficult to standardize in a primary care setting than in a specialized setting.…”

Section: Future Outlookmentioning

confidence: 99%

Increasing the reproducibility of fluid biomarker studies in neurodegenerative studies

et al. 2020

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Biomarkers have revolutionized scientific research on neurodegenerative diseases, in particular Alzheimer’s disease, transformed drug trial design, and are also increasingly improving patient management in clinical practice. A few key cerebrospinal fluid biomarkers have been robustly associated with neurodegenerative diseases. Several novel biomarkers are very promising, especially blood-based markers. However, many biomarker findings have had low reproducibility despite initial promising results. In this perspective, we identify possible sources for low reproducibility of studies on fluid biomarkers for neurodegenerative diseases, with a focus on Alzheimer’s disease. We suggest guidelines for researchers and journal editors, with the aim to improve reproducibility of findings.

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Section: Future Outlookmentioning

confidence: 99%

Increasing the reproducibility of fluid biomarker studies in neurodegenerative studies

et al. 2020

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“…This is particularly relevant for older people, who often have multiple comorbidities and may present with many other possible causes of dyspnea, fatigue or peripheral edema. Additionally, natriuretic peptide biomarkers and echocardiography are underused, leading to under-and over-diagnosis of HF [3,4,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…A primary discharge diagnosis of HF after hospitalization is a validated method of identifying patients with HF, but it is not a sensitive one in general practice [11]. Searching for coded diagnoses in electronic medical records is a potential strategy [12], but studies have failed to confirm HF in 50%-75% of patients with a coded diagnosis of HF, and many HF cases remain undetected with this methodology [9,13]. However, a robust method of identifying patients with HF is the initial requirement for studying and improving care for this important patient population.…”

Section: Introductionmentioning

confidence: 99%

Methods to identify heart failure patients in general practice and their impact on patient characteristics: A systematic review

Smeets

Henrard

Aertgeerts

et al. 2018

International Journal of Cardiology

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“…This is an issue that HF guideline developers should consider 1 18. NT-proBNP could support GPs in this risk stratification, as it provides prognostic information in cardiac outpatients 1 3 20 28 29. Additionally, in our study, the concepts of HFrEF and HFpEF were cited by very few GPs.…”

Section: Discussionmentioning

confidence: 76%

“…Early diagnosis of HF is important to initiate treatment in a timely manner and to delay progression to overt HF 1. However, a diagnosis of CHF in general practice is challenging, leading to both underdiagnosis and overdiagnosis 1 3–6…”

Section: Introductionmentioning

confidence: 99%

Think-aloud study about the diagnosis of chronic heart failure in Belgian general practice

et al. 2019

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ObjectivesDiagnosing chronic heart failure (CHF) in general practice is challenging. Our aim was to investigate how general practitioners (GPs) diagnose CHF in real-world patients.DesignThink-aloud study.MethodsFourteen GPs were asked to reason about four real-world CHF cases from their own practices. The cases were selected through a clinical audit. This was followed by an interview to get a deeper insight in their reasoning. The Qualitative Analysis Guide of Leuven was used as a guide in data analysis.ResultsWe developed a conceptual diagnostic model based on three important reasoning steps. First, GPs assessed the likelihood of CHF based on the presence or absence of HF signs and symptoms. However, this approach had serious limitations since GPs experienced many barriers in their clinical assessment, especially in comorbid elderly. Second, if CHF was considered based on step 1, the main influencing factor to take further diagnostic steps was the GPs’ perception of the added value of a validated CHF diagnosis in that specific case. Third, the choice and implications of these further diagnostic steps (N-terminal pro B-type natriuretic peptide, ECG and/or cardiac ultrasound) were influenced by the GPs’ knowledge about these tests and the quality of the cardiologists’ reports.ConclusionThis think-aloud study identified the factors that influenced the diagnostic reasoning about CHF in general practice. As a consequence, targets to improve this diagnostic reasoning were withheld: a paradigm shift towards an earlier and more comprehensive risk assessment with, among others, access to natriuretic peptide testing and convincing GPs of the added value of a validated HF diagnosis.

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Evaluation of B-type Natriuretic Peptide for validation of a heart failure register in primary care

Cited by 5 publications

References 21 publications

Increasing the reproducibility of fluid biomarker studies in neurodegenerative studies

Increasing the reproducibility of fluid biomarker studies in neurodegenerative studies

Methods to identify heart failure patients in general practice and their impact on patient characteristics: A systematic review

Think-aloud study about the diagnosis of chronic heart failure in Belgian general practice

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