Wang CS, et al. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005 Oct 19;294(15):1944-56.
Objective: Assess the usefulness of exam, including routine diagnostic studies, such as serum B-type natriuretic peptide [BNP], that differentiate heart failure from other causes of dyspnea in the emergency department. Includes
♦Searched MEDLINE (1966-July 2005) and the reference lists from retrieved articles, previous reviews, and physical examination textbooks
♦2 authors independently abstracted data and assessed methodological quality
♦Specifically excluded studies with convenience samples including patients who obviously had the disease and studies with unvalidated reference standard in convenience samples
11 studies (N=3,302) evaluated cutoffs of serum BNP in diagnosing heart failure in the emergency department.
Table 5 shows the pooled sensitivities, specificities and likelihood ratios of various cutoffs.