Rapid measurement of B-type natriuretic peptides reduced time to discharge and treatment costs in patients with acute dyspnea
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LetterJanuary 1, 2005Rapid measurement of B-type natriuretic peptides reduced time to discharge and treatment costs in patients with acute dyspneaEric Schwam, MDEric Schwam, MDSturdy Memorial Hospital, Attleboro, Massachusetts, USA (E.S.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2005-142-1-A14 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail To the EditorI would like to remark on a recent commentary (1) about B-type natriuretic peptide (BNP) as a test for heart failure and on the B-Type Natriuretic Peptide for Acute Shortness of Breath Evaluation (BASEL) study (2). Schünemann and Akl cite the BNP Multinational Study (3, 4) as demonstrating that BNP has good test characteristics for the diagnosis of heart failure. However, their stated positive likelihood ratios (LRs) of 2.5 to 5.0 (for the 50 pg/mL cutpoint) only result in small-to-moderate changes in test probability. Moreover, this study was flawed by its practice of enrolling undifferentiated patients with dyspnea, ...References1 Schünemann HJ, Akl E. Rapid measurement of B-type natriuretic peptides reduced time to discharge and treatment costs in patients with acute dyspnea. ACP J Club. 2004 Sep-Oct;141:35. [PMID: 15341455] Google Scholar2 Mueller C, Scholer A, Laule-Kilian K, et al. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med. 2004;350:647-54. [PMID: 14960741] Google Scholar3 Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347:161-7. [PMID: 12124404] Google Scholar4 McCullough PA, Nowak RM, McCord J, et al. B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study. Circulation. 2002;106:416-22. [PMID: 12135939] Google Scholar5 Hohl CM, Mitelman BY, Wyer P, Lang E. Should emergency physicians use B-type natriuretic peptide testing in patients with unexplained dyspnea? Canadian Journal of Emergency Medicine. 2003;5:162-5. Google Scholar6 Brown MD, Reeves MJ. Evidence-based emergency medicine/skills for evidence-based emergency care. Interval likelihood ratios: another advantage for the evidence-based diagnostician. Ann Emerg Med. 2003;42:292-7. [PMID: 12883521] Google Scholar7 Schwam E. B-type natriuretic peptide for diagnosis of heart failure in emergency department patients: a critical appraisal. Acad Emerg Med. 2004;11:686-91. [PMID: 15175210] Google Scholar8 Kucher N, Printzen G, Goldhaber SZ. Prognostic role of brain natriuretic peptide in acute pulmonary embolism. Circulation. 2003;107:2545-7. [PMID: 12742987] Google Scholar9 Jones AE, Kline JA. Elevated brain natriuretic peptide in septic patients without heart failure. Ann Emerg Med. 2003;42:714-5. [PMID: 14596247] Google Scholar10 McCullough PA, Duc P, Omland T, et al. B-type natriuretic peptide and renal function in the diagnosis of heart failure: an analysis from the Breathing Not Properly Multinational Study. Am J Kidney Dis. 2003;41:571-9. [PMID: 12612980] Google Scholar11 Mueller C, Laule Kilian K, Scholer A, et al. B-type natriuretic peptide for acute dyspnea in patients with kidney disease: insights from a randomized comparison. Kidney Int. 2004; in press. Google Scholar12 Wang TJ, Larson MG, Levy D, et al. Impact of obesity on plasma natriuretic peptide levels. Circulation. 2004;109:594-600. [PMID: 14769680] Google Scholar13 Cowie MR, Struthers AD, Wood DA, et al. Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care. Lancet. 1997;350:1349-53. [PMID: 9365448] Google Scholar14 Wright SP, Doughty RN, Pearl A, et al. Plasma amino-terminal pro-brain natriuretic peptide and accuracy of heart-failure diagnosis in primary care: a randomized, controlled trial. J Am Coll Cardiol. 2003;42:1793-800. [PMID: 14642690] Google Scholar15 Davis M, Espiner E, Richards G, et al. Plasma brain natriuretic peptide in assessment of acute dyspnoea. Lancet. 1994;343:440-4 7905953 Google Scholar16 Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347:161-7. [PMID: 12124404] Google Scholar17 McCullough PA, Nowak RM, McCord J, et al. B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study. Circulation. 2002;106:416-22 [PMID: 12135939] Google Scholar18 Mueller C, Scholer A, Laule-Kilian K, et al. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med. 2004;350:647-54. [PMID: 14960741] Google Scholar19 Mueller C, Scholer A, Laule-Kilian K, et al. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med. 2004;350:647-54. [PMID: 14960741] Google Scholar20 Schünemann HJ, Akl E. Rapid measurement of B-type natriuretic peptides reduced time to discharge and treatment costs in patients with acute dyspnea. ACP J Club. 2004 Sep-Oct;141:35. [PMID: 15341455] Google Scholar21 Doust JA, Glasziou PP, Pietrzak E, Dobson AJ. A systematic review of the diagnostic accuracy of natriuretic peptides for heart failure. Arch Intern Med. 2004;164:1978-84. [PMID: 15477431] Google Scholar22 Schwam E. B-type natriuretic peptide for diagnosis of heart failure in emergency department patients: a critical appraisal. Acad Emerg Med. 2004;11:686-91. [PMID: 15175210] Google Scholar Author, Article, and Disclosure InformationAffiliations: Sturdy Memorial Hospital, Attleboro, Massachusetts, USA (E.S.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails January 1, 2005Volume 142, Issue 1Page: A14KeywordsDyspneaHeart failureNatriuretic peptidesObesityPulmonary diseasesPulmonary embolismSaltsSepsisSpecificitySystematic reviews ePublished: 9 March 2020 Issue Published: January 1, 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,022 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».