Rapid measurement of B-type natriuretic peptides reduced time to discharge and treatment costs in patients with acute dyspnea
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Bibliographic record
Abstract
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 ...
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it