Diagnostic Accuracy of Natriuretic Peptides for Heart Failure
Simple and reliable tests to diagnose heart failure in elderly patients presenting with symptoms or signs of impaired left ventricular function would be of great practical importance. In recent years, brain natriuretic peptides have emerged as a promising, novel test. Enzyme-linked immunosorbent assay (ELISA), in contrast to radioimmunosorbent assay, does not require long incubation periods and would be particularly suitable to assist rapid diagnosis on site in primary and emergency care settings. The systematic review by Doust et al1 of test accuracy studies is therefore timely and of great interest, but not without limitations. We have 3 observations.
Publikationen Medizinische Poliklinik USZ - 2005 1 Selbstständige Literatur Dissertationen Scharplatz Madlaina (2005): Pharmacogenetics opportunities and Challenges. Description of a generic evaluation model to assess the clinical usefuleness of pharmacogenetic testing. Pharmazeutische Wissenschaften0Comments 0Citations
- [Show abstract] [Hide abstract] ABSTRACT: In replyIn the March 28 issue of the ARCHIVES, Battalgia et al1 raised 3 issues related to our recent review of the diagnostic accuracy of natriuretic peptides.2 First, they were aware of 4 studies of the rapid enzyme-linked immunosorbent assay (ELISA) form of the test that were not included in our review. It is not clear from their letter if these studies were published before or after the search date for our review, December 2002. We excluded 5 studies from our review that had used the rapid ELISA form of the test because the dates of recruitment and the recruitment sites overlapped with those of the studies by Maisel et al, 2002,3 and Krishnaswamy et al, 2001.4 We have also recently updated the review (search date, March 2004) and found a further 2 studies that used the rapid ELISA form of the test. We agree with the correspondents that the type of assay may be one reason for the significant heterogeneity seen in the test characteristics between the studies. One difficulty in determining this, however, is that there are no studies, to our knowledge, comparing these 2 forms of the test within 1 population. The results of any comparison made between studies would need to be interpreted with considerable caution. Of interest, we are currently conducting a study of the variability of 2 versions of the test. The 2 forms of the test are showing considerable and inconsistent variability.0Comments 4Citations
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