Original Title: Application 1087

Authors' results and conclusions: Part A (hospital emergency setting)- Safety - The likelihood of adverse events as a consequence of the B-type natriuretic peptide (BNP) testing procedure is low and similar to that of any blood test. Diagnostic effectiveness - On the basis of the evidence presented, BNP testing appears to be a valuable 'first line' diagnostic test that, when added to conventional diagnostic assessment, assists the acute care physician to correctly 'rule out' heart failure (HF) in patients presenting with acute dyspnoea. It also appears to benefit the patient by reducing or preventing hospital stay, and decreasing the time to treatment. It may also have the potential to reduce mortality rates within 30 days in some patients. N-terminal proBNP (NT-proBNP) testing appears to be a valuable diagnostic test that, when added to conventional diagnostic assessment, may assist the acute care physician to correctly 'rule out' HF in patients presenting with acute dyspnoea. Effectiveness for monitoring - One good quality, but small, randomised controlled trial (RCT) demonstrated that monitoring patients via NT-proBNP resulted in fewer cardiovascular deaths and total cardiovascular events than in patients monitored via clinical criteria. An abstract of an RCT trial reported similar results for BNP assay-guided monitoring, but more detail is necessary to determine whether this study could be considered supporting evidence. Part B - (non-hospital setting)- Safety - The likelihood of adverse events as a consequence of the BNP testing procedure is low and similar to that of any blood test. Diagnostic effectiveness - On the basis of the evidence presented, BNP testing appears to be a valuable 'first line' diagnostic test that, when added to conventional diagnostic assessment, assists the GP to determine which HF-like symptoms exhibited by patients are not caused by HF. The clinical impact of the test on patient health is, however, currently unknown in the non-hospital setting. NT-proBNP assays appear to be sensitive 'first-line' diagnostic tests that, when added to conventional diagnostic assessment, contribute to a change in the clinical practice of GPs. Their main role is to assist the GP to correctly 'rule out' HF more frequently in those patients presenting with dyspnoea and/or oedema of recent onset and suspected of HF. The clinical impact of the test (i.e. on patient health) is, however, currently unknown in the non-hospital setting.

Project Status: Completed

URL for project: http://www.msac.gov.au/internet/msac/publishing.nsf/Content/1087-public

Year Published: 2007

URL for published report: http://www.msac.gov.au/internet/msac/publishing.nsf/Content/B68AAF8993749793CA25801000123B83/$File/1087-Assessment-Report.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Adelaide Health Technology Assessment

Contact Address: School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617

Contact Name: ahta@adelaide.edu.au

Contact Email: ahta@adelaide.edu.au

Copyright: Adelaide Health Technology Assessment (AHTA)