Primary care REFerral for EchocaRdiogram (REFER) in heart failure: A diagnostic accuracy study

British Journal of General Practice

Volumn 67, Issue 655, 2017, Pages e94-e102

  Taylor, Clare J ^a   Roalfe, Andrea K ^b   Iles, Rachel ^b   Hobbs, F D Richard ^a   Barton, P ^b   Cowie, M R ^c   Davis, R C ^d   Deeks, J ^b   Mant, J ^e   McCahon, D ^b   Tait, L ^g   Sutton, G ^c  

^a UNIVERSITY OF OXFORD   (United Kingdom)

^b UNIVERSITY OF BIRMINGHAM   (United Kingdom)

^c NATIONAL HEART AND LUNG INSTITUTE   (United Kingdom)

^d SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST   (United Kingdom)

^e UNIVERSITY OF CAMBRIDGE   (United Kingdom)

^f KING S COLLEGE HOSPITAL   (United Kingdom)

^g Institute of Neuroscience   (United Kingdom)

Author keywords

Clinical decision rule; Diagnostic; Echocardiography; General practice; Heart failure; Natriuretic peptide.

Indexed keywords

AMINO TERMINAL PRO BRAIN NATRIURETIC PEPTIDE; ANGIOTENSIN RECEPTOR ANTAGONIST; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; BIOLOGICAL MARKER; BRAIN NATRIURETIC PEPTIDE; PEPTIDE FRAGMENT; PRO-BRAIN NATRIURETIC PEPTIDE (1-76);

AGED; ANKLE EDEMA; ARTICLE; ASSAY; CARDIOLOGIST; CLINICAL DECISION MAKING; DIAGNOSTIC ACCURACY; DYSPNEA; ECHOCARDIOGRAPHY; ENGLAND; FEMALE; GENERAL PRACTICE; HEART FAILURE; HUMAN; LETHARGY; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; OUTCOME ASSESSMENT; PRIMARY MEDICAL CARE; PROSPECTIVE STUDY; SENSITIVITY AND SPECIFICITY; TASK PERFORMANCE; VALIDATION STUDY; ADULT; BLOOD; CLINICAL PROTOCOL; ELECTROCARDIOGRAPHY; FATIGUE; METHODOLOGY; MIDDLE AGED; PATIENT REFERRAL; PRIMARY HEALTH CARE; RECEIVER OPERATING CHARACTERISTIC;

ADULT; AGED; BIOMARKERS; CLINICAL PROTOCOLS; DYSPNEA; ELECTROCARDIOGRAPHY; ENGLAND; FATIGUE; FEMALE; HEART FAILURE; HUMANS; MALE; MIDDLE AGED; NATRIURETIC PEPTIDE, BRAIN; PEPTIDE FRAGMENTS; PRIMARY HEALTH CARE; PROSPECTIVE STUDIES; REFERRAL AND CONSULTATION; RESEARCH DESIGN; ROC CURVE;

EID: 85016054357     PISSN: 09601643     EISSN: 14785242     Source Type: Journal    
DOI: 10.3399/bjgp16X688393     Document Type: Article

References (34)

1. Zapka JG, Moran WP, Goodlin SJ, et al. Advanced heart failure: Prognosis, uncertainty and decision making. Congest Heart Fail 2007; 13(5): 268-274.
2. Stewart S, Jenkins A, Buchan S, et al. The current cost of heart failure to the National Health Service in the UK. Eur J Heart Fail 2002; 4(3): 361-371.
3. Taylor CJ, Roalfe AK, Iles R, et al. Ten-year prognosis of heart failure in the community: Follow-up data from the Echocardiographic Heart of England Screening (ECHOES) study. Eur J Heart Fail 2012; 14(2): 176-184.
4. National Institute for Health and Care Excellence. Chronic heart failure in adults: Management. CG108. London: NICE, 2010. https://www.nice.org.uk/guidance/cg108?unlid=715333182201621351854 (accessed 15 Nov 2016).
5. Rutten FH, Cramer MJ, Grobbee DE, et al. Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease. Eur Heart J 2005; 26(18): 1887-1894.
6. Bertens LC, Reitsma JB, van Mourik Y, et al. COPD detected with screening: Impact on patient management and prognosis. Eur Respir J 2014; 44(6): 1571-1578.
7. Barnett K, Mercer SW, Norbury M, et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: A crosssectional study. Lancet 2012; 380(9836): 37-43.
8. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2016; DOI: Http://eurheartj.oxfordjournals.org/lookup/doi/10.1093/eurheartj/ehw128. Epub 2016 May 20.
9. Le Jemtel TH, Padeletti M, Jelic S. Diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. J Am Coll Cardiol 2007; 49(2): 171-180.
10. Fuat A, Hungin AP, Murphy JJ. Barriers to accurate diagnosis and effective management of heart failure in primary care: Qualitative study. BMJ 2003; 326(7382): 196.
11. van Ierland Y, Elshout G, Berger MY, et al. Translation of clinical prediction rules for febrile children to primary care practice: An observational cohort study. Br J Gen Pract 2015; DOI: Https://doi.org/10.3399/bjgp15X684373.
12. Stiell I, Wells G, Laupacis A, et al. Multicentre trial to introduce the Ottawa ankle rules for use of radiography in acute ankle injuries. Multicentre Ankle Rule Study Group. BMJ 1995; 311(7005): 594-597.
13. Lip GY. Using the CHADS2 and CHA2DS2-VASc scores for stroke risk prediction as well as the identification of stroke outcomes and cardiac complications in patients with and without atrial fibrillation. Cerebrovasc Dis 2013; 36(4): 281-282.
14. Mant J, Doust J, Roalfe A, et al. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technol Assess 2009; 13(32): 1-207.
15. Zaphiriou A, Robb S, Murray-Thomas T, et al. The diagnostic accuracy of plasma BNP and NTproBNP in patients referred from primary care with suspected heart failure: Results of the UK natriuretic peptide study. Eur J Heart Fail 2005; 7(4): 537-541.
16. Hobbs FDR, Davis RC, Roalfe AK, et al. Reliability of N-terminal pro-brain natriuretic peptide assay in diagnosis of heart failure: Cohort study in representative and high risk community populations. BMJ 2002; 324(7352): 1498-1503.
17. 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(9088): 1349-1353.
18. Cost B. Heart failure in the elderly. PhD thesis. Erasmus University Rotterdam, 2000.
19. 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(10): 1793-1800.
20. Booth RA, Hill SA, Don-Wauchope A, et al. Performance of BNP and NT-proBNP for diagnosis of heart failure in primary care patients: A systematic review. Heart Fail Rev 2014; 19(4): 439-451.
21. Tait L, Roalfe AK, Mant J, et al. The REFER (REFer for EchocaRdiogram) protocol: A prospective validation of a clinical decision rule, NT-proBNP, or their combination, in the diagnosis of heart failure in primary care. Rational and design. BMC Cardiovasc Disord 2012; 12: 97.
22. Noble M, McLennan D, Wilkinson K, et al. The English Indices of Deprivation 2007. London: Department for Communities and Local Government, 2008.
23. NHS England Primary Care Transformation Programme. Transforming primary care in London. NHS England, 2013.
24. Taylor CJ, Hobbs FDR. Heart failure therapy in patients with coronary artery disease. Curr Opin Pharmacol 2013; 13(2): 205-209.
25. Hobbs FDR, Bankhead C, Mukhtar T, et al. Clinical workload in UK primary care: A retrospective analysis of 100 million consultations in England, 2007-14. Lancet 2016; 387(10035): 2323-2330.
26. Ho JE, Gona P, Pencina MJ, et al. Discriminating clinical features of heart failure with preserved vs. reduced ejection fraction in the community. Eur Heart J 2012; 33(14): 1734-1741.
27. Bertens LC, van Mourik Y, Rutten FH, et al. Staged decision making was an attractive alternative to a plenary approach in panel diagnosis as reference standard. J Clin Epidemiol 2015; 68(4): 418-425.
28. Adams ST, Leveson SH. Clinical prediction rules. BMJ 2012; 344: D8312.
29. Lucassen W, Geersing GJ, Erkens PM, et al. Clinical decision rules for excluding pulmonary embolism: A meta-analysis. Ann Intern Med 2011; 155(7): 448-460.
30. Le Marechal F, Martinot A, Duhamel A, et al. Streptococcal pharyngitis in children: A meta-analysis of clinical decision rules and their clinical variables. BMJ Open 2013; 9(3): E001482.
31. Balla J, Heneghan C, Thompson M, Balla M. Clinical decision making in a highrisk primary care environment: A qualitative study in the UK. BMJ Open 2012; 2: E000414.
32. Owan TE, Hodge DO, Herges RM, et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 2006; 355(3): 251-259.
33. Hobbs FD, Davis RC, Roalfe AK, et al. Reliability of N-terminal proBNP assay in diagnosis of left ventricular systolic dysfunction within representative and high risk populations. Heart 2004; 90(8): 866-870.
34. Taylor CJ, Roalfe AK, Iles R, et al. The potential role of NT-proBNP in screening for and predicting prognosis in heart failure: A survival analysis. BMJ Open 2014; 4(4): E004675.