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.
Battaglia M, Bachmann LM, Egger M. Diagnostic Accuracy of Natriuretic Peptides for Heart Failure. Arch Intern Med. 2005;165(6):704. doi:10.1001/archinte.165.6.704