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B type natriuretic peptide testing was more cost effective than conventional diagnosis in patients with acute dyspnoea

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 Q In patients who presented to the emergency department (ED) with acute dyspnoea, is a diagnostic strategy based on rapid measurement of B type natriuretic peptide (BNP) concentrations more cost effective than conventional diagnosis?

Clinical impact ratings Respirology ★★★★★★☆ Internal medicine ★★★★★★☆ Emergency medicine ★★★★★☆☆ Cardiology ★★★★★☆☆


Embedded ImageDesign:

cost effectiveness analysis of a randomised {allocation concealed*}†, blinded (outcome assessors*), controlled trial (B Type Natriuretic Peptide for Acute Shortness of Breath Evaluation [BASEL] study) with follow up of 180 days.

Embedded ImageSetting:

ED in a university hospital in Basel, Switzerland.

Embedded ImagePatients:

452 patients (mean age 71 y, 58% men) who presented to the ED with acute dyspnoea. Exclusion criteria included trauma, severe renal disease, and cardiogenic shock.

Embedded ImageIntervention:

diagnostic strategy with rapid measurement of BNP concentrations (n = 225) or conventional diagnostic strategy (n = 227).

Embedded ImageOutcomes:

included all cause …

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  • For correspondence: Dr C Mueller, University of Basel, Basel, Switzerland. chmueller{at}

  • Sources of funding: Swiss National Science Foundation; Swiss Heart Foundation; Novartis Foundation; Krokus Foundation; University of Basel.

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