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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 ★★★★★☆☆
METHODS
Design:
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.
Setting:
ED in a university hospital in Basel, Switzerland.
Patients:
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.
Intervention:
diagnostic strategy with rapid measurement of BNP concentrations (n = 225) or conventional diagnostic strategy (n = 227).
Outcomes:
included all cause …
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