What are the common issues in the studies evaluating the diagnostic accuracy of NT-proBNP and/or BNP at diagnosing heart failure in the general suspected heart failure population?
Common issues in in the studies were risk of bias due to unclear participant selection methods, high (or not reported) loss to follow up, extended length of time between BNP test and echo, and poor reporting of accuracy results. Some studies were also downgraded for indirectness of the population, where the prevalence of heart failure was much higher than would be expected in the target population indicating the populations may have been from different settings with a potential variation in the distribution of symptoms and severity.