What evidence was found for the diagnostic accuracy of BNP for diagnosing heart failure in a population with CKD and respiratory distress?
One diagnostic accuracy study was included that evaluated the diagnostic accuracy of BNP at diagnosing heart failure in a population with CKD and respiratory distress. The reference standard used in the study was unclear and may not have fully matched the protocol, but the study was included in the review in the absence of any direct evidence. The evidence was graded very low quality due to very high risk of bias, serious indirectness and serious imprecision. Risk of bias was very high due to it being unclear how participants were selected, unclear whether the reference standard was applied blind to BNP results, and unclear whether any patients were lost to follow up or missing from the analysis. Only the results of the subgroup of patients with CKD stages G3 to G4 were reported in accordance with the protocol.