What is the most appropriate NT-proBNP threshold for identifying patients who should be referred for echocardiography and specialist clinical assessment?
The committee considered the clinical evidence with the aim to determine which NT-proBNP threshold was most appropriate for identifying patients who should be referred for echocardiography and specialist clinical assessment, focussing on sensitivity of the test. The pooled sensitivity at a threshold of 125pg/mL was 96% (72%-100%), at a threshold of 280pg/mL was 89% (41%-89%), and at a threshold of 400pg/mL was 79% (42%-96%). The committee noted that the pooled evidence was very low quality due to inconsistency between the included studies and consequently very wide confidence intervals around the meta-analysed data. At a threshold of 400pg/mL, the committee also noted that specificity was likely to be much higher (82% (52%-95%)) compared with specificity at the which would reduce any clinical harms of over-referral.