6/29/23, 1:44 AM Pivetta Pathway Feedback Search Clinical Topics Home Studies Pivetta Pivetta Disease Heart failure Trial question What is the role of lung ultrasound integrated with clinical assessment in patients with acute decompensated HF in the emergency department? Study design Multi-center Open label RCT Population Characteristics of study participants 47.0% female N = 518 53.0% male 518 patients (241 female, 277 male) Inclusion criteria: adult patients who presented to the emergency department with acute dyspnea Key exclusion criteria: mechanical ventilation with positive pressure, either invasively or non invasively, at the time of first evaluation, or presentation with acute dyspnea in the context of trauma Interventions N=258 LUS (lung ultrasound with clinical assessment) N=260 CXR/NT-proBNP (chest radiography and level of N-terminal pro-B-type natriuretic peptide with clinical evaluation) https://web.pathway.md/studies/recDjgxNZEyHuHKGz 1/2 6/29/23, 1:45 AM Pivetta Pathway Primary outcome Diagnostic accuracy, area under receiver operating characteristic curve 94.5 % 94.5 87.2 70.9 % 47.3 % Significant increase 23.6 % NNH = 14 0.0 % LUS CXR/NT-proBNP Significant increase in diagnostic accuracy, area under the receiver operating characteristic curve (94.5% vs. 87.2%; AD 7.3%, 95% CI 1.74 to 12.86) Secondary outcomes Significant decrease in median time needed to formulate the diagnostic hypothesis (5 min vs. 104.5 min; AD -99.5 min, 95% CI -175.23 to -23.77) Safety outcomes No significant difference in death in the hospital. Conclusion In adult patients who presented to the emergency department with acute dyspnea, LUS was superior to CXR/NT-proBNP with respect to diagnostic accuracy, area under the receiver operating characteristic curve. Reference Emanuele Pivetta, Alberto Goffi, Peiman Nazerian et al. Lung ultrasound integrated with clinical assessment for the diagnosis of acute decompensated heart failure in the emergency department: a randomized controlled trial. Eur J Heart Fail. 2019 Jun;21(6):754-766. Open reference URL https://web.pathway.md/studies/recDjgxNZEyHuHKGz 2/2