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Dear Richard: I believe your cynicism about BNP has some basis. The Biosite BNP test was rolled out about a year ago amid the hoopla over a clinical trial conducted at a VA hospital in San Diego that appeared to demonstrate the impressive discriminatory power of BNP levels in the diagnosis of congestive heart failure. In a subsequent multi-center trial (the "Breathing Not Properly," or "BNP" study, reported in both New England Journal of Medicine and Circulation), the results were less impressive. I quote from the article in Circulation: "In determining the correct diagnosis (CHF versus no CHF), adding BNP to clinical judgment would have enhanced diagnostic accuracy from 74% to 81%." I'm not sure how many echocardiograms this modest enhancement of diagnostic accuracy would save. I'm still waiting for the Evidence-Based Medicine gurus to weigh in on this. Our emergency department physicians also have inquired about BNP, and we plan to add the pro-BNP method to our Elecsys platform when the test receives FDA approval, which is anticipated within a month or so. I don't recall them mentioning any savings with regard to the number of echocardiograms, but it is my understanding that they will use the BNP result to decide whether to initiate Nesiritide therapy. Kind regards, Roger Roger L. Bertholf, Ph.D. Associate Professor of Pathology Director of Clinical Chemistry & Toxicology University of Florida Health Science Center/Jacksonville > -----Original Message----- > From: Mainwaring-Burton Richard (RGZ) > [mailto:[log in to unmask]] > Sent: Friday, November 01, 2002 5:27 AM > To: [log in to unmask] > Subject: BNP > > > We are being asked to look into measuring BNP as an index of > heart failure with a view to cutting costs of unnecessary > echocardiograms as part of a fairly big study. As ever, the > laboratory are somewhat late in the involvement stakes. I am > currently aware of the Triage "POCT" device which measures > whole blood BNP and the Roche Elecsys method for serum > pro-BNP. Does anyone know of (or better still use) any other > manufacturer/method which runs on any other platform please ? > > I wonder whether the savings invoked in the echo suite will > be diverted to the laboratory This brings to mind troponins > and empty beds and arouses my cynicism* > > With best wishes > Richard > Biochemistry Department > Queen Mary's Hospital > Sidcup, Kent > DA14 6LT > > * cynicism is the product of disappointment > > ------ACB discussion List Information-------- > This is an open discussion list for the academic and clinical > community working in clinical biochemistry. Please note, > archived messages are public and can be viewed via the > internet. Views expressed are those of the individual and > they are responsible for all message content. > > ACB Web Site > http://www.acb.org.uk > List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html > List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ > ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/