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Economics
B type natriuretic peptide testing was more cost effective than conventional diagnosis in patients with acute dyspnoea

https://doi.org/10.1136/ebm.12.1.28

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    Mueller C, Laule-Kilian K, Schindler C, et al. Cost-effectiveness of B-type natriuretic peptide testing in patients with acute dyspnea. Arch Intern Med 2006;166:1081–7.
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 Q In patients who presented to the emergency department (ED) with acute dyspnoea, is a diagnostic strategy based on rapid measurement of B type natriuretic peptide (BNP) concentrations more cost effective than conventional diagnosis?

    Clinical impact ratings Respirology ★★★★★★☆ Internal medicine ★★★★★★☆ Emergency medicine ★★★★★☆☆ Cardiology ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    cost effectiveness analysis of a randomised {allocation concealed*}†, blinded (outcome assessors*), controlled trial (B Type Natriuretic Peptide for Acute Shortness of Breath Evaluation [BASEL] study) with follow up of 180 days.

    Embedded ImageSetting:

    ED in a university hospital in Basel, Switzerland.

    Embedded ImagePatients:

    452 patients (mean age 71 y, 58% men) who presented to the ED with acute dyspnoea. Exclusion criteria included trauma, severe renal disease, and cardiogenic shock.

    Embedded ImageIntervention:

    diagnostic strategy with rapid measurement of BNP concentrations (n = 225) or conventional diagnostic strategy (n = 227).

    Embedded ImageOutcomes:

    included all cause …

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    Footnotes

    • For correspondence: Dr C Mueller, University of Basel, Basel, Switzerland. chmueller{at}uhbs.ch

    • Sources of funding: Swiss National Science Foundation; Swiss Heart Foundation; Novartis Foundation; Krokus Foundation; University of Basel.

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