Table 41Strength of evidence for studies evaluating the benefit of BNP and NT-proBNP-guided therapy compared to usual care for HF

DesignRisk of Bias*ConsistencyDirectnessPrecisionEffect Size, RR (95% CI)Strength of Evidence
RCTLowInconsistent (5 studies with no effect and 2 studies with a lower RR)DirectImprecise (Unable to assess if the studies were adequately powered and the overall event rates were variable because of length of followupBeck daSilva167 2005: 0.48 (0.05,4.85)
Berger168 2010: 0.56 (0.35,0.89)
PRIMA169 2001: 0.79 (0.57,1.10)
STARS-BNP173 2011: 0.64 (0.26,1.58)
UPSTEP175 2007: 0.96 (0.61,1.50)
SIGNAL-HF171 2010: 0.98 (0.36,2.72)
TIME-CHF174 2009: 0.65 (0.52,0.81)
The strength of evidence was rated as Low.
BNP/NT-proBNP guided therapy, when compared with usual care, reduced all-cause mortality.
Future research is likely to change the magnitude and direction of the effects for the outcome of all-cause mortality
*

Modified Jadad scale

Abbreviations: CI = confidence interval; RCT = randomized controlled trial; RR = relative risk

From: Results

Cover of Use of Natriuretic Peptide Measurement in the Management of Heart Failure
Use of Natriuretic Peptide Measurement in the Management of Heart Failure [Internet].
Comparative Effectiveness Reviews, No. 126.
Balion C, Don-Wauchope A, Hill S, et al.

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