2006/07/26 by M Rebecca Fokkema, M. Rebecca Fokkema, Zuzana Herrmann +4 · 23 citations
Medicine · Decision Sciences · #Hemodynamic Monitoring and Therapy #Heart Failure Treatment and Management #Reliability and Agreement in Measurement
paper · doi:10.1373/clinchem.2006.069369
In 2004, Bruins et al. (1) published a report in which they used the approach of Harris and Yasaka (2) to determine the reference change values (RCVs) for B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP). Week-to-week RCVs were 113% and 98%, respectively, meaning that concentrations had to increase or decrease by these percentages to be assessed as different from the previous measurement, with a 5% error probability for falsely assessing a change as significant. The clinical relevance of these large RCVs led to a lively discussion (3)(4)(5)(6) regarding RCV methodology. In response, we have developed some ideas for improving RCV calculation by addressing the skewness of the distribution. The previous study used for the new approach investigated 43 patients with stable chronic heart failure by within-day, day-to-day, and week-to-week measurements of BNP (Abbott Diagnostics) and NT-proBNP (Elecsys® proBNP, Roche Diagnostics GmbH). For details, see the original report (1). Natriuretic peptides are secreted in response to increased demand …