title: Evaluation of natriuretic peptide recommendations in heart failure clinical practice guidelines.
abstract: BACKGROUND
  The B-type naturietic peptides (NPs) are associated with heart failure (HF). This investigation was designed to evaluate heart failure clinical practice guideline (CPG) recommendations for the use of NPs.
  
  
  METHODS
  A search for English language CPGs for HF published since 2011 was conducted. A search for systematic reviews (SR) and meta-analysis for NPs in HF was conducted for the years 2004-2012. Each HF CPG was evaluated by two independent reviewers. Key recommendations for NPs and the supporting references were abstracted. The key findings from each SR were abstracted.
  
  
  RESULTS
  Seven English language HF CPGs were found, all of which made recommendations for the use of NPs in diagnosis. Four made recommendations for prognosis and three for management. The European CPG scored highly for rigor of development with the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) while the others did not. North American CPGs made stronger recommendations citing higher grades of evidence for the use of NPs in HF than the European or Australian CPGs. The CPGs mostly cited primary studies 47/66 to support the recommendations. From twelve available SRs, five were cited by CPGs. One CPG conducted a SR.
  
  
  CONCLUSIONS
  The SR evidence to support NP use in CPGs has not been well cited in the CPGs and the recommendations are only partially supported by the SR evidence. Future CPGs should consider improving the methodology used to evaluate laboratory tests.
authors: Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, L8S 4K1 ON, Canada.
authors: Janet E
authors: JE
authors: Simons
authors: Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, L8S 4K1 ON, Canada; Hamilton Regional Laboratory Medicine Program, 50 Charlton Avenue East, Hamilton, L8N 4A6 ON, Canada. Electronic address: donwauc@mcmaster.ca.
authors: Andrew C
authors: AC
authors: Don-Wauchope
mesh_terms: D019208:Brain-Derived Neurotrophic Factor / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic
chemical_list: D019208:Brain-Derived Neurotrophic Factor
keywords: AGREE II; Appraisal tools; B-type natriuretic peptides; Clinical practice guidelines; Heart failure; Systematic review