The REFER (REFer for EchocaRdiogram) study: a prospective validation of a clinical decision rule, NT-proBNP, or their combination, in the diagnosis of heart failure in primary care

Diagnosis of heart failure (HF) in primary care is difficult, with high rates of misdiagnosis. Access to objective testing such as echocardiography is variable, often delayed and GPs have difficulty deciding who to refer for further tests.

We aim to prospectively validate a Clinical Decision Rule (CDR), a natriuretic peptide assay (NT-proBNP) or their combination, to diagnose suspected HF in primary care to determine if the CDR or assay can be used in routine clinical practice to establish referral on for echocardiography in patients presenting with symptoms suggestive of HF, and to quantify the most reliable cut off level of the assay in this group of symptomatic presenting patients.

We are recruiting patients from 20 urban/rural general practices in Birmingham, aged 55+ presenting with new onset symptoms of breathlessness, lethargy, or ankle oedema. All patients undergo structured clinical assessment, including echocardiogram and NT proBNP.

For further details, please contact Dr Lynda Tait – Study Manager