Methodology: 4/5
Usefulness: 3/5

Thiruganasambandamoorthy V, et al. Ann Intern Med. 2020 May 19;172(10):648-655.

Methods: Prospective cohort study to evaluate whether adding NT-proBNP to the CSRS improves prediction of 30-day SAEs.

Findings: Adding NT-proBNP provided no additional benefit to the model and would result in 10% of patients being correctly reclassified and 8.7% of patients being incorrectly reclassified in terms of risk.

Limitations: Possible selection bias, study powered to only detect 3% difference in AUC, small number of patients with SAEs in subgroups.

Interpretation: There is no current role for adding NT-proBNP to the ED work-up of syncope; CSRS alone has high predictive performance for 30-day SAEs.

By: Dr.  Simon Wells

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.