A search was also conducted for diagnostic RCTs comparing outcomes in people tested with BNP versus NT-proBNP. The search dates were limited to studies published from 2009 onwards, as this review was an update of a review within CG108 (the 2010 CHF guideline). The 2010 update included Mant 2009212 . Mant Chronic Heart Failure Diagnosing heart failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 conducted a meta-analysis of studies investigating the accuracy of BNP and/or NT-proBNP in diagnosing heart failure in a range of settings and populations, and using a range of reference standards. Only those studies from Mant 2009212 that matched the current protocol were included in this review. which used echocardiography as the reference standard, these papers have been excluded within the current update as the committee agreed that echocardiography was not an appropriate reference standard for the diagnosis of heart failure. In total, 8 diagnostic accuracy studies were included in the review79,173,243,245,330, 359,379,380 these are summarised in Table 11 below. Evidence from these studies is summarised in the clinical evidence summary. See also the study selection flow chart in Appendix C, sensitivity/specificity forest plots in Appendix E, study evidence tables in Appendix F and excluded studies list in Appendix I. No diagnostic RCTs meeting the protocol were identified. Table 11: Summary of studies included in the review Study Population Target condition Index test Reference standard Comments People with suspected heart failure Age range: 24- Gender (M:F): UK Heart failure BNP ESC criteria, assessed by panel of three cardiologists People with suspected heart failure Age (mean Gender (M:F): The Netherlands Heart failure BNP NT-proBNP ESC criteria and Heart Failure Society of America assessed by panel of cardiologist, pulmonologist and a GP. Full diagnostic accuracy results not reported. 