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N-terminal pro-B-ty...
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Potgieter, DanielleUniversity of KwaZulu Natal, South Africa
(author)
N-terminal pro-B-type Natriuretic Peptides Prognostic Utility Is Overestimated in Meta-analyses Using Study-specific Optimal Diagnostic Thresholds
- Article/chapterEnglish2015
Publisher, publication year, extent ...
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LIPPINCOTT WILLIAMS and WILKINS,2015
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Numbers
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LIBRIS-ID:oai:DiVA.org:liu-122778
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-122778URI
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https://doi.org/10.1097/ALN.0000000000000728DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies|CLS Behring Biotherapies for Life (Vienna, Austria); Astra Zeneca (Vienna, Austria); Boehringer Ingelheim (Ingelheim, Germany); CLS Behring Biotherapies for Life; Novo Nordisk Pharma GmbH (Vienna, Austria)
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Background:N-terminal fragment B-type natriuretic peptide (NT-proBNP) prognostic utility is commonly determined post hoc by identifying a single optimal discrimination threshold tailored to the individual study population. The authors aimed to determine how using these study-specific post hoc thresholds impacts meta-analysis results. Methods: The authors conducted a systematic review of studies reporting the ability of preoperative NT-proBNP measurements to predict the composite outcome of all-cause mortality and nonfatal myocardial infarction at 30 days after noncardiac surgery. Individual patient-level data NT-proBNP thresholds were determined using two different methodologies. First, a single combined NT-proBNP threshold was determined for the entire cohort of patients, and a meta-analysis conducted using this single threshold. Second, study-specific thresholds were determined for each individual study, with meta-analysis being conducted using these study-specific thresholds. Results: The authors obtained individual patient data from 14 studies (n = 2,196). Using a single NT-proBNP cohort threshold, the odds ratio (OR) associated with an increased NT-proBNP measurement was 3.43 (95% CI, 2.08 to 5.64). Using individual study-specific thresholds, the OR associated with an increased NT-proBNP measurement was 6.45 (95% CI, 3.98 to 10.46). In smaller studies (less than100 patients) a single cohort threshold was associated with an OR of 5.4 (95% CI, 2.27 to 12.84) as compared with an OR of 14.38 (95% CI, 6.08 to 34.01) for study-specific thresholds. Conclusions:Post hoc identification of study-specific prognostic biomarker thresholds artificially maximizes biomarker predictive power, resulting in an amplification or overestimation during meta-analysis of these results. This effect is accentuated in small studies.
Subject headings and genre
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Simmers, DaleUniversity of KwaZulu Natal, South Africa
(author)
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Ryan, LisaGreys Hospital, South Africa
(author)
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Biccard, Bruce M.University of KwaZulu Natal, South Africa
(author)
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Lurati-Buse, Giovanna A.University of Basel Hospital, Switzerland
(author)
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Cardinale, Daniela M.European Institute Oncol, Italy
(author)
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Chong, Carol P. W.Northern Hospital, Australia; University of Melbourne, Australia
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Cnotliwy, MiloslawPomeranian Medical University, Poland
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Farzi, Sylvia I.Medical University of Graz, Austria
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Jankovic, Radmilo J.University of Nis, Serbia
(author)
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Kwang Lim, WenMedical University of Graz, Austria
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Mahla, ElisabethMedical University of Graz, Austria
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Manikandan, RamaswamyStepping Hill Hospital, England
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Oscarsson, AnnaLinköpings universitet,Avdelningen för läkemedelsforskning,Medicinska fakulteten,Region Östergötland, ANOPIVA US(Swepub:liu)annos67
(author)
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Phy, Michael P.Texas Technical University, TX 79430 USA
(author)
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Rajagopalan, SriramUniversity of Aberdeen, Scotland; Aberdeen Royal Infirm, Scotland
(author)
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Van Gaal, William J.University of Melbourne, Australia
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Waliszek, MarekM Pirogow Prov Specialist Hospital, Poland
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Rodseth, Reitze N.University of KwaZulu Natal, South Africa; Cleveland Clin, OH 44106 USA
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University of KwaZulu Natal, South AfricaGreys Hospital, South Africa
(creator_code:org_t)
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In:Anesthesiology: LIPPINCOTT WILLIAMS and WILKINS123:2, s. 264-2710003-30221528-1175
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Potgieter, Danie ...
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Simmers, Dale
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Ryan, Lisa
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Biccard, Bruce M ...
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Lurati-Buse, Gio ...
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Cardinale, Danie ...
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Chong, Carol P. ...
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Cnotliwy, Milosl ...
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Farzi, Sylvia I.
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Jankovic, Radmil ...
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Kwang Lim, Wen
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Mahla, Elisabeth
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Manikandan, Rama ...
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Oscarsson, Anna
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Phy, Michael P.
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Rajagopalan, Sri ...
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Van Gaal, Willia ...
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Waliszek, Marek
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Rodseth, Reitze ...
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Anesthesiology
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Linköping University