The authors do not have a reference test for heart failure. They
choose not to use echocardiography both because it is imperfect, not a
'gold standard', and because it is not freely available in primary care.
For their study, instead of a reference test, they use a panel of two
cardiologists, a pulmonologist and a GP. This panel then decides on the
diagnosis for each patient in the study using the variables measured as
part of the study (apart from natriuretic peptide). I am concerned that
this introduces a circularity into the study so that, in effect, they are
merely reporting on what variables this panel believes constitute a
diagnosis of heart failure. This could have been achieved without
measuring any of the variables; just interviewing the panel.
Rapid Response:
Reference test for heart failure
The authors do not have a reference test for heart failure. They
choose not to use echocardiography both because it is imperfect, not a
'gold standard', and because it is not freely available in primary care.
For their study, instead of a reference test, they use a panel of two
cardiologists, a pulmonologist and a GP. This panel then decides on the
diagnosis for each patient in the study using the variables measured as
part of the study (apart from natriuretic peptide). I am concerned that
this introduces a circularity into the study so that, in effect, they are
merely reporting on what variables this panel believes constitute a
diagnosis of heart failure. This could have been achieved without
measuring any of the variables; just interviewing the panel.
Competing interests:
None declared
Competing interests: No competing interests