[Should B-type natriuretic peptide (BNP) be used in daily practice?]

Each diagnostic test should be systematically evaluated before acceptation for use in daily practice. The principles for validating a diagnostic test are reviewed using B-type natriuretic peptide (BNP) as an example. BNP seems promising to diagnose symptomatic left-sided heart failure in the emergency department, especially when the diagnosis remains uncertain (intermediate clinical probability). However, before its widespread use, its efficacy on clinical outcome measures such as reduction of time to treatment or in-hospital length of stay should be more clearly demonstrated through pragmatic studies.