Performance characteristics of the clinical decision rule and NT-proBNP
| AUROC | Sensitivity 95% CI | Specificity 95% CI | PPV 95% CI | NPV 95% CI | |
|---|---|---|---|---|---|
| Derivation dataset15 | |||||
| CDR (lower cutoffs)a | 0.74 (0.70 to 0.79) | 90.2 (82.7 to 95.2) | 58.2 (50.9 to 65.2) | 52.9 (42.6 to 64.8) | 91.9 (75.8 to 100) |
| CDR (upper cutoffs)b | 0.75 (0.70 to 0.80) | 87.3 (79.2 to 93.0) | 62.2 (55.5 to 69.1) | 54.6 (46.6 to 62.4) | 90.4 (84.1 to 94.8) |
| REFER | |||||
| CDR (MICE variables) | 0.54 (0.48 to 0.60) | 44.2 (34.5 to 54.3) | 64.0 (56.9 to 70.6) | 39.0 (30.1 to 48.4) | 68.8 (61.6 to 75.4) |
| CDR+NT-proBNP (lower cut-offsa) | 0.68 (0.64 to 0.72) | 90.4 (83.0 to 95.3) | 45.5 (38.5 to 52.7) | 46.3 (39.3 to 53.4) | 90.1 (82.5 to 95.1) |
| CDR+NT-proBNP (upper cutoffsb) | 0.71 (0.66 to 0.76) | 78.8 (69.7 to 86.2) | 63.5 (56.4 to 70.2) | 52.9 (44.7 to 61.0) | 85.2 (78.5 to 90.5) |
| NTproBNP≥125pg/ml alone | 0.72 (0.67 to 0.76) | 94.2 (87.9 to 97.9) | 49.0 (41.9 to 56.1) | 49.0 (41.9 to 56.1) | 94.2 (87.9 to 97.9) |
| NT-proBNP≥400pg/ ml alone | 0.84 (0.80 to 0.89) | 76.9 (67.6 to 84.6) | 91.5 (86.7 to 95.0) | 82.5 (73.4 to 89.4) | 88.4 (83.2 to 92.4) |
↵a Post-test probability of 20%.
↵b Post-test probability of 30%. AUROC = area under the receiver operating curve. CDR = clinical decision rule. MICE = Male, Infarction, Crepitations, Edema. NPV = negative predictive factor. PPV = positive predictive factor. NT-proBNP = N-Terminal pro-B type natriuretic peptide levels.