Thomas E. Finucane, MD
Finucane TE. NICE Guideline for Management of Chronic Heart Failure in Adults. Ann Intern Med. 2012;156:69. doi: 10.7326/0003-4819-156-1-201201030-00023
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Published: Ann Intern Med. 2012;156(1_Part_1):69.
TO THE EDITOR:
The National Institute for Health and Clinical Excellence (NICE) guidelines presented by Mant and colleagues (1) for management of chronic heart failure in adults describe the problem as “a complex clinical syndrome.” The diagnostic algorithm begins with a detailed history and a clinical examination.
However, the authors then say, “Clinical signs and symptoms are of limited use in the diagnosis of heart failure” (1). This must surely be a misprint.
The next node down in the algorithm is either “Specialist assessment and Doppler echocardiography” or “Measure serum natriuretic peptide.” Are these the real tools to diagnose of heart failure? It seems to be another example of gizmo idolatry (2).
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