NICE Guideline for Management of Chronic Heart Failure in Adults
Authors: Jonathan Mant, Abdallah Al-Mohammad, Sharon Swain
Journal: Annals of Internal Medicine (2012)

Letters3 January 2012NICE Guideline for Management of Chronic Heart Failure in AdultsJonathan Mant, MD, Abdallah Al-Mohammad, MD, and Sharon Swain, BA (Hons)Jonathan Mant, MDFrom University of Cambridge, Cambridge CB2 0SR, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, United Kingdom; and Royal College of Physicians of London, London NW1 4LE, United Kingdom.Search for more papers by this author, Abdallah Al-Mohammad, MDFrom University of Cambridge, Cambridge CB2 0SR, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, United Kingdom; and Royal College of Physicians of London, London NW1 4LE, United Kingdom.Search for more papers by this author, and Sharon Swain, BA (Hons)From University of Cambridge, Cambridge CB2 0SR, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, United Kingdom; and Royal College of Physicians of London, London NW1 4LE, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-1-201201030-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We are grateful to Dr. Finucane for his comments and agree with him regarding the central role of history and physical examination in the evaluation of heart failure (and other complex clinical syndromes). It is through history and examination that a clinician will suspect heart failure as a diagnosis and consider potential aggravating factors and alternative diagnoses (1). However, the limitations of symptoms and signs alone need to be acknowledged.A systematic review of the evidence found that individual symptoms and signs are of limited use in the diagnosis of heart failure (2). Furthermore, diagnoses of heart failure ...References1. National Clinical Guideline Centre. Chronic Heart Failure: Management of Chronic Heart Failure in Adults in Primary and Secondary Care. Full version of NICE Clinical Guideline 108. London: National Clinical Guideline Centre; 2010. Google Scholar2. Mant J, Doust J, Roalfe A, Barton P, Cowie MR, Glasziou P, et al. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technol Assess. 2009;13:1-207, iii. [PMID: 19586584] CrossrefMedlineGoogle Scholar3. Hobbs FD, Davis RC, Roalfe AK, Hare R, Davies MK, Kenkre JE. Reliability of N-terminal pro-brain natriuretic peptide assay in diagnosis of heart failure: cohort study in representative and high risk community populations. BMJ. 2002;324:1498. [PMID: 12077039] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jonathan Mant, MD; Abdallah Al-Mohammad, MD; Sharon Swain, BA (Hons)Affiliations: From University of Cambridge, Cambridge CB2 0SR, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, United Kingdom; and Royal College of Physicians of London, London NW1 4LE, United Kingdom.Disclosures: Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0261. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Chronic Heart Failure in Adults: Synopsis of the National Institute for Health and Clinical Excellence Guideline Jonathan Mant , Abdallah Al-Mohammad , Sharon Swain , and Philippe Laramée , for the Guideline Development Group* NICE Guideline for Management of Chronic Heart Failure in Adults Thomas E. Finucane NICE Guideline for Management of Chronic Heart Failure in Adults David L. Simel Metrics 3 January 2012Volume 156, Issue 1_Part_1Page: 70KeywordsAlgorithmsDisclosureEchocardiographyEvidence based medicineHeart diseasesHeart failureMyocardial infarctionNatriuretic peptidesSigns and symptomsSystematic reviews ePublished: 3 January 2012 Issue Published: 3 January 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...