The use of natriuretic peptides like B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) has increased during the last decade and so has the medical evidence of their utility. This article highlights natriuretic peptide synthesis and release. Based on essential clinical trials the article gives medical...

Chris Price and Andrew St John have followed their book Point-of-Care Testing for Managers and Policymakers with another look at the subject from strategic vision to change management and implementation in Point-of-Care Testing: Making Innovation Work for Patient-Centered Care. In their latest book the authors give...

Clinical biomarker studies seldom follow recommendations for the evaluation of new biomarkers. Therefore it is important to assess any published clinical value of a biomarker or comparison of two or more biomarkers and see whether or not the published study applies to your situation. If the published study does not...

A new parameter called critical reference change value (CrRCV) to be applied for the interpretation of serial measurements of cardiac troponin I (cTnI) is introduced. To illustrate the practical utility of CrRCV a set of clinical examples based on two consecutive cTnI results are presented. Thus three cTnI changes...

Various guidelines and recommendations are available for the use of natriuretic peptides in the diagnosis of heart failure. As it is known that old age may lead to higher natriuretic peptide values in the absence of heart failure, it is relevant to decide whether to use age-dependent reference intervals for clinical...

Emergency departments (ED) are challenged by increasing patient visits, overcrowding and prolonged length of stay (LOS). The cause of these problems is multifactorial. Delays in the laboratory are often perceived as contributing to delays in care and increased LOS. Implementation of selected point-of-care tests in...

ROC curves are frequently used to show in a graphical way the connection/trade-off between clinical sensitivity and specificity for every possible cut-off for a test or a combination of tests. In addition the area under the ROC curve gives an idea about the benefit of using the test(s) in question.  ROC curves are...

PURPOSE – The purpose of this article is to discuss lean as a learning system in a hospital ward. DESIGN/METHODOLOGY/APPROACH – Discusses lean as a learning system in a hospital ward. FINDINGS – The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards’ context,...

Some of the frequently asked questions are: Should we use BE (base excess) or SID (strong ion difference) as a measure of a metabolic acid-base disturbance?  Is there any difference between BB (buffer base) and SID? Should we use SBE (standard base excess), i.e. BE referring to the expanded extracellular fluid or...

The following is a copy of an article from Evidence-Based Practice, 2007; 10(12):1-2. Venous thromboembolism refers to a spectrum of disease that includes both pulmonary embolus and deep-venous thrombosis (DVT). More than 250,000 people in the United States are diagnosed annually with venous thromboembolic disease;...