Clinical Chemistry
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Clinical Chemistry 52: 1602-1603, 2006; 10.1373/clinchem.2006.069369
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(Clinical Chemistry. 2006;52:1602-1603.)
© 2006 American Association for Clinical Chemistry, Inc.


Letters to the Editor

Reference Change Values for Brain Natriuretic Peptides Revisited

M. Rebecca Fokkema1,a, Zuzana Herrmann2, Frits A.J. Muskiet1 and Joachim Moecks2

1 Pathology and Laboratory Medicine, University Medical Hospital Groningen, Groningen, The Netherlands
2 Roche Diagnostics GmbH, Mannheim, Germany

aAddress correspondence to this author at: University Medical Hospital Groningen, Department of Pathology and Laboratory Medicine, CMC-V, Room Y1.165, PO Box 30.001, 9700 RB Groningen, The Netherlands. E-mail m.r.fokkema@lc.umcg.nl.

The first 20% of the full text of this article appears below.


To the Editor:

In 2004, Bruins et al. (1) published a report in which they used the approach of Harris and Yasaka (2) to determine the reference change values (RCVs) for B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP). Week-to-week RCVs were 113% and 98%, respectively, meaning that concentrations had to increase or decrease by these percentages to be assessed as different from the previous measurement, with a 5% error probability for falsely assessing a change as significant. The clinical relevance of these large RCVs led to a lively discussion (3)(4)(5)(6) regarding RCV methodology. In response, we have developed some ideas for improving RCV calculation by addressing the skewness of the distribution.

The previous study used for the new approach investigated 43 patients with stable chronic heart failure by within-day, day-to-day, and week-to-week measurements of BNP (Abbott Diagnostics) and NT-proBNP (Elecsys® proBNP, Roche Diagnostics GmbH). For details, see the original report (1).

Natriuretic peptides are . . . [Full Text of this Article]




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