Evidence
How we made the decision
How we made the decision
We check our guidelines regularly to ensure they remain up to date. We based the decision on surveillance after the publication of NICE's guideline on acute heart failure (NICE guideline CG187) in 2014.
For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.
Evidence
We found 68 studies in a search for systematic reviews and randomised controlled trials published between 28 January 2014 and 29 June 2017. We also included 2 relevant studies from a total of 29 identified by members of the guideline committee who originally worked on this guideline.
From all sources, we considered 70 studies to be relevant to the guideline.
We also checked for relevant ongoing research, which will be evaluated again at the next surveillance review of the guideline.
See appendix A: summary of evidence from surveillance for details of all evidence considered, and references.
Views of topic experts
We considered the views of topic experts, including those who helped to develop the guideline.
Views of stakeholders
Stakeholders commented on the decision not to update the guideline. Overall, 5 stakeholders commented. See appendix B for stakeholders' comments and our responses.
Two stakeholders agreed with the decision to not update the guideline. Three stakeholders disagreed with the decision to not update the guideline.
The issues raised by stakeholders were:
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That the guideline should address the role of procalcitonin testing to guide antibiotic prescribing in people presenting with acute heart failure and suspected pneumonia. NICE's guideline on diagnosis and assessment of pneumonia in adults recommended testing of C‑reactive protein instead of procalcitonin to help guide antibiotic prescribing in situations in which a diagnosis of pneumonia is uncertain. The stakeholder highlighted an ongoing study of procalcitonin testing in people with acute heart failure (IMPACT-EU). We plan to check the publication status of this study regularly, and evaluate the impact of the results on current recommendations as quickly as possible.
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That the guideline should address the role of NT‑proBNP in discharge planning. On reviewing the evidence provided by the stakeholder, there was no anticipated impact on the guideline because although evidence suggests that higher NT‑proBNP levels at discharge are associated with worse outcomes, there was no evidence to support the use of NT‑proBNP levels to guide treatment decisions.
See ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual, for more details on our consultation processes.
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