Table 4

Choice and implications of further diagnostic steps—influencing factors

NT-proBNP	Price as a barrier, demand for reimbursement Utility (not) known Interpretation problems
NT-proBNP and ECG	Perception of positive and negative predictive value Integrated in workflow Uncertainty about indication
Cardiologist and cardiac US	Perception of positive and negative predictive value GPs’ knowledge about cardiac US Quality of cardiologist report Confirmation of HF diagnosis by cardiologist Remaining diagnostic uncertainty after cardiologist appointment Clinical assessment of HF by cardiologist and mutual trust Importance of cardiorenal consultation HFpEF as a new difficult entity

GP, general practitioner; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; NT-proBNP, N-terminal pro B-type natriuretic peptide; US, ultrasound.