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.