BACKGROUND: The value of routine aminoterminal pro type B natriuretic peptide 
(NT-proBNP) measurements in outpatient clinics remains unknown.
OBJECTIVES: We sought to determine the accuracy with which heart failure (HF) 
specialists can predict NT-proBNP levels in HF outpatients based on clinical 
assessment.
METHODS: We prospectively studied 160 consecutive HF patients followed in an 
outpatient multidisciplinary HF clinic. During a regular office visit, HF 
specialists were asked to estimate a patient's current NT-proBNP level based 
upon their clinical assessment and all available information from their chart, 
including a previous NT-proBNP level (if available). NT-proBNP estimations were 
grouped into prognostic categories (<125, 125-1000, 1000-4998, or >/=4999 pg/mL) 
and comparisons made between actual and estimate values.
RESULTS: Overall, HF specialists estimated 67.5% of NT-proBNP levels correctly. 
After adjusting for clinical characteristics, knowledge of a prior NT-proBNP 
measurement was the only significant predictor of estimation accuracy (p=0.01). 
Compared to patients with a prior NT-proBNP level <125 pg/mL, physicians were 
95% less likely to get a correct estimation in patients with the highest prior 
NT-proBNP level (>/=4999 pg/mL).
CONCLUSION: HF specialists are reasonably accurate at estimating current 
NT-proBNP levels based upon clinical assessment and a previous NT-proBNP level, 
if those levels were < 4999 pg/mL. Likely, initial but not routine NT-proBNP 
measurements are useful in outpatient HF clinics.