NPPB and heart failure: Results from the SGR: The recommendations in the source guidelines on the use of BNP tests in patients suspected of heart failure showed a major inconsistency (type A): The test was treated in 7/16 guidelines; recommendations differed completely in content (2/7 'not recommended', 3/7 'recommended under certain circumstances', 1/7 'recommended in every case', 1/7 'recommended ruling out CHF before an echocardiogram'), and in grading.