When we pooled data at and around the thresholds recommended by the ESC and NICE guidelines for studies in ambulatory care settings and with a low prevalence of CHF (see supplementary table S2), the sensitivity of BNP was highest at 100 pg/mL (recommended by NICE for all settings and by ESC for acute settings5, 6): pooled sensitivity 0.95 (95% confidence interval 0.90 to 0.98) and pooled specificity 0.64 (0.46 to 0.78). The gene discussed is NPPB; the disease is congestive heart failure.