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Most patients with acute heart failure who require admission present to the emergency department with shortness of breath. To date, no study has compared the judgment of qualified emergency physicians to the results of B-type natriuretic peptide (BNP) testing for clinical decision making. In a randomized, single-blind study, 612 patients aged 40 and older who presented to two Australian EDs with severe dyspnea without cardiogenic shock received usual care directed by an attending-level physician, with or without BNP testing. Physicians were advised that a BNP level <100 ng/L indicates that heart failure is unlikely to be the cause of the patient’s dyspnea and a level >500 ng/L suggests that heart failure is present. One EP and one cardiolog…