{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T17:29:25Z","timestamp":1768930165013,"version":"3.49.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2012,9,1]],"date-time":"2012-09-01T00:00:00Z","timestamp":1346457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Diagnosis of heart failure in primary care is often inaccurate, and access to and use of echocardiography is suboptimal. This study aimed to develop and provisionally validate a clinical prediction rule to optimize referral for echocardiography of people identified in primary care with suspected heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A systematic review identified studies of diagnosis of heart failure set in primary care. The individual patient data for five of these studies were obtained. Logistic regression models to predict heart failure were developed on one of the data sets and validated on the others using area under the receiver operating characteristic curve (AUROC), and goodness-of-fit calibration plots. A model based upon four simple clinical features (Male, history of myocardial Infarction, Crepitations, Edema: MICE) and natriuretic peptide had good validity when applied to other data sets, with AUROCs between 0.84 and 0.93, and reasonable calibration. The rule performed well across the data sets, with sensitivity between 81% and 96% and specificity between 57% and 74%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A simple clinical rule based upon gender, history of myocardial infarction, presence of ankle oedema, and presence of basal lung crepitations can discriminate between people with suspected heart failure who should be referred straight for echocardiography and people for whom referral should depend upon the result of a natriuretic peptide test. Prospective validation and an implementation evaluation of the rule is now warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjhf\/hfs089","type":"journal-article","created":{"date-parts":[[2012,6,23]],"date-time":"2012-06-23T03:27:09Z","timestamp":1340422029000},"page":"1000-1008","source":"Crossref","is-referenced-by-count":26,"title":["Development and Initial Validation of a Simple Clinical Decision Tool to Predict the Presence of Heart Failure in Primary Care: The MICE (Male, Infarction, Crepitations, Edema, MICE) Rule"],"prefix":"10.1093","volume":"14","author":[{"given":"Andrea K.","family":"Roalfe","sequence":"first","affiliation":[{"name":"Primary Care Clinical Sciences, University of Birmingham \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Mant","sequence":"additional","affiliation":[{"name":"Primary Care Unit, Department of Public Health & Primary Care, Strangeways Research Laboratory, Wort's Causeway, University of Cambridge , Cambridge, CB1 8RN ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny A.","family":"Doust","sequence":"additional","affiliation":[{"name":"Centre for Research in Evidence Based Practice, Bond University \u00a0","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pelham","family":"Barton","sequence":"additional","affiliation":[{"name":"Health Economics Unit, University of Birmingham \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin R.","family":"Cowie","sequence":"additional","affiliation":[{"name":"National Heart & Lung Institute, Imperial College London (Royal Brompton Hospital) , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Glasziou","sequence":"additional","affiliation":[{"name":"Centre for Research in Evidence Based Practice, Bond University \u00a0","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Mant","sequence":"additional","affiliation":[{"name":"Department of Primary Health Care, University of Oxford \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"McManus","sequence":"additional","affiliation":[{"name":"Department of Primary Health Care, University of Oxford \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Holder","sequence":"additional","affiliation":[{"name":"Primary Care Clinical Sciences, University of Birmingham \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Deeks","sequence":"additional","affiliation":[{"name":"Public Health, Epidemiology and Biostatistics, University of Birmingham \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert N.","family":"Doughty","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Auckland \u00a0","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arno W.","family":"Hoes","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht \u00a0","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Primary Care Clinical Sciences, University of Birmingham \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.D. Richard","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Department of Primary Health Care, University of Oxford \u00a0","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2014,2,27]]},"reference":[{"key":"2026011921172320900_ejhfhfs089-bib-0001","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0140-6736(01)05620-3","article-title":"Prevalence of left ventricular systolic dysfunction and heart failure in the general population: main findings from the ECHOES (Echocardiographic Heart of England Screening) Study","volume":"358","author":"Davies","year":"2001","journal-title":"Lancet"},{"key":"2026011921172320900_ejhfhfs089-bib-0002","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1053\/euhj.2002.3255","article-title":"Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population","volume":"23","author":"Hobbs","year":"2002","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0003","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1093\/eurheartj\/ehm102","article-title":"Prognosis of all-cause heart failure and borderline left ventricular systolic dysfunction: 5 year mortality follow-up of the Echocardiographic Heart of England Screening Study (ECHOES)","volume":"28","author":"Hobbs","year":"2007","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0004","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1161\/01.CIR.88.1.107","article-title":"Survival after the onset of congestive heart failure in Framingham Heart Study subjects","volume":"88","author":"Ho","year":"1993","journal-title":"Circulation"},{"key":"2026011921172320900_ejhfhfs089-bib-0005","first-page":"21","article-title":"Left ventricular dysfunction, natriuretic peptides, and mortality in an urban population","volume":"86","author":"McDonagh","year":"2001","journal-title":"Heart"},{"key":"2026011921172320900_ejhfhfs089-bib-0006","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1001\/jama.1995.03520420066040","article-title":"Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure","volume":"273","author":"Garg","year":"1995","journal-title":"JAMA"},{"key":"2026011921172320900_ejhfhfs089-bib-0007","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1161\/01.CIR.98.12.1184","article-title":"Beta-blockers in heart failure: meta-analysis of randomized trials","volume":"98","author":"Lechat","year":"1998","journal-title":"Circulation"},{"key":"2026011921172320900_ejhfhfs089-bib-0008","volume-title":"Chronic Heart Failure: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care. Full Version of NICE Guideline no. 5","author":"National Collaborating Centre for Chronic Conditions","year":"2003"},{"key":"2026011921172320900_ejhfhfs089-bib-0009","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1093\/eurheartj\/ehn309","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)","volume":"29","author":"Dickstein","year":"2008","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0010","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1053\/euhj.2000.2170","article-title":"European survey of primary care physician perceptions and practice in heart failure diagnosis and management (Euro-HF study)","volume":"21","author":"Hobbs","year":"2000","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0011","volume-title":"Pushing the Boundaries: Improving Services for People with Heart Failure","author":"Healthcare Commission","year":"2007"},{"key":"2026011921172320900_ejhfhfs089-bib-0012","article-title":"Management of chronic heart failure. Guideline No. 95","author":"Scottish Intercollegiate Guidelines Network (SIGN)","year":"2007"},{"key":"2026011921172320900_ejhfhfs089-bib-0013","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ejheart.2004.03.013","article-title":"Accuracy of a 12-lead electrocardiogram in screening patients with suspected heart failure for open access echocardiography: a systematic review and meta-analysis","volume":"6","author":"Khunti","year":"2004","journal-title":"Eur J Heart Fail"},{"key":"2026011921172320900_ejhfhfs089-bib-0014","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1136\/bmj.324.7352.1498","article-title":"Reliability of N-terminal pro-brain natriuretic peptide assay in diagnosis of heart failure: cohort study in representative and high risk community populations","volume":"324","author":"Hobbs","year":"2002","journal-title":"BMJ"},{"key":"2026011921172320900_ejhfhfs089-bib-0015","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1023\/A:1007383914444","article-title":"Classification of heart failure in population based research: an assessment of six heart failure scores","volume":"13","author":"Mosterd","year":"1997","journal-title":"Eur J Epidemiol"},{"key":"2026011921172320900_ejhfhfs089-bib-0016","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1093\/oxfordjournals.eurheartj.a059414","article-title":"Symptoms and signs of heart failure in patients with myocardial infarction: reproducibility and relationship to chest X-ray, radionuclide ventriculography and right heart catheterization","volume":"10","author":"Gadsboll","year":"1989","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0017","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1378\/chest.114.5.1283","article-title":"The accuracy interobserver agreement in detecting \u2018gallop sounds\u2019 by cardiac auscultation","volume":"114","author":"Lok","year":"1998","journal-title":"Chest"},{"key":"2026011921172320900_ejhfhfs089-bib-0018","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta13320","article-title":"Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care","volume":"13","author":"Mant","year":"2009","journal-title":"Health Technol Assess"},{"key":"2026011921172320900_ejhfhfs089-bib-0019","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1093\/eurheartj\/ehi204","article-title":"Task Force for the Diagnosis Treatment of Chronic Heart Failure of the European Society of Cardiology. Task Force for the diagnosis and treatment of CHF of the European Society of Cardiology. Guidelines for the diagnosis and treatment of Chronic Heart Failure: full text (update 2005)","volume":"26","author":"Swedberg","year":"2005","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0020","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.ejheart.2005.01.022","article-title":"The diagnostic accuracy of plasma BNP and NTproBNP in patients referred from primary care with suspected heart failure: results of the UK natriuretic peptide study","volume":"7","author":"Zaphiriou","year":"2005","journal-title":"Eur J Heart Fail"},{"key":"2026011921172320900_ejhfhfs089-bib-0021","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/S0140-6736(97)06031-5","article-title":"Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care","volume":"350","author":"Cowie","year":"1997","journal-title":"Lancet"},{"key":"2026011921172320900_ejhfhfs089-bib-0022","author":"Cost","year":"2000"},{"key":"2026011921172320900_ejhfhfs089-bib-0023","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/S1388-9842(00)00108-2","article-title":"A Rapid Access Heart Failure Clinic provides a prompt diagnosis and appropriate management of new heart failure presenting in the community","volume":"2","author":"Fox","year":"2000","journal-title":"Eur J Heart Fail"},{"key":"2026011921172320900_ejhfhfs089-bib-0024","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1016\/j.jacc.2003.05.011","article-title":"Plasma amino-terminal pro-brain natriuretic peptide and accuracy of heart-failure diagnosis in primary care: a randomized, controlled trial","volume":"42","author":"Wright","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"2026011921172320900_ejhfhfs089-bib-0025","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1373\/49.8.1337","article-title":"Utility of the amino-terminal fragment of pro-brain natriuretic peptide in plasma for the evaluation of cardiac dysfunction in elderly patients in primary health care","volume":"49","author":"Alehagen","year":"2003","journal-title":"Clin Chem"},{"key":"2026011921172320900_ejhfhfs089-bib-0026","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.1093\/eurheartj\/ehi410","article-title":"What is the normal range for N-terminal pro-brain natriuretic peptide? How well does this normal range screen for cardiovascular disease?","volume":"26","author":"Galasko","year":"2005","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0027","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.ejheart.2005.05.008","article-title":"Increased left atrial volume index is an independent predictor of raised serum natriuretic peptide in patients with suspected heart failure but normal left ventricular ejection fraction: implication for diagnosis of diastolic heart failure","volume":"8","author":"Lim","year":"2006","journal-title":"Eur J Heart Fail"},{"key":"2026011921172320900_ejhfhfs089-bib-0028","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1136\/hrt.2003.026021","article-title":"Diagnostic and prognostic evaluation of left ventricular systolic heart failure by plasma N-terminal pro-brain natriuretic peptide concentrations in a large sample of the general population","volume":"90","author":"Groenning","year":"2004","journal-title":"Heart"},{"key":"2026011921172320900_ejhfhfs089-bib-0029","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ejheart.2003.10.003","article-title":"N-terminal pro-brain natriuretic peptide for discriminating between cardiac and non-cardiac dyspnoea","volume":"6","author":"Nielsen","year":"2004","journal-title":"Eur J Heart Fail"},{"key":"2026011921172320900_ejhfhfs089-bib-0030","article-title":"Diagnosing heart failure in primary care. The role of clinical features and BNP: a multicentre UK diagnostic study","author":"Barksfield","year":"2005","journal-title":"BSc dissertation, Imperial College London"},{"key":"2026011921172320900_ejhfhfs089-bib-0031","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1016\/S0195-668X(03)00476-7","article-title":"Clinical applications of B-type natriuretic peptide testing","volume":"24","author":"Cowie","year":"2003","journal-title":"Eur Heart J"},{"key":"2026011921172320900_ejhfhfs089-bib-0032","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jclinepi.2007.02.012","article-title":"Three methods to construct predictive models using logistic regression likelihood ratios to facilitate adjustment for pre-test probability give similar results","volume":"61","author":"Chan","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"2026011921172320900_ejhfhfs089-bib-0033","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1093\/clinchem\/28.5.1113","article-title":"On the use and computation of likelihood ratios in clinical chemistry","volume":"28","author":"Albert","year":"1982","journal-title":"Clin Chem"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1093%2Feurjhf%2Fhfs089","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/14\/9\/1000\/66442440\/eurjhf_14_9_1000.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/14\/9\/1000\/66442440\/eurjhf_14_9_1000.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:22:31Z","timestamp":1768875751000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/article\/14\/9\/1000\/8428915"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9,1]]},"references-count":33,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2014,2,27]]},"published-print":{"date-parts":[[2012,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjhf\/hfs089","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2012,9]]},"published":{"date-parts":[[2012,9,1]]}}}