Buessler A, Chouihed T, Duarte K, et al. - Researchers undertook this prospective study in four EDs, to evaluate the value of various lung ultrasound (LUS) strategies for detecting acute heart failure (AHF) in the ED. Participants included patients with diagnostic uncertainty based on initial clinical judgment. They quantified a clinical diagnosis score for AHF (Brest score). After that, an extensive LUS examination was carried out based on the 4-point (BLUE protocol) and 6-, 8-, and 28-point methods. Total 117 patients were included. Among these, AHF detection was enabled in 27.4% of patients with the 4-point (two bilateral positive points) method, in 56.2% with 6-point method, in 54.8% using 8-point (≥ 1 bilateral positive point) method, and in 76.7% of patients using 28-point (B-line count ≥ 30) method. For the Brest score, the C-index (95% CI) was 72.8 (65.3-80.3), whereas the C-index of the 4-, 6-, 8-, and 28-point methods were 63.7 (58.5-68.8), 72.4 (65.0-79.8), 74.0 (67.1-80.9), and 72.4 (63.9-80.9). An improved accuracy for AHF diagnosis in patients with diagnostic uncertainty was achieved with the 6-point/8-point LUS method (using the 1 bilateral positive point threshold) on top of the BREST score.