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OBJECTIVE: To assess whether a cumulative clinical risk score (Wells score) can optimise imaging strategies in patients with suspected pulmonary embolism (PE). DESIGN, SETTING AND PARTICIPANTS: Prospective, consecutive series of 633 studies on 595 patients referred to a major teaching hospital for ventilation/perfusion (V/Q) scanning for suspected acute PE between September 2004 and November 2005. Ventilation scintigraphy was performed using technetium-99m Technegas, and V/Q results were interpreted in conjunction with Wells scores. MAIN OUTCOME MEASURES: Likelihood of PE for each Wells score interval; overall prevalence of PE. RESULTS: The likelihood of PE for a given Wells score in our study was not significantly different from the likelihood in the original study by Wells et al. Scores of 6 with a 67% risk. The overall prevalence of PE in our study was significantly less than that in the original study (9% v 16%; P 2 warrant imaging assessment for PE, but for those with scores < 2, further imaging may be problematic.
Yap et al. (Sat,) studied this question.