Key result
All 4 clinical decision rules combined with a normal d-dimer result showed similar performance for excluding acute pulmonary embolism, with total failure rates of 0.5% to 0.6%.
Why the study?
Do 4 clinical decision rules (Wells rule, revised Geneva score, simplified Wells rule, and simplified revised Geneva score) combined with d-dimer testing perform similarly in excluding acute pulmonary embolism in patients with suspected acute PE?
Cohort (n=807)
Yes
Do 4 clinical decision rules (Wells rule, revised Geneva score, simplified Wells rule, and simplified revised Geneva score) combined with d-dimer testing perform similarly in excluding acute pulmonary embolism in patients with suspected acute PE?
All 4 clinical decision rules (Wells, revised Geneva, simplified Wells, simplified revised Geneva) combined with d-dimer testing show similar and safe performance for excluding acute pulmonary embolism.
No takes yet. Share an insight, caveat, or question.
Similar exclusion rates may support flexible rule selection with d-dimer in suspected PE; leaves open need for randomized confirmation.
Renée A. Douma (2011) conducted a cohort in suspected acute pulmonary embolism (n=807). 4 clinical decision rules (Wells rule, revised Geneva score, simplified Wells rule, and simplified revised Geneva score) combined with d-dimer testing was evaluated on failure to exclude PE (PE identified by computed tomography or venous thromboembolism at 3-month follow-up). All 4 clinical decision rules combined with a normal d-dimer result showed similar performance for excluding acute pulmonary embolism, with total failure rates of 0.5% to 0.6%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: