Key result
Wells score outperforms Kline and Geneva for predicting PE with an AUC of 0.75.
Why the study?
Does the Wells scoring system provide better diagnostic accuracy than the Kline or Geneva methods for predicting pulmonary embolism in emergency department patients?
Observational (n=74)
No
Does the Wells scoring system provide better diagnostic accuracy than the Kline or Geneva methods for predicting pulmonary embolism in emergency department patients?
Absolute Event Rate: 0.75% vs 0.53%
The Wells scoring system demonstrates superior diagnostic utility compared to the Geneva and Kline methods for assessing the pretest probability of pulmonary embolism in the emergency department.
Wells score may aid PE pretest probability assessment in the ED; small Level 5 data leave superiority over Geneva/Kline open to validation.
Pulmonary embolism (PE) is a clinical entity with high mortality rate and therefore rapid diagnosis is necessary. For this purpose many diagnostic strategies have been developed for avoiding or necessitating further investigations. The hallmark of these strategies is assessing the pretest clinic probability of PE. In this study, the effectiveness of Wells, Geneva and Kline methods were investigated in a university hospital emergency department. 74 patients were enrolled in this study. The inter-group differences in scoring systems were significant for Wells and Kline but non-significant for Geneva method. The diagnosis of PE was correlated with Wells and Kline system but Geneva system lacked it. The Receiver Operating Characteristic analyses was performed for comparing the pretest clinical probability scoring systems and the greatest area under the curve was found in Wells system. Wells method seems more useful compared to Geneva and Kline methods particularly in emergency department.
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Arslan et al. (2012) conducted an observational in Suspected Pulmonary Embolism (n=74). Wells scoring system vs. Geneva and Kline scoring systems was evaluated on Area under the receiver operating characteristic curve (AUC) for predicting pulmonary embolism. The Wells scoring system demonstrated the highest diagnostic accuracy for predicting pulmonary embolism with an area under the curve of 0.75, compared to 0.63 for Kline and 0.53 for Geneva.
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