September 1, 2004Current Opinion in Pulmonary Medicine
External validation and comparison of recently described prediction rules for suspected pulmonary embolism
Key result
PE prediction rules show similar accuracy to empiric clinical assessment for suspected pulmonary embolism.
Why the study?
Prediction rules for pulmonary embolism, such as the Wells score and Geneva score, require external validation and outcome studies to confirm safe patient management based on clinical probability assessment.
Do objective prediction rules (Wells score, Geneva score) provide accurate clinical probability assessment compared to empiric assessment in patients with suspected pulmonary embolism?
Population
Patients clinically suspected of having pulmonary embolism
Comparison
Prediction rules (Wells score and Geneva score) vs empiric assessment
Design
Review of external validation and prospective management studies
Authors
Discussion
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Member takes
Implication
Clinicians may rely on empiric judgment for suspected PE probability; leaves open whether scores enhance outcomes in prospective studies.
Structured PICO
Do objective prediction rules (Wells score, Geneva score) provide accurate clinical probability assessment compared to empiric assessment in patients with suspected pulmonary embolism?
P
Population
Patients clinically suspected of having pulmonary embolism
E
Exposure
Clinical probability assessment using prediction rules (Wells score and Geneva score)
C
Comparator
Empiric assessment
O
Outcome
Accuracy and validity of the prediction rules
Objective prediction rules like the Wells and Geneva scores are valid tools for assessing pretest probability of pulmonary embolism, performing similarly to empiric assessment but offering advantages for less experienced clinicians.
Cite This Study
Righini et al. (2004) conducted a review in Suspected pulmonary embolism. Prediction rules (Wells score and Geneva score) vs. Empiric assessment was evaluated. Objective prediction rules (Wells and Geneva scores) showed similar accuracy to empiric assessment for evaluating clinical probability in patients with suspected pulmonary embolism.