A67-07 Comparative Accuracy of the Modified Wells Score and the Revised Geneva Score in Predicting Acute Pulmonary Embolism: A Retrospective Study

Abstract Rationale Pulmonary embolism (PE) is responsible for over 50,000 annual deaths in the United States. It is essential for timely diagnosis and appropriate therapeutic management of PE to reduce the mortality and morbidity associated with PE. Computed tomographic pulmonary angiography (CTPA) remains the gold standard test for diagnosis of acute PE. CTPA often exposes extra radiation to the patient and is time-consuming and costly. Several clinical scoring systems, validated by clinical trials and prospective cohort studies, have been used to determine pretest probability of acute PE based on clinical signs, symptoms, and medical history. We did a retrospective study to compare between Modified Wells score and Revised Geneva score for pretest probability for acute PE. Methods This was a retrospective study done at Desert Valley Hospital. Medical Records were obtained from 2019 to 2024 where CT Angio Chest results were evaluated. With a total sample size of 364, the study was divided into two groups according to the presence or absence of pulmonary emboli based only on CTA chest results. The PE Group consisted of 175 patients, and the Group Without PE consisted of 189 patients. Modified Well score and Revised Geneva Score were calculated for patients in both groups and statistical analysis was performed. Results The Area Under the Curve (AUC) for the Modified Well score was 0.812 with a 95% Confidence Interval of 0.767 to 0.858. The AUC for Revised Geneva score was 0.662 with a 95% confidence interval of 0.607 to 0.718. Both tests were statistically significant but the Modified Well score demonstrated better discriminatory ability for the outcome compared to the Revised Geneva score. Similar results were found with Mann-Whitney Test where both scales showed a statistically significant ability to differentiate between the two groups i.e. PE vs non-PE. The larger absolute Z-score for the Modified Well score (Z = -10.550) suggested it may have a stronger separation between the groups compared to the Revised Geneva score ( Z = -5.405). Conclusion In our study, the Modified Well score appeared to be a more effective tool for assessing the likelihood of PE compared to the Revised Geneva score based on these analyses. There are some limitations of our study including possible selection bias and non-generalizability of the results to other populations as the data come from a retrospective study from a single institution. Further validation with larger studies will help us confirm this finding. This abstract is funded by: None