Comparison of two clinical prediction rules and implicit assessment among patients with suspected pulmonary embolism

2002 ◽  
Vol 113 (4) ◽  
pp. 269-275 ◽  
Author(s):  
Isabelle Chagnon ◽  
Henri Bounameaux ◽  
Drahomir Aujesky ◽  
Pierre-Marie Roy ◽  
Anne-Laurence Gourdier ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Prediction ◽  
Suspected Pulmonary Embolism ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Implicit Assessment

scholarly journals Wells’ Score in Diagnosis of Pulmonary Embolism in Patient with Thrombocytopenia: A Case Report

2019 ◽  
Vol 20 (3) ◽  
pp. 281-285
Author(s):  
Dragan Panic ◽  
Andreja Todorovic ◽  
Milica Stanojevic ◽  
Violeta Iric Cupic
Keyword(s):  
Pulmonary Embolism ◽  
Chest Pain ◽  
Acute Pulmonary Embolism ◽  
Pretest Probability ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Clinical Probability ◽  
Wells Score ◽  
D Dimer

Abstract Current diagnostic workup of patients with suspected acute pulmonary embolism (PE) usually starts with the assessment of clinical pretest probability, using clinical prediction rules and plasma D-dimer measurement. Although an accurate diagnosis of acute pulmonary embolism (PE) in patients is thus of crucial importance, the diagnostic management of suspected PE is still challenging. A 60-year-old man with chest pain and expectoration of blood was admitted to the Department of Cardiology, General Hospital in Cuprija, Serbia. After physical examination and laboratory analyses, the diagnosis of Right side pleuropne monia and acute pulmonary embolism was established. Clinically, patient was hemodynamically stable, auscultative slightly weaker respiratory sound right basal, without pretibial edema. Laboratory: C-reactive protein (CRP) 132.9 mg/L, Leukocytes (Le) 18.9x109/L, Erythrocytes (Er) 3.23x1012/L, Haemoglobin (Hgb) 113 g/L, Platelets (Plt) 79x109/L, D-dimer 35.2. On the third day after admission, D-dimer was increased and platelet count was decreased (Plt up to 62x109/L). According to Wells’ rules, score was 2.5 (without symptoms on admission), a normal clinical finding with clinical manifestation of hemoptysis and chest pain, which represents the intermediate level of clinical probability of PE. After the recidive of PE, Wells’ score was 6.5. In summary, this study suggests that Wells’ score, based on a patient’s risk for pulmonary embolism, is a valuable guidance for decision-making in combination with knowledge and experience of clinicians. Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being consiered.

Diagnosis: clinical prediction rules and laboratory tests

ESC CardioMed ◽  
2018 ◽  
pp. 2758-2761
Author(s):  
Piotr Pruszczyk
Keyword(s):  
Pulmonary Embolism ◽  
High Probability ◽  
Clinical Manifestations ◽  
High Sensitivity ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Vein Thrombosis ◽  
Clinical Probability ◽  
D Dimer

Clinical manifestations of venous thromboembolism (VTE) usually are non-specific. In order to facilitate proper diagnosis, clinical prediction rules were derived. The best studied models are the Wells criteria for deep vein thrombosis and pulmonary embolism and the Geneva score for pulmonary embolism. They classify patients into different categories of clinical pretest VTE probability. Pulmonary embolism prevalence is approximately 10% in low-, 30% in moderate-, and up to 65% in high-probability categories. Plasma D-dimer levels are elevated in not only VTE but also in other conditions. A D-dimer assay should be used in combination with pretest VTE clinical probability. A normal high-sensitivity D-dimer level excludes pulmonary embolism in patients with low/intermediate or non-high VTE probability, while in the high probability category does not allow VTE to be safely excluded. Age-adjusted D-dimer thresholds (age × 10 μ‎g/L above 50 years) can limit the need for imaging methods without increasing the rate of missed diagnoses in non-high clinical probability patients.

C0302 Prognostic clinical prediction rules to identify low-risk pulmonary embolism: A systematic review and meta-analysis

2012 ◽  
Vol 130 ◽  
pp. S125
Author(s):  
Alessandro Squizzato ◽  
Marco P. Donadini ◽  
Luca Galli ◽  
Francesco Dentali ◽  
Drahomir Aujesky ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Meta Analysis ◽  
Low Risk ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules

scholarly journals GPs’ familiarity with and use of cardiovascular clinical prediction rules: a UK survey study

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101081
Author(s):  
Jong-Wook Ban ◽  
Rafael Perera ◽  
Richard Stevens
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Survey Study ◽  
Risk Scores ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Vein Thrombosis ◽  
The Uk ◽  
Deep Vein

BackgroundClinical prediction rules (CPRs) can help general practitioners (GPs) address challenges in cardiovascular disease. A survey published in 2014 evaluated GPs’ awareness and use of CPRs in the UK. However, many new CPRs have been published since and it is unknown which cardiovascular CPRs are currently recognised and used.AimTo identify cardiovascular CPRs recognised and used by GPs, and to assess how GPs’ familiarity and use have changed over time.Design & settingAn online survey of GPs in the UK was undertaken.MethodUsing comparable methods to the 2014 survey, GPs were recruited from a network of doctors in the UK. They were asked how familiar they were with cardiovascular CPRs, how frequently they used them, and why they used them. The results were compared with the 2014 survey.ResultsMost of 401 GPs were familiar with QRISK scores, ABCD scores, CHADS scores, HAS-BLED score, Wells scores for deep vein thrombosis, and Wells scores for pulmonary embolism. The proportions of GPs using these CPRs were 96.3%, 65.1%, 97.3%, 93.0%, 92.5%, and 82.0%, respectively. GPs’ use increased by 31.2% for QRISK scores, by 13.5% for ABCD scores, by 54.6% for CHADS scores, by 33.2% for Wells scores for deep vein thrombosis, and by 43.6% for Wells scores for pulmonary embolism; and decreased by 45.9% for the Joint British Societies (JBS) risk calculator, by 38.7% for Framingham risk scores, and by 8.7% for New Zealand tables. GPs most commonly used cardiovascular CPRs to guide therapy and referral.ConclusionThe study found GPs’ familiarity and use of cardiovascular CPRs changed substantially. Integrating CPRs into guidelines and practice software might increase familiarity and use.

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