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Thromb Haemost 2000; 83(02): 199-203
DOI: 10.1055/s-0037-1613785
Rapid Communication
Schattauer GmbH

Comparison of a Clinical Probability Estimate and Two Clinical Models in Patients with Suspected Pulmonary Embolism

Bernd-Jan Sanson
1   From the Department of Vascular Medicine, Amsterdam, The Netherlands
,
Jeroen G. Lijmer
2   Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands
,
Melvin R. Mac Gillavry
3   Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
,
Franktien Turkstra
1   From the Department of Vascular Medicine, Amsterdam, The Netherlands
3   Department of Internal Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
,
Martin H. Prins
2   Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands
,
Harry R. Büller
1   From the Department of Vascular Medicine, Amsterdam, The Netherlands
,
the ANTELOPE-Study Group › Author AffiliationsFinancial support for this study was provided by the Dutch Health Insurance Council. Dr. Büller is an established investigator of the Dutch Heart Foundation.
Further Information

Publication History

Received 20 July 1999

Accepted 03 September 1999

Publication Date:
11 December 2017 (online)

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Summary

Recent studies have suggested that both the subjective judgement of a physician and standardized clinical models can be helpful in the estimation of the probability of the disease in patients with suspected pulmonary embolism (PE). We performed a multi-center study in consecutive in- and outpatients with suspected PE to compare the potential diagnostic utility of these methods. Of the 517 study patients, 160 (31%) were classified as having PE. Of these patients, 14% had a low probability as estimated by the treating physician, while 25 to 36% were categorized as having a low clinical probability with the use of two previously described clinical models. The objectively confirmed prevalence of PE in these three low probability categories was 19%, 28% and 28%, respectively. The three methods yielded comparable predictive values for PE in the other probability categories. We conclude that a physician’s clinical judgement alone and two standardized clinical models, although comparable, perform disappointingly in categorizing the pre-test probability in patients with suspected PE.

Keywords

Pulmonary embolism - diagnosis - probability - estimate - model

** Participating centers are listed in the appendix, p. 202.


 

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