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DOI: 10.1055/s-0037-1613785
Comparison of a Clinical Probability Estimate and Two Clinical Models in Patients with Suspected Pulmonary Embolism
Financial support for this study was provided by the Dutch Health Insurance Council. Dr. Büller is an established investigator of the Dutch Heart Foundation.
Publication History
Received
20 July 1999
Accepted
03 September 1999
Publication Date:
11 December 2017 (online)
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.
** Participating centers are listed in the appendix, p. 202.
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