What is it about?
This publication shifts the context from the Emergency Department to a Department of Internal Medicine where scores for preclinical test of pulmonary embolism were assessed.
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Why is it important?
Shifting the context from the Emergency department, where these scores were born, to a department of Medicine, where the several comorbidities could be better identified, the assessment by a training and a validation group makes, from a statistical viewpoint, the reader to better strenghten the difference between score's performance.
Perspectives
The perspective coming from this publication would be to use Well score combined with D-Dimer test for assessing preclinical probability of incident pulmonary embolism in the departments of Internal Medicine, given the relevant proportion of patients, hospitalized in these departments, who harbour several comorbidities which are risk factors of pulmonary embolism. It goes without saying that Wells score does not necessarily imply, when it falls in the range of low probability, the exclusion of pulmonary embolism. In this setting, clinical judgemnt remains a useful guide to finalize diagnosis by anngio-CT scan anyway, if the physician is firmly suspicious that pulmonary embolism ha occurred.
Lorenzo Malatino
University of Catania Department of Clinical and Experimental Medicine
Read the Original
This page is a summary of: Comparison of Wells and Revised Geneva Rule to Assess Pretest Probability of Pulmonary Embolism in High-Risk Hospitalized Elderly Adults, Journal of the American Geriatrics Society, June 2015, Wiley,
DOI: 10.1111/jgs.13459.
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