2012
DOI: 10.1016/j.annemergmed.2011.10.022
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Diagnostic Accuracy of Pulmonary Embolism Rule-Out Criteria: A Systematic Review and Meta-analysis

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Cited by 40 publications
(25 citation statements)
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“…The pooled (95% CI) sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 0.97 (0.96 to 0.98), 0.22 (0.22 to 0.23), 1.22 (1.16 to 1.29) and 0.17 (0.13 to 0.23), respectively, for PERC alone. Even though minimal decrease was seen in pooled specificity, positive likelihood ratio and negative likelihood ratio after combining the PERC rule with the clinical gestalt, it was clinically insignificant 12. The pooled (95% CI) diagnostic OR was 7.4 (5.5 to 9.8).…”
Section: Resultsmentioning
confidence: 86%
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“…The pooled (95% CI) sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 0.97 (0.96 to 0.98), 0.22 (0.22 to 0.23), 1.22 (1.16 to 1.29) and 0.17 (0.13 to 0.23), respectively, for PERC alone. Even though minimal decrease was seen in pooled specificity, positive likelihood ratio and negative likelihood ratio after combining the PERC rule with the clinical gestalt, it was clinically insignificant 12. The pooled (95% CI) diagnostic OR was 7.4 (5.5 to 9.8).…”
Section: Resultsmentioning
confidence: 86%
“…Data points were study characteristics (author, country, publication year, number of patients, study settings, study design, description of study participants and duration of follow-up), subject selection (inclusion and exclusion criteria), PERC classification, outcome definition and measurement, outcomes in PERC positives and negatives, and follow-up. In a study reporting multiple cohorts, each cohort was included separately 12. The primary outcome of our study was the diagnosis of PE or venous thromboembolism or death caused by venous thromboembolism within 90 days of initial ED evaluation.…”
Section: Methodsmentioning
confidence: 99%
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“…However, just the fact that the Wells/Geneva score was calculated was not associated with positive CTPA. But, patients with a high pretest probability for PE were more likely to have a positive CTPA, regardless of whether the pretest probability was estimated by using the Wells/Geneva score, or if it was estimated by considering other criteria (e.g., the Pulmonary Embolism Rule Out Criteria (PERC), including the risk factor oral contraceptive [17]), or the clinical experience of the physician. Thus, the Wells/Geneva score should be seen as one possible tool for estimating the pretest probability of PE, among a variety of other factors that influence the estimation of pretest probability, such as all clinical experience and diagnostic skills of the physician.…”
Section: Discussionmentioning
confidence: 99%
“…The pulmonary embolism rule-out criteria (PERC) is an alternative method for pretest probability assessment in low-risk patients, as determined either by Wells criteria or by physician gestalt [39]. When all components of the rule are satisfied (low risk of PE, age less than 50 years, oxygen saturation 95 % or greater, pulse rate below 100 beats per minute, no hemoptysis, no estrogen use, no hospitalization within 4 weeks for surgery/trauma, no prior VTE, and no unilateral leg swelling) the probability of VTE is less than 2 % [38].…”
Section: Clinical Scoring Systemsmentioning
confidence: 99%