Prediction of Pulmonary Embolism in the Emergency Department: The Revised Geneva Score

Gal, Grégoire Le; Righini, Marc; Roy, Pierre‐Marie; Sanchez, Olivier; Aujesky, Drahomir; Bounameaux, Henri; Perrier, Arnaud

doi:10.7326/0003-4819-144-3-200602070-00004

Cited by 875 publications

(354 citation statements)

References 22 publications

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“…This uses a number of clinical features in a structured manner to generate an estimate of the clinical risk of PE or a rule to determine whether or not PE should be investigated. In the general (non-pregnant) population with suspected PE, Wells'sscore 3 and revised Geneva score 4 have been developed to estimate the risk of developing PE, whereas the PE rule-out criteria (PERC) rule 5 has been developed to select patients for investigation (details of the scores and the rule are provided in Chapter 3). These scores and the rule have been extensively validated in the general population with a suspected PE, but the differences between the pregnant and non-pregnant populations mean that findings cannot be automatically extrapolated to the pregnant or postpartum population.…”

Section: Background and Rationalementioning

confidence: 99%

“…4 These rules were not developed for use in the pregnant population, so we removed criteria that were not relevant to the pregnant population and adapted criteria when appropriate to be relevant to the pregnant population. We therefore removed exogenous oestrogen from the PERC rule and used the thresholds developed for our analysis of clinical variables to dichotomise age, oxygen saturation and heart rate (see Table 4).…”

Section: Case-control Studymentioning

confidence: 99%

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Selecting pregnant or postpartum women with suspected pulmonary embolism for diagnostic imaging: the DiPEP diagnostic study with decision-analysis modelling

Goodacre

Horspool

Shephard

et al. 2018

Health Technol Assess

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Article:Goodacre, S. orcid.org/0000-0003-0803-8444, Horspool, K., Shephard, N. et al. (8 more authors) (2018) Selecting pregnant or postpartum women with suspected pulmonary embolism for diagnostic imaging: the DiPEP diagnostic study with decision-analysis modelling. Health Technology Assessment, 22 (47). ISSN 1366-5278 https://doi.org/10.3310/hta22470 © Queen's Printer and Controller of HMSO 2018. This work was produced by Goodacre et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Items deposited in White Rose Research Online are protected by copyright, with all rights reserved unless indicated otherwise. They may be downloaded and/or printed for private study, or other acts as permitted by national copyright laws. The publisher or other rights holders may allow further reproduction and re-use of the full text version. This is indicated by the licence information on the White Rose Research Online record for the item. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/). HEALTH TECHNOLOGY ASSESSMENTEditorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health techno...

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Section: Background and Rationalementioning

confidence: 99%

Section: Case-control Studymentioning

confidence: 99%

Selecting pregnant or postpartum women with suspected pulmonary embolism for diagnostic imaging: the DiPEP diagnostic study with decision-analysis modelling

Goodacre

Horspool

Shephard

et al. 2018

Health Technol Assess

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“…The Wells criteria consist of six objective variables and one subjective variable which requires physician assessment regarding the chance of a diagnosis, other than PE, for the patient's condition (Table 1) (17). Conversely, the more recently revised Geneva score incorporates eight objective clinical variables (12).…”

Section: Discussionmentioning

confidence: 99%

“…However, in order to eliminate this restriction, the Geneva group created and verified a com- pletely standardized objective rule called the Geneva score revised later. It has been recently simplified into the simplified revised Geneva score (11,12).…”

Section: Introductionmentioning

confidence: 99%

Correlation of the Wells and Simplified Revised Geneva Scores with CT Pulmonary Artery Obstruction Index in Pulmonary Embolism

2017

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Background: The pulmonary artery obstruction index (PAOI), which is evaluated by the CT pulmonary angiography, offers an objective method to measure the severity of pulmonary arteries obstruction. Objectives: We decided to investigate the correlation between the PAOI determined by CT pulmonary angiography, as an index to determine the severity of pulmonary embolism (PE), with two clinical models used for predicting the probability of acute PE, namely the Wells criteria and the simplified revised Geneva score. Patients and Methods: Sixty-four consecutive patients with definite diagnosis of acute PE based on CT pulmonary angiography were enrolled. The Wells score as well as simplified revised Geneva score were calculated retrospectively using the medical records. Then, the PAOI was determined by CT pulmonary angiography. By applying the Pearson's correlation coefficient, the relationships were investigated. Results: The Wells score had a weak correlation with the PAOI (r = 0.29; P = 0.01). The simplified revised Geneva score did not have significant correlation with the PAOI (r = 0.1; P = 0.2). Furthermore, patients with active cancer had significantly higher CT indexes than the other patients with PE (P = 0.046). Conclusion: Although the Wells and simplified revised Geneva scores are used widely for assessing clinical probability of PE, these scores may not necessarily correlate with the severity of PE. The Wells score had a weak correlation and may somehow predict the severity of PE. Malignancy is a significant risk factor found to be correlated with more severe PE.

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“…1,2 To promote appropriate use of resources, several groups have validated clinical prediction rules to guide clinicians to either test further or exclude PE as a potential diagnosis. [3][4][5][6][7][8] However, a survey of emergency clinicians demonstrated that many use implicit, nonvalidated criteria when formulating a pretest probability. 9 The goal of this study was to determine the association of validated (explicit) and nonvalidated (implicit) criteria with the diagnosis of PE.…”

Section: Introductionmentioning

confidence: 99%

Critical predictors of pulmonary embolism

Guttman

Dankoff

2012

CJEM

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Clinical questionDo specific elements of the history and physical examination predict the presence of pulmonary embolism in the emergency department?Article chosen Courtney DM, Kline JA, Kabrhel C, et al. Clinical features from the history and physical examination that predict the presence or absence of pulmonary embolism in symptomatic emergency department patients: results of a prospective, multicenter study. Ann Emerg Med 2010;55:307-15. ObjectiveTo determine whether implicit clinical predictors previously untested predict the presence of pulmonary embolism in the emergency department.

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Prediction of Pulmonary Embolism in the Emergency Department: The Revised Geneva Score

Abstract: The proposed score is entirely standardized and is based on clinical variables. It has sustained internal and external validation and should now be tested for clinical usefulness in an outcome study.

Cited by 875 publications

References 22 publications

Selecting pregnant or postpartum women with suspected pulmonary embolism for diagnostic imaging: the DiPEP diagnostic study with decision-analysis modelling

Selecting pregnant or postpartum women with suspected pulmonary embolism for diagnostic imaging: the DiPEP diagnostic study with decision-analysis modelling

Correlation of the Wells and Simplified Revised Geneva Scores with CT Pulmonary Artery Obstruction Index in Pulmonary Embolism

Critical predictors of pulmonary embolism

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