Comparison of new clinical and scintigraphic algorithms for the diagnosis of pulmonary embolism
Autor: | M. Chew, C. Bui, J C Ford, S. S. Wadhwa, R G McLean, B. Elison, M Carolan, O Arvela |
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Rok vydání: | 2004 |
Předmět: |
Adult
Male Adolescent Provisional diagnosis Perfusion scanning Logistic regression Scintigraphy Severity of Illness Index medicine Humans Radiology Nuclear Medicine and imaging Radionuclide Imaging Grading (education) Technetium Tc 99m Aggregated Albumin Aged Sodium Pertechnetate Tc 99m Aged 80 and over High probability medicine.diagnostic_test business.industry Reproducibility of Results Diagnostic algorithms General Medicine Middle Aged medicine.disease Pulmonary embolism Logistic Models Female Pulmonary Embolism business Nuclear medicine Algorithm Algorithms |
Zdroj: | The British Journal of Radiology. 77:372-376 |
ISSN: | 1748-880X 0007-1285 |
DOI: | 10.1259/bjr/83624598 |
Popis: | Since the publication of the modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) criteria for the diagnosis of pulmonary embolism (PE), new clinical and scintigraphic diagnostic algorithms (the McMaster clinical criteria, the PisaPED simplified scintigraphic grading and the Miettinen logistic regression analysis) have been reported although the results have not been reproduced in other sites. Ventilation-perfusion lung scintigraphy was performed in 238 consecutive patients with a provisional diagnosis of PE. Scans were reported as normal/very low, low, intermediate or high probability for PE using standardized criteria. Each patient received a clinical grading of probability of PE as low, moderate or high using the McMaster clinical criteria. Using the PisaPED criteria (an alternate simplified scintigraphic grading system using the perfusion scan alone) each scan was also graded as normal/near normal, abnormal but not PE, or abnormal and PE. Using the logistic regression algorithm of Miettinen each scan received a numerical probability of PE. Frequencies for differing levels of probability of PE varied widely between the various algorithms. Cross tabulations revealed correlation of the standardized criteria with the Miettinen grading but not with the McMaster or the PisaPED gradings. We were unable to reproduce similar results using the McMaster clinical grading or the PisaPED simplified scintigraphic grading although the Miettinen logistic regression formula gave comparable results. New algorithms are not automatically transferable to new environments. |
Databáze: | OpenAIRE |
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