Pulmonary embolism exclusion: a practical approach to low probability using the PIOPED data. Prospective Investigation of Pulmonary Embolism Diagnosis

Eur J Nucl Med. 1998 Mar;25(3):271-6. doi: 10.1007/s002590050228.

Abstract

A recent trend among physicians is the categorisation of lung scans as normal [excludes pulmonary embolism (PE)], high probability (confirms PE) and non-diagnostic (no judgement on PE risk). The low probability scan is therefore being eliminated as a functional category. This occasional survey contends that such an approach is misguided. Correction of the original PIOPED data with certain assumptions provides a more reproducible, albeit restricted, low probability scan category which excludes PE in 97% of cases in the low pre-test clinical category. Patients with a low probability scan with risk factors for PE (i.e. medium clinical risk) will require further investigation. More important, the very low probability scan category excludes PE in 98% of patients with low and more than 92% of patients with medium pre-test clinical likelihood. The demise of "low probability" is premature.

Publication types

  • Clinical Trial

MeSH terms

  • Bayes Theorem
  • Databases, Factual
  • Humans
  • Lung / diagnostic imaging*
  • Probability
  • Pulmonary Embolism / diagnostic imaging*
  • Radionuclide Imaging