Perc validating devices domain
This corresponds to a D-dimer concentration above 80 ng/m L.
Only a control line will be visible if the test is negative.
Diagnostic models with predictors that cannot easily be obtained in primary care were excluded from the main analyses.
The AMUSE-2 cohort was designed to prospectively validate the Wells pulmonary embolism rule in a Dutch primary care setting.
The study took place between 1 July 2007 and 31 December 2010.
In short, it included 662 adult patients presenting at one of the participating general practices with complaints raising suspicion of pulmonary embolism (that is, acute dyspnoea, pain on inspiration, or unexplained cough; all at the discretion of the including physicians).
Irrespective of the diagnostic prediction model used, three patients were incorrectly classified as having low probability of pulmonary embolism; pulmonary embolism was diagnosed only after referral to secondary care.
Conclusions Five diagnostic pulmonary embolism prediction models that are easily applicable in primary care were validated in this setting.
We then critically appraised studies on the development of diagnostic prediction models by using the CHARMS checklist (appendix table A).All retrieved papers were examined by two independent reviewers (JH, GJG) and a third independent reviewer (KGMM) in case of disagreement.Given the scope of our systematic review (see appendix box A), we assessed all diagnostic prediction models for pulmonary embolism, retrieved by our search, on their applicability in a primary care domain.Main outcome measures Discriminative ability of all models retrieved by systematic literature search, assessed by calculation and comparison of C statistics.After stratification into groups with high and low probability of pulmonary embolism according to pre-specified model cut-offs combined with qualitative D-dimer test, sensitivity, specificity, efficiency (overall proportion of patients with low probability of pulmonary embolism), and failure rate (proportion of pulmonary embolism cases in group of patients with low probability) were calculated for all models.