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Guidelines — no matter how carefully developed, validated, and introduced — are used infrequently. Researchers evaluated a hand-held computer-based decision-support system for guiding diagnosis of pulmonary embolism (PE). The device was equipped with specially developed software that calculated pretest likelihood of PE based on the modified Geneva score and provided test probability of PE. During a 6-month preintervention period, providers at 20 emergency departments in France used the device to enter real-time patient data but not for decision support. After this period, the EDs were randomized either to use the device for decision support or to use paper guidelines.
The primary endpoint was the appropriateness of the diagnostic work-up. Af…