Do Common Previously Unvalidated Clinical Variables Predict Venous Thromboembolism?

Despite the existence of validated clinical scoring systems for assessing pretest clinical suspicion for pulmonary embolism (PE), many physicians continue to use unstructured reasoning when evaluating patients for venous thromboembolism (VTE). In a prospective cohort study of 7940 patients who were evaluated for PE with objective testing (d-dimer, computed tomographic angiography, or ventilation-perfusion scan) at 12 emergency departments, researchers assessed the individual predictive value of 12 previously validated (explicit) clinical variables and 13 previously unvalidated (implicit) clinical variables that are commonly considered indications for testing (see table).

VTE was diagnosed in 568 patients (7.2%). In multivariate analysis, eig…