Estimating the Likelihood of Pulmonary Embolus: Go with Your Gut

Clinician gestalt was as accurate as attribute matching for diagnosing pulmonary embolism but not acute coronary syndrome.

In prior research, numerical scoring systems were shown to be no better than clinical judgment at estimating the likelihood of pulmonary embolus (PE) in a given patient (NEJM JW Emerg Med Mar 22 2013). In a secondary data analysis, researchers compared the accuracy of clinician gestalt with attribute matching for the estimation of PE and acute coronary syndrome among 840 patients who had participated in a clinical trial. One of the investigators owns stock in the company that makes attribute matching software.

Attribute matching is an application that compares a patient receiving care with all patients from a large database who have the same values for certain clinical attributes. The application then provides the chance of the outcome in th…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Estimating the Likelihood of Pulmonary Embolus: Go with Your Gut

Topics

Reviewing Author