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. 2020 May;48(5):704-708.
doi: 10.1097/CCM.0000000000004271.

YEARS Algorithm Versus Wells' Score: Predictive Accuracies in Pulmonary Embolism Based on the Gold Standard CT Pulmonary Angiography

Ahmed Abdelaal Ahmed Mahmoud M Alkhatip  1   2 , Maria Donnelly  3 , Lindi Snyman  3 , Patrick Conroy  3 , Mohamed Khaled Hamza  4 , Ian Murphy  5 , Andrew Purcell  3 , David McGuire  3
Affiliations

YEARS Algorithm Versus Wells' Score: Predictive Accuracies in Pulmonary Embolism Based on the Gold Standard CT Pulmonary Angiography

Ahmed Abdelaal Ahmed Mahmoud M Alkhatip et al. Crit Care Med. 2020 May.

Abstract

Objectives: This study retrospectively applied Wells' score and YEARS algorithm to the same sample of patients to evaluate the predictive performance of each when compared with the gold standard CT pulmonary angiography.

Design: Retrospective analytical study.

Setting: A tertiary University Hospital in Ireland.

Patients: Data from 794 patients who underwent CT pulmonary angiography to rule out pulmonary embolism.

Interventions: Patients were analyzed using retrospective application of both Wells' score and YEARS algorithm. Sensitivity, specificity, and diagnostic odds ratio were calculated and compared.

Measurements and main results: Of 794 scans, 78 (9.8%) were positive for pulmonary embolism. The YEARS algorithm was more sensitive than the Wells' score (97.44% vs 74.36%) but was less specific (13.97% vs 33.94%). Furthermore, the diagnostic odds ratio of YEARS was higher than Wells' score (6.27 vs 1.48). YEARS provides better negative predictive value (98% vs 92.4%), and both scores have poor positive predictive value (10.9%).

Conclusions: Both scores successfully exclude pulmonary embolism, although YEARS has a better negative predictive value. Both exhibit poor positive predictive value.

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Comment in

  • Acute Pulmonary Embolism: How to Best Predict It.
    Barbas CSV. Barbas CSV. Crit Care Med. 2020 May;48(5):769-770. doi: 10.1097/CCM.0000000000004297. Crit Care Med. 2020. PMID: 32301775 No abstract available.
  • YEARS Algorithm Versus Wells' Score: Incomplete Reporting Undermines Study Quality Assessment.
    Korevaar DA, Cohen JF, van Es J. Korevaar DA, et al. Crit Care Med. 2020 Aug;48(8):e730. doi: 10.1097/CCM.0000000000004369. Crit Care Med. 2020. PMID: 32697515 No abstract available.
  • The authors reply.
    Abdelaal Ahmed Mahmoud M Alkhatip A, Conroy P, Hamza MK, Murphy I, Purcell A, McGuire D. Abdelaal Ahmed Mahmoud M Alkhatip A, et al. Crit Care Med. 2020 Aug;48(8):e731-e732. doi: 10.1097/CCM.0000000000004454. Crit Care Med. 2020. PMID: 32697516 No abstract available.
  • The YEARS Algorithm in Patients With Suspected Pulmonary Embolism.
    Izumida T, Imamura T. Izumida T, et al. Crit Care Med. 2020 Oct;48(10):e983. doi: 10.1097/CCM.0000000000004422. Crit Care Med. 2020. PMID: 32925271 No abstract available.
  • The authors reply.
    Purcell A, Abdelaal Ahmed Mahmoud M Alkhatip A. Purcell A, et al. Crit Care Med. 2020 Oct;48(10):e983-e984. doi: 10.1097/CCM.0000000000004541. Crit Care Med. 2020. PMID: 32925272 No abstract available.
  • The authors reply.
    Abdelaal Ahmed Mahmoud M Alkhatip A, Conroy P, Khaled Hamza M, Purcell A, Murphy I, Snyman L. Abdelaal Ahmed Mahmoud M Alkhatip A, et al. Crit Care Med. 2020 Dec;48(12):e1378-e1379. doi: 10.1097/CCM.0000000000004701. Crit Care Med. 2020. PMID: 33255145 No abstract available.

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