Assessing properly the usefulness of clinical prediction rules and tests

BMJ ◽  
2012 ◽  
Vol 344 (feb21 1) ◽  
pp. e1238-e1238 ◽  
Author(s):  
H. Llewelyn
Keyword(s):  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules

Should a Head-Injured Child Receive a Head CT Scan? A Systematic Review of Clinical Prediction Rules

PEDIATRICS ◽  
2009 ◽  
Vol 124 (1) ◽  
pp. e145-e154 ◽  
Author(s):  
J. L. Maguire ◽  
K. Boutis ◽  
E. M. Uleryk ◽  
A. Laupacis ◽  
P. C. Parkin
Keyword(s):  
Systematic Review ◽  
Ct Scan ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Injured Child ◽  
Prediction Rules ◽  
Head Ct ◽  
Head Injured

scholarly journals Wells’ Score in Diagnosis of Pulmonary Embolism in Patient with Thrombocytopenia: A Case Report

2019 ◽  
Vol 20 (3) ◽  
pp. 281-285
Author(s):  
Dragan Panic ◽  
Andreja Todorovic ◽  
Milica Stanojevic ◽  
Violeta Iric Cupic
Keyword(s):  
Pulmonary Embolism ◽  
Chest Pain ◽  
Acute Pulmonary Embolism ◽  
Pretest Probability ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Clinical Probability ◽  
Wells Score ◽  
D Dimer

Abstract Current diagnostic workup of patients with suspected acute pulmonary embolism (PE) usually starts with the assessment of clinical pretest probability, using clinical prediction rules and plasma D-dimer measurement. Although an accurate diagnosis of acute pulmonary embolism (PE) in patients is thus of crucial importance, the diagnostic management of suspected PE is still challenging. A 60-year-old man with chest pain and expectoration of blood was admitted to the Department of Cardiology, General Hospital in Cuprija, Serbia. After physical examination and laboratory analyses, the diagnosis of Right side pleuropne monia and acute pulmonary embolism was established. Clinically, patient was hemodynamically stable, auscultative slightly weaker respiratory sound right basal, without pretibial edema. Laboratory: C-reactive protein (CRP) 132.9 mg/L, Leukocytes (Le) 18.9x109/L, Erythrocytes (Er) 3.23x1012/L, Haemoglobin (Hgb) 113 g/L, Platelets (Plt) 79x109/L, D-dimer 35.2. On the third day after admission, D-dimer was increased and platelet count was decreased (Plt up to 62x109/L). According to Wells’ rules, score was 2.5 (without symptoms on admission), a normal clinical finding with clinical manifestation of hemoptysis and chest pain, which represents the intermediate level of clinical probability of PE. After the recidive of PE, Wells’ score was 6.5. In summary, this study suggests that Wells’ score, based on a patient’s risk for pulmonary embolism, is a valuable guidance for decision-making in combination with knowledge and experience of clinicians. Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being consiered.

The risk of bleeding with warfarin: A systematic review and performance analysis of clinical prediction rules

2007 ◽  
Vol 98 (11) ◽  
pp. 980-987 ◽  
Author(s):  
Karen Dahri ◽  
Peter Loewen
Keyword(s):  
Systematic Review ◽  
Major Bleeding ◽  
Warfarin Therapy ◽  
Risk Index ◽  
Predictive Ability ◽  
Bleeding Risk ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Risk Of Bleeding

SummaryIt was the objective of this article to qualitatively review and evaluate the clinical prediction rules (CPRs) available for estimating bleeding risk in patients commencing warfarin therapy. A systematic review of PubMed (1949 to December 2006), MEDLINE (1966 to December 2006); EMBASE (1980 to December 2006), Cochrane Database of Systematic Reviews (to December 2006), and International Pharmaceutical Abstracts (1970 to Demember 2006) was conducted. Seven studies were found that detailed CPRs used to assess risk of bleeding prior to commencing warfarin therapy. Four studies described distinct CPRs. The remaining three studies were further validations of one of the CPRs, the Outpatient Bleeding Risk Index. The Outpatient Bleeding Risk Index was classified as being of Level 2 evidence while the remaining three indices were classified as being of Level 4 evidence. In no case did the CPRs exhibit performance characteristics that would indicate“strong” ability to predict the presence of absence of major bleeding among warfarin recipients. The modified Outpatient Bleeding Risk Index exhibited moderate predictive ability for major bleeding in two studies, although pooling of all studies of this CPR did not reveal moderate or better performance. None of the CPRs identified “any bleeding” with moderate or strong predictive ability. None of the available CPRs exhibit sufficient predictive accuracy or have trials evaluating the impact of their use on patient outcomes. Hence, no existing CPR can be recommended for widespread use in practice at present.

Comparison of two clinical prediction rules and implicit assessment among patients with suspected pulmonary embolism

2002 ◽  
Vol 113 (4) ◽  
pp. 269-275 ◽  
Author(s):  
Isabelle Chagnon ◽  
Henri Bounameaux ◽  
Drahomir Aujesky ◽  
Pierre-Marie Roy ◽  
Anne-Laurence Gourdier ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Prediction ◽  
Suspected Pulmonary Embolism ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Implicit Assessment
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