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

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

Dr. Abdelaal Ahmed Mahmoud M. Alkhatip involved in study design, data collection, writing primary and final article. Dr. Donnelly was involved in supervising the research and editing the final article. Dr. Snyman was involved in application of the scores on the patients. Dr. Conroy was involved in data collection and editing the final article. Dr. Hamza was involved in statistical and article revision and editing. Dr. Murphy was involved in data collection and article revision and editing. Dr. Purcell was involved in applications of the scores on the patients. Dr. McGuire was involved in data collection and article revision and editing.

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The authors have disclosed that they do not have any potential conflicts of interest.

Ethical approval: Waived due to retrospective analytical nature of the study.

For information regarding this article, E-mail: carnitin7@yahoo.com; dr.ahmedabdelaalmahmoud@gmail.com; ahmed.alkhatip@nhs.net

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