Abdelaal Ahmed Mahmoud M Alkhatip Ahmed, Donnelly Maria, Snyman Lindi, Conroy Patrick, Hamza Mohamed Khaled, Murphy Ian, Purcell Andrew, McGuire David
Department of Anesthesia, Beni-Suef University Hospital and Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom.
Crit Care Med. 2020 May;48(5):704-708. doi: 10.1097/CCM.0000000000004271.
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.
Retrospective analytical study.
A tertiary University Hospital in Ireland.
Data from 794 patients who underwent CT pulmonary angiography to rule out pulmonary embolism.
Patients were analyzed using retrospective application of both Wells' score and YEARS algorithm. Sensitivity, specificity, and diagnostic odds ratio were calculated and compared.
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%).
Both scores successfully exclude pulmonary embolism, although YEARS has a better negative predictive value. Both exhibit poor positive predictive value.
本研究对同一组患者样本回顾性应用Wells评分和YEARS算法，以评估与金标准CT肺动脉造影相比时各自的预测性能。
回顾性分析研究。
爱尔兰的一家三级大学医院。
794例接受CT肺动脉造影以排除肺栓塞患者的数据。
对患者采用Wells评分和YEARS算法的回顾性应用进行分析。计算并比较敏感性、特异性和诊断比值比。
在794次扫描中，78例（9.8%）肺栓塞呈阳性。YEARS算法比Wells评分更敏感（97.44%对74.36%），但特异性较低（13.97%对33.94%）。此外，YEARS的诊断比值比高于Wells评分（6.27对1.48）。YEARS具有更好的阴性预测值（98%对92.4%），且两种评分的阳性预测值均较差（10.9%）。
尽管YEARS具有更好的阴性预测值，但两种评分均能成功排除肺栓塞。两者的阳性预测值均较差。
