| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Harvard Medical School and the Peter Bent Brigham Hospital, Boston, Massachusetts
Correspondence: For reprints contact: Barbara J. McNeil, MD, Harvard Medical School, 25 Shattuck St., Boston, MA 02115.
ABSTRACT
Various diagnostic strategies for the assessment of pulmonary embolism were developed using the results of scintigraphic examinations In 169 patients who had both scintigraphic studies and pulmonary angiography. Likelihood ratios for several perfusion and ventilation-perfusion patterns were first obtained, and Bayes' Theorem was then applied using a range of prior probabilities for pulmonary embolism. Resulting posterior probabilities ranged from under 10% to over 90%. The former values held for patients with small perfusion defects and no ventilation study, regardless of their prior probabilities for pulmonary embolism. The latter values held for patients with average to high prior probabilities and ventilation-perfusion mismatches.
This article has been cited by other articles:
|
|
 |
|
  P. D. Stein, R. D. Hull, W. A. Ghali, K. C. Patel, R. E. Olson, F. A. Meyers, and N. K. Kalra Tracking the Uptake of Evidence: Two Decades of Hospital Practice Trends for Diagnosing Deep Vein Thrombosis and Pulmonary Embolism Arch Intern Med, May 26, 2003; 163(10): 1213 - 1219. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. R. van Beek, E. M. J. Brouwers, Bing Song, A. H. H. Bongaerts, and M. Oudkerk Lung Scintigraphy and Helical Computed Tomography for the Diagnosis of Pulmonary Embolism: A Meta-Analysis Clinical and Applied Thrombosis/Hemostasis, April 1, 2001; 7(2): 87 - 92. [Abstract] [PDF]
|
|
|
|
 |
|
 P. D. Stein and A. Gottschalk Review of Criteria Appropriate for a Very Low Probability of Pulmonary Embolism on Ventilation-Perfusion Lung Scans: A Position Paper RadioGraphics, January 1, 2000; 20(1): 99 - 105. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Rajendran and A. F. Jacobson Review of 6-Month Mortality Following Low-Probability Lung Scans Arch Intern Med, February 22, 1999; 159(4): 349 - 352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hirsh and J. Hoak Management of Deep Vein Thrombosis and Pulmonary Embolism : A Statement for Healthcare Professionals From the Council on Thrombosis (in Consultation With the Council on Cardiovascular Radiology), American Heart Association Circulation, June 15, 1996; 93(12): 2212 - 2245. [Full Text]
|
|
|
|
|
|
R. D. Hull, W. Feldstein, P. D. Stein, and G. F. Pineo Cost-effectiveness of Pulmonary Embolism Diagnosis Arch Intern Med, January 8, 1996; 156(1): 68 - 72. [Abstract] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, G. F. Pineo, and R. F. Brant The Low-Probability Lung Scan: A Need for Change in Nomenclature Arch Intern Med, September 25, 1995; 155(17): 1845 - 1851. [Abstract] [PDF]
|
|
|
|
 |
|
 D.M. Systrom and E.J. Mark Case 19-1995- A 55-year-old woman with acute respiratory failure and radiographically clear lungs N. Engl. J. Med., June 22, 1995; 332(25): 1700 - 1707. [Full Text] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, G. F. Pineo, and R. F. Brant The Treatment of Proximal Vein Thrombosis with Subcutaneous Low-Mole Molecular-Weight Heparin Compared with Continuous Intravenous Heparin Clinical and Applied Thrombosis/Hemostasis, March 1, 1995; 1(2): 151 - 159. [Abstract] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, J. S. Ginsberg, A. A. Panju, P. Brill-Edwards, G. Coates, and G. F. Pineo A Noninvasive Strategy for the Treatment of Patients With Suspected Pulmonary Embolism Arch Intern Med, February 14, 1994; 154(3): 289 - 297. [Abstract] [PDF]
|
|
|
|
 |
|
 G. E. Hastings, D. S. Seery, and D. L. Vine Recent Developments in the Diagnosis, Treatment, and Prevention of Pulmonary Embolism Arch Fam Med, June 1, 1993; 2(6): 655 - 669. [Abstract] [PDF]
|
|
|
|
|
|
M. Oudkerk, E. J. R. van Beek, W. L. J. van Putten, and H. R. Buller Cost-effectiveness Analysis of Various Strategies in the Diagnostic Management of Pulmonary Embolism Arch Intern Med, April 26, 1993; 153(8): 947 - 954. [Abstract] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, D. Rosenbloom, J. Lemaire, G. F. Pineo, B. Baylis, J. S. Ginsberg, A. A. Panju, P. Brill-Edwards, and R. Brant Optimal Therapeutic Level of Heparin Therapy in Patients With Venous Thrombosis Arch Intern Med, August 1, 1992; 152(8): 1589 - 1595. [Abstract] [PDF]
|
|
|
|
 |
|
 W. Seed Pulmonary embolism: Part 2 Diagnostic methods and management Vascular Medicine, September 1, 1991; 2(2): 121 - 136. [PDF]
|
|
|
|
 |
|
 R. D. Hull and G. E. Raskob Low-Probability Lung Scan Findings: A Need for Change Ann Intern Med, January 15, 1991; 114(2): 142 - 143. [Abstract] [PDF]
|
|
|
|
 |
|
 The PIOPED Investigators Value of the Ventilation/Perfusion Scan in Acute Pulmonary Embolism: Results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) JAMA, May 23, 1990; 263(20): 2753 - 2759. [Abstract] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, M. Gent, D. McLoughlin, D. Julian, F. C. Smith, N. I. Dale, R. Reed-Davis, R. N. Lofthouse, and C. Anderson Effectiveness of Intermittent Pneumatic Leg Compression for Preventing Deep Vein Thrombosis After Total Hip Replacement JAMA, May 2, 1990; 263(17): 2313 - 2317. [Abstract] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, G. Coates, A. A. Panju, and G. J. Gill A New Noninvasive Management Strategy for Patients With Suspected Pulmonary Embolism Arch Intern Med, November 1, 1989; 149(11): 2549 - 2555. [Abstract] [PDF]
|
|
|
|
|
|
D. Kahn, D. L. Bushnell, R. Dean, and S. B. Perlman Clinical Outcome of Patients With a 'Low Probability' of Pulmonary Embolism on Ventilation-Perfusion Lung Scan Arch Intern Med, February 1, 1989; 149(2): 377 - 379. [Abstract] [PDF]
|
|
|
|
|
|
R. D. Hull, G. E. Raskob, C. J. Carter, G. Coates, G. J. Gill, D. L. Sackett, J. Hirsh, and M. Thompson Pulmonary Embolism in Outpatients With Pleuritic Chest Pain Arch Intern Med, April 1, 1988; 148(4): 838 - 844. [Abstract] [PDF]
|
|
|
|
|
|
C. M REMBOLD and D. WATSON Posttest Probability Calculation by Weights: A Simple Form of Bayes' Theorem Ann Intern Med, January 1, 1988; 108(1): 115 - 120. [Abstract] [PDF]
|
|
|
|
|
|
J. P. KASSIRER, A. J. MOSKOWITZ, J. LAU, and S. G. PAUKER Decision Analysis: A Progress Report Ann Intern Med, February 1, 1987; 106(2): 275 - 291. [Abstract] [PDF]
|
|
|
|
|
|
W. J. Fulkerson, R. E. Coleman, C. E. Ravin, and H. A. Saltzman Diagnosis of Pulmonary Embolism Arch Intern Med, May 1, 1986; 146(5): 961 - 967. [Abstract] [PDF]
|
|
|
|
|
|
J. T. PHILBRICK Diagnosis of Pulmonary Embolism Ann Intern Med, November 1, 1983; 99(5): 729 - 732. [Abstract] [PDF]
|
|
|
|
|
|
R. D. HULL, J. HIRSH, C. J. CARTER, R. M. JAY, P. E. DODD, P. A. OCKELFORD, G. COATES, G. J. GILL, A. G. TURPIE, D. J. DOYLE, et al. Pulmonary Angiography, Ventilation Lung Scanning, and Venography for Clinically Suspected Pulmonary Embolism with Abnormal Perfusion Lung Scan Ann Intern Med, June 1, 1983; 98(6): 891 - 899. [Abstract] [PDF]
|
|
|
|
|
|
R. H. SECKER-WALKER On Purple Emperors, Pulmonary Embolism, and Venous Thrombosis Ann Intern Med, June 1, 1983; 98(6): 1006 - 1008. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
