Document Detail


Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED).
MedLine Citation:
PMID:  2332918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the sensitivities and specificities of ventilation/perfusion lung scans for acute pulmonary embolism, a random sample of 933 of 1493 patients was studied prospectively. Nine hundred thirty-one underwent scintigraphy and 755 underwent pulmonary angiography; 251 (33%) of 755 demonstrated pulmonary embolism. Almost all patients with pulmonary embolism had abnormal scans of high, intermediate, or low probability, but so did most without pulmonary embolism (sensitivity, 98%; specificity, 10%). Of 116 patients with high-probability scans and definitive angiograms, 102 (88%) had pulmonary embolism, but only a minority with pulmonary embolism had high-probability scans (sensitivity, 41%; specificity, 97%). Of 322 with intermediate-probability scans and definitive angiograms, 105 (33%) had pulmonary embolism. Follow-up and angiography together suggest pulmonary embolism occurred among 12% of patients with low-probability scans. Clinical assessment combined with the ventilation/perfusion scan established the diagnosis or exclusion of pulmonary embolism only for a minority of patients--those with clear and concordant clinical and ventilation/perfusion scan findings.
Authors:
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA     Volume:  263     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:    1990 May 23-30
Date Detail:
Created Date:  1990-06-07     Completed Date:  1990-06-07     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2753-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Female
Follow-Up Studies
Humans
Lung / radionuclide imaging
Male
Methods
Middle Aged
Observer Variation
Outcome and Process Assessment (Health Care)
Predictive Value of Tests
Probability
Prospective Studies
Pulmonary Artery / radiography,  radionuclide imaging
Pulmonary Embolism / radionuclide imaging*
Random Allocation
Grant Support
ID/Acronym/Agency:
N01-HR-34007/HR/NHLBI NIH HHS; N01-HR-34008/HR/NHLBI NIH HHS; N01-HR-34009/HR/NHLBI NIH HHS
Comments/Corrections
Comment In:
JAMA. 1990 May 23-30;263(20):2794-5   [PMID:  2185372 ]
JAMA. 1990 Nov 28;264(20):2623-5   [PMID:  2232035 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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