Adding a visual linear scale probability to the PIOPED probability of pulmonary embolism.
OBJECTIVE
Reporting a lung scintigraphy diagnosis as a PIOPED categorical probability of pulmonary embolism offers the clinician a wide range of interpretation. Therefore the purpose of this study was to analyze the impact on lung scintigraphy reporting of adding a visual linear scale (VLS) probability assessment to the ordinary PIOPED categorical probability.


METHODS
The study material was a re-evaluation of lung scintigrams from a prospective study of 170 patients. All patients had been examined by lung scintigraphy and pulmonary angiography. The scintigrams were re-evaluated by 3 raters, and the probability of pulmonary embolism was estimated by the PIOPED categorization and by a VLS probability. The test was repeated after 6 months.


RESULTS
There was no significant difference (p > 0.05) in the area under the ROC curve between the PIOPED categorization and the VLS for any of the 3 raters. Analysis of agreement among raters and for repeatability demonstrated low agreement in the mid-range of probabilities.


CONCLUSIONS
A VLS probability estimate did not significantly improve the overall accuracy of the diagnosis compared to the categorical PIOPED probability assessment alone. From the data of our present study we cannot recommend the addition of a VLS score to the PIOPED categorization.
Christiansen
F
F
Department of Diagnostic Radiology, Orebro Medical Center Hospital, Sweden.
Nilsson
T
T
Måre
K
K
Carlsson
A
A
D000792:Angiography; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D006801:Humans; D015588:Observer Variation; D011336:Probability; D011446:Prospective Studies; D011652:Pulmonary Circulation; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012372:ROC Curve; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012119:Respiration; D018570:Risk Assessment; D013668:Technetium Tc 99m Aggregated Albumin; D014692:Ventilation-Perfusion Ratio
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin