{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:11:07Z","timestamp":1791544267157,"version":"4.3.4"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2021,6,1]]},"DOI":"10.1001\/jamacardio.2021.0064","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T16:49:43Z","timestamp":1614790183000},"page":"669","source":"Crossref","is-referenced-by-count":49,"title":["Derivation and Validation of a 4-Level Clinical Pretest Probability Score for Suspected Pulmonary Embolism to Safely Decrease Imaging Testing"],"prefix":"10.1001","volume":"6","author":[{"given":"Pierre-Marie","family":"Roy","sequence":"first","affiliation":[{"name":"Emergency Department, CHU Angers, Institut Mitovasc UMR (CNRS 6015\u2014INSERM 1083), UNIV Angers, F-CRIN INNOVTE, Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Friou","sequence":"additional","affiliation":[{"name":"Emergency Department, CHU Angers, Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Germeau","sequence":"additional","affiliation":[{"name":"Emergency Department, Cliniques Universitaires Saint Luc, Universit\u00e9 Catholique de Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Douillet","sequence":"additional","affiliation":[{"name":"Emergency Department, CHU Angers, Institut Mitovasc UMR (CNRS 6015\u2014INSERM 1083), UNIV Angers, F-CRIN INNOVTE, Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey Allen","family":"Kline","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Righini","sequence":"additional","affiliation":[{"name":"Division of Angiology and Hemostasis, Department of Internal Medicine, Faculty of Medicine, Geneva University Hospital, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gr\u00e9goire","family":"Le Gal","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, The Ottawa Hospital, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Moumneh","sequence":"additional","affiliation":[{"name":"Emergency Department, CHU Angers, Institut Mitovasc UMR (CNRS 6015\u2014INSERM 1083), UNIV Angers, F-CRIN INNOVTE, Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Penaloza","sequence":"additional","affiliation":[{"name":"Emergency Department, Cliniques Universitaires Saint Luc, Universit\u00e9 Catholique de Louvain, F-CRIN INNOVTE, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"hoi210002r1","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"issue":"1","key":"hoi210002r2","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCOUTCOMES.119.005753","article-title":"Over-testing for suspected pulmonary embolism in American emergency departments: the continuing epidemic.","volume":"13","author":"Kline","year":"2020","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"11","key":"hoi210002r3","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.26930","article-title":"Trends in imaging for suspected pulmonary embolism across US health care systems, 2004 to 2016.","volume":"3","author":"Wang","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"1","key":"hoi210002r4","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1183\/20734735.0339-2018","article-title":"Overdiagnosis of pulmonary embolism: definition, causes and implications.","volume":"15","author":"Dobler","year":"2019","journal-title":"Breathe (Sheff)"},{"issue":"9","key":"hoi210002r5","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1001\/archinternmed.2011.178","article-title":"Time trends in pulmonary embolism in the United States: evidence of overdiagnosis.","volume":"171","author":"Wiener","year":"2011","journal-title":"Arch Intern Med"},{"issue":"6","key":"hoi210002r6","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1111\/j.1553-2712.2012.01374.x","article-title":"Prospective study of the incidence of contrast-induced nephropathy among patients evaluated for pulmonary embolism by contrast-enhanced computed tomography.","volume":"19","author":"Mitchell","year":"2012","journal-title":"Acad Emerg Med"},{"issue":"7","key":"hoi210002r7","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1177\/0284185113485069","article-title":"Computed tomography for pulmonary embolism: assessment of a 1-year cohort and estimated cancer risk associated with diagnostic irradiation.","volume":"54","author":"Niemann","year":"2013","journal-title":"Acta Radiol"},{"issue":"3","key":"hoi210002r8","doi-asserted-by":"publisher","first-page":"165","DOI":"10.7326\/0003-4819-144-3-200602070-00004","article-title":"Prediction of pulmonary embolism in the emergency department: the revised Geneva score.","volume":"144","author":"Le Gal","year":"2006","journal-title":"Ann Intern Med"},{"issue":"11","key":"hoi210002r9","doi-asserted-by":"publisher","first-page":"812","DOI":"10.7326\/0003-4819-144-11-200606060-00007","article-title":"An evaluation of D-dimer in the diagnosis of pulmonary embolism: a randomized trial.","volume":"144","author":"Kearon","year":"2006","journal-title":"Ann Intern Med"},{"issue":"8","key":"hoi210002r10","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1111\/jth.2004.2.issue-8","article-title":"Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism.","volume":"2","author":"Kline","year":"2004","journal-title":"J Thromb Haemost"},{"issue":"11","key":"hoi210002r11","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1001\/jama.2014.2135","article-title":"Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study.","volume":"311","author":"Righini","year":"2014","journal-title":"JAMA"},{"issue":"10091","key":"hoi210002r12","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/S0140-6736(17)30885-1","article-title":"Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study.","volume":"390","author":"van der Hulle","year":"2017","journal-title":"Lancet"},{"issue":"22","key":"hoi210002r13","doi-asserted-by":"publisher","first-page":"2125","DOI":"10.1056\/NEJMoa1909159","article-title":"Diagnosis of pulmonary embolism with D-dimer adjusted to clinical probability.","volume":"381","author":"Kearon","year":"2019","journal-title":"N Engl J Med"},{"issue":"9","key":"hoi210002r14","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1136\/emermed-2012-201730","article-title":"Pulmonary Embolism Rule-out Criteria (PERC) in pulmonary embolism\u2014revisited: a systematic review and meta-analysis.","volume":"30","author":"Singh","year":"2013","journal-title":"Emerg Med J"},{"issue":"5","key":"hoi210002r15","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1111\/jth.2008.6.issue-5","article-title":"Prospective multicenter evaluation of the Pulmonary Embolism Rule-out Criteria.","volume":"6","author":"Kline","year":"2008","journal-title":"J Thromb Haemost"},{"issue":"5","key":"hoi210002r16","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1111\/jth.2017.15.issue-5","article-title":"Towards a tailored diagnostic standard for future diagnostic studies in pulmonary embolism: communication from the SSC of the ISTH.","volume":"15","author":"Dronkers","year":"2017","journal-title":"J Thromb Haemost"},{"issue":"3","key":"hoi210002r17","doi-asserted-by":"publisher","first-page":"157","DOI":"10.7326\/0003-4819-144-3-200602070-00003","article-title":"Appropriateness of diagnostic management and outcomes of suspected pulmonary embolism.","volume":"144","author":"Roy","year":"2006","journal-title":"Ann Intern Med"},{"issue":"10","key":"hoi210002r18","doi-asserted-by":"publisher","first-page":"677","DOI":"10.7326\/0003-4819-151-10-200911170-00003","article-title":"A computerized handheld decision-support system to improve pulmonary embolism diagnosis: a randomized trial.","volume":"151","author":"Roy","year":"2009","journal-title":"Ann Intern Med"},{"issue":"9621","key":"hoi210002r19","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1016\/S0140-6736(08)60594-2","article-title":"Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial.","volume":"371","author":"Righini","year":"2008","journal-title":"Lancet"},{"issue":"12","key":"hoi210002r20","doi-asserted-by":"publisher","first-page":"e615","DOI":"10.1016\/S2352-3026(17)30210-7","article-title":"Pulmonary Embolism Rule-out Criteria (PERC) rule in European patients with low implicit clinical probability (PERCEPIC): a multicentre, prospective, observational study.","volume":"4","author":"Penaloza","year":"2017","journal-title":"Lancet Haematol"},{"issue":"12","key":"hoi210002r21","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1093\/qjmed\/hcm113","article-title":"The value of clinical features in the diagnosis of acute pulmonary embolism: systematic review and meta-analysis.","volume":"100","author":"West","year":"2007","journal-title":"QJM"},{"issue":"13","key":"hoi210002r22","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1056\/NEJM198509263131306","article-title":"Clinical prediction rules. applications and methodological standards.","volume":"313","author":"Wasson","year":"1985","journal-title":"N Engl J Med"},{"issue":"4","key":"hoi210002r24","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4&lt;361::AID-SIM168&gt;3.0.CO;2-4","article-title":"Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors.","volume":"15","author":"Harrell","year":"1996","journal-title":"Stat Med"},{"issue":"5","key":"hoi210002r25","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1056\/NEJM197507312930513","article-title":"Letter: nomogram for Bayes theorem.","volume":"293","author":"Fagan","year":"1975","journal-title":"N Engl J Med"},{"issue":"3","key":"hoi210002r26","doi-asserted-by":"publisher","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach.","volume":"44","author":"DeLong","year":"1988","journal-title":"Biometrics"},{"issue":"2","key":"hoi210002r27","doi-asserted-by":"publisher","first-page":"271","DOI":"10.2214\/AJR.14.13938","article-title":"Overdiagnosis of pulmonary embolism by pulmonary CT angiography.","volume":"205","author":"Hutchinson","year":"2015","journal-title":"AJR Am J Roentgenol"},{"issue":"5","key":"hoi210002r28","doi-asserted-by":"publisher","first-page":"e189","DOI":"10.1016\/j.thromres.2012.02.016","article-title":"Performance of the Pulmonary Embolism Rule-out Criteria (the PERC rule) combined with low clinical probability in high prevalence population.","volume":"129","author":"Penaloza","year":"2012","journal-title":"Thromb Res"},{"issue":"2","key":"hoi210002r29","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1111\/j.1538-7836.2010.04147.x","article-title":"The Pulmonary Embolism Rule-out Criteria (PERC) rule does not safely exclude pulmonary embolism.","volume":"9","author":"Hugli","year":"2011","journal-title":"J Thromb Haemost"},{"issue":"4","key":"hoi210002r30","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1111\/j.1538-7836.2012.04647.x","article-title":"D-dimer threshold increase with pretest probability unlikely for pulmonary embolism to decrease unnecessary computerized tomographic pulmonary angiography.","volume":"10","author":"Kline","year":"2012","journal-title":"J Thromb Haemost"},{"key":"hoi210002r31","doi-asserted-by":"crossref","DOI":"10.1111\/jth.15083","article-title":"External validation of the YEARS diagnostic algorithm for suspected pulmonary embolism.","author":"Eddy","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"9","key":"hoi210002r32","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1111\/acem.12471","article-title":"Systematic review and meta-analysis of pregnant patients investigated for suspected pulmonary embolism in the emergency department.","volume":"21","author":"Kline","year":"2014","journal-title":"Acad Emerg Med"},{"issue":"2","key":"hoi210002r33","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.annemergmed.2012.11.002","article-title":"Comparison of the unstructured clinician gestalt, the Wells score, and the revised Geneva score to estimate pretest probability for suspected pulmonary embolism.","volume":"62","author":"Penaloza","year":"2013","journal-title":"Ann Emerg Med"},{"issue":"9","key":"hoi210002r34","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1111\/acem.12450","article-title":"Arming the bayesian physician to rule out pulmonary embolism: using evidence-based diagnostics to combat overtesting.","volume":"21","author":"Carpenter","year":"2014","journal-title":"Acad Emerg Med"},{"key":"hoi210002r23","volume-title":"Applied Logistic Regression","author":"Hosmer","year":"1989"}],"container-title":["JAMA Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/articlepdf\/2776853\/jamacardiology_roy_2021_oi_210002_1623268694.15043.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T15:02:11Z","timestamp":1623682931000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/fullarticle\/2776853"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,1]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamacardio.2021.0064","relation":{},"ISSN":["2380-6583"],"issn-type":[{"value":"2380-6583","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6,1]]}}}