Jeffry A. Kline, MD
How does a simplified version compare with the original version of the revised Geneva score for diagnosing pulmonary embolism (PE)?
Pooling of 2 cohort studies to validate a simplified version of the previously developed revised Geneva score.
4 hospitals in Europe.
1049 patients (60% women) with suspected PE: 749 from study A (mean age 60 y) and 300 from study B (mean age 47 y).
The revised Geneva score was a summation of 8 variables: age > 65 years = 1, previous deep venous thrombosis or PE = 3, surgery under general anesthesia or fracture of the lower limbs within 1 month = 2, active cancer = 2, unilateral lower limb pain = 3, hemoptysis = 2, heart rate (75 to 94 beats/min = 3, ≥ 95 beats/min = 5), pain on lower limb deep venous palpation and unilateral edema = 4. In the simplified score, all variables had the same weight (1 point/item). The revised Geneva score categorized patients into 3 risk groups: low (score 0 to 3, simplified score 0 to 1), intermediate (score 4 to 10, simplified score 2 to 4), and high (score ≥ 11, simplified score ≥ 5).
Diagnosis of PE.
Overall, 241 patients (23%) in the pooled cohort had venous thromboembolism. The prevalences of PE and likelihood ratios according to risk group are in the Table. The areas under the receiver-operating characteristic curve for 3-level risk classification using the simplified and original versions of the revised Geneva score were 0.68 (95% CI 0.64 to 0.72) and 0.70 (CI 0.66 to 0.74), respectively.
A simplified version did not differ from the original version of the revised Geneva score for diagnosing pulmonary embolism.
Prevalence and likelihood ratios (LRs) for pulmonary embolism (PE) using the simplified version of the revised Geneva score*
*LR and CI defined in Glossary.
Kline JA. Simplification of the revised Geneva score did not decrease accuracy for diagnosis of pulmonary embolism. Ann Intern Med. ;150:JC3–15. doi: 10.7326/0003-4819-150-6-200903170-02015
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Published: Ann Intern Med. 2009;150(6):JC3-15.
Emergency Medicine, Pulmonary Embolism, Pulmonary/Critical Care, Venous Thromboembolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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