A Comparison of ECG and Three Clinical Scoring Methods for the Diagnosis of Pulmonary Thromboembolism

Objective: The clinical diagnosis of pulmonary thromboembolism (PTE) is unreliable because the most frequent symptoms are non-specific. The most important step in making the diagnosis of PTE is to clinically suspect the disease. The aim of the present study was to compare the diagnostic efficiency of an electrocardiogram (ECG) and the Wells, Geneva, and Miniati clinical scoring methods for the diagnosis of PTE. Material and Method: A prospective study was conducted between January 2006 and January 2007, in which 52 consecutive patients with suspected PTE were enrolled. Results: Twenty-seven patients were males and 25 were females; the mean age was 52±16.3 years. Thirty-six patients were diagnosed with a PTE. The PTE diagnosis rates among the high probability group were 91.3%, 76.5%, and 100% for the Wells, Geneva, and Miniati clinical scoring methods, respectively. The sensitivity and specificity were 66% and 56%, respectively, when the cut-off value of the ECG score was 3, whereas the sensitivity and specificity were 36% and 100%, respectively, when the cut-off value was 5. Conclusion: The Wells and Miniati clinical scoring methods were shown to be more predictive of PTE than the Geneva clinical scoring method and an ECG, whereas an ECG was more predictive than the Geneva clinical scoring method.