Comparison of a clinical probability estimate and two clinical models in patients with suspected pulmonary embolism. ANTELOPE-Study Group

Thromb Haemost. 2000 Feb;83(2):199-203.


Recent studies have suggested that both the subjective judgement of a physician and standardized clinical models can be helpful in the estimation of the probability of the disease in patients with suspected pulmonary embolism (PE). We performed a multi-center study in consecutive in- and outpatients with suspected PE to compare the potential diagnostic utility of these methods. Of the 517 study patients, 160 (31%) were classified as having PE. Of these patients, 14% had a low probability as estimated by the treating physician, while 25 to 36% were categorized as having a low clinical probability with the use of two previously described clinical models. The objectively confirmed prevalence of PE in these three low probability categories was 19%, 28% and 28%, respectively. The three methods yielded comparable predictive values for PE in the other probability categories. We conclude that a physician's clinical judgement alone and two standardized clinical models, although comparable, perform disappointingly in categorizing the pre-test probability in patients with suspected PE.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Arteries / pathology
  • Decision Support Techniques
  • Diagnosis, Computer-Assisted
  • Diagnostic Techniques and Procedures*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Observer Variation
  • Predictive Value of Tests
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / pathology
  • Reproducibility of Results