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Geneva Score
The Geneva score is a clinical prediction rule used in determining the pre-test probability of pulmonary embolism (PE) based on a patient's risk factors and clinical findings. It has been shown to be as accurate as the Wells Score, and is less reliant on the experience of the doctor applying the rule. The Geneva score has been revised and simplified from its original version. The simplified Geneva score is the newest version for the general population, and predicted to have the same diagnostic utility as the original Geneva score. A version of the revised score was modified to be applicable to pregnant patients. Original Geneva Score The original Geneva score was developed in 2001 in Geneva, Switzerland. It's calculated using 7 risk factors and clinical variables: The score obtained relates to the probability of the patient having had a pulmonary embolism (the lower the score, the lower the probability): * 8 points indicates a high probability of PE. (81%) Revised Geneva Sc ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Clinical Prediction Rule
A clinical prediction rule or clinical probability assessment specifies how to use medical signs, symptoms, and other findings to estimate the probability of a specific disease or clinical outcome. Physicians have difficulty in estimated risks of diseases; frequently erring towards overestimation, perhaps due to cognitive biases such as base rate fallacy in which the risk of an adverse outcome is exaggerated. Methods In a prediction rule study, investigators identify a consecutive group of patients who are suspected of having a specific disease or outcome. The investigators then obtain a standard set of clinical observations on each patient and a test or clinical follow-up to define the true state of the patient. They then use statistical methods to identify the best clinical predictors of the patient's true state. The probability of disease will depend on the patient's key clinical predictors. Published methodological standards specify good practices for developing a clinical pred ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pre- And Post-test Probability
Pre-test probability and post-test probability (alternatively spelled pretest and posttest probability) are the probabilities of the presence of a condition (such as a disease) before and after a diagnostic test, respectively. ''Post-test probability'', in turn, can be ''positive'' or ''negative'', depending on whether the test falls out as a positive test or a negative test, respectively. In some cases, it is used for the probability of developing the condition of interest in the future. Test, in this sense, can refer to any medical test (but usually in the sense of diagnostic tests), and in a broad sense also including questions and even assumptions (such as assuming that the target individual is a female or male). The ability to make a difference between pre- and post-test probabilities of various conditions is a major factor in the indication of medical tests. Pre-test probability The pre-test probability of an individual can be chosen as one of the following: *The prevalenc ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pulmonary Embolism
Pulmonary embolism (PE) is a blockage of an pulmonary artery, artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include dyspnea, shortness of breath, chest pain particularly upon breathing in, and coughing up blood. Symptoms of a deep vein thrombosis, blood clot in the leg may also be present, such as a erythema, red, warm, swollen, and painful leg. Signs of a PE include low blood oxygen saturation, oxygen levels, tachypnea, rapid breathing, tachycardia, rapid heart rate, and sometimes a mild fever. Severe cases can lead to Syncope (medicine), passing out, shock (circulatory), abnormally low blood pressure, obstructive shock, and cardiac arrest, sudden death. PE usually results from a blood clot in the leg that travels to the lung. The risk of blood clots is increased by advanced age, cancer, prolonged bed rest and immobilization, smoking, stroke, long-haul travel over 4 hours, certain genetics, g ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pulmonary Embolism
Pulmonary embolism (PE) is a blockage of an pulmonary artery, artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include dyspnea, shortness of breath, chest pain particularly upon breathing in, and coughing up blood. Symptoms of a deep vein thrombosis, blood clot in the leg may also be present, such as a erythema, red, warm, swollen, and painful leg. Signs of a PE include low blood oxygen saturation, oxygen levels, tachypnea, rapid breathing, tachycardia, rapid heart rate, and sometimes a mild fever. Severe cases can lead to Syncope (medicine), passing out, shock (circulatory), abnormally low blood pressure, obstructive shock, and cardiac arrest, sudden death. PE usually results from a blood clot in the leg that travels to the lung. The risk of blood clots is increased by advanced age, cancer, prolonged bed rest and immobilization, smoking, stroke, long-haul travel over 4 hours, certain genetics, g ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Wells' Score For Pulmonary Embolism
The Wells score is a clinical prediction rule used to classify patients suspected of having pulmonary embolism (PE) into risk groups by quantifying the pre-test probability. It is different than Well's score for DVT (deep vein thrombosis). It was originally described by Well's et al. in 1998, using their experience from creating Well's score for DVT in 1995. Today, there are multiple (revised or simplified) versions of the rule, which may lead to ambiguity. The purpose of the rule is to select the best method of investigation (e.g. D-dimer testing, CT angiography) for ruling in or ruling out the diagnosis of PE, and to improve the interpretation and accuracy of subsequent testing, based on a Bayesian framework for the probability of the diagnosis. The rule is more objective than clinician gestalt, but still includes subjective opinion (unlike e.g. Geneva score). Original algorithm Originally it was developed in 1998 to improve the low specificity of V/Q scan results (which ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Arterial Blood Gas Sampling
An arterial blood gas (ABG) test, or arterial blood gas analysis (ABGA) measures the amounts of arterial gases, such as oxygen and carbon dioxide. An ABG test requires that a small volume of blood be drawn from the radial artery with a syringe and a thin needle, but sometimes the femoral artery in the groin or another site is used. The blood can also be drawn from an arterial catheter. An ABG test measures the blood gas tension values of the arterial partial pressure of oxygen (PaO2), and the arterial partial pressure of carbon dioxide (PaCO2), and the blood's pH. In addition, the arterial oxygen saturation (SaO2) can be determined. Such information is vital when caring for patients with critical illnesses or respiratory disease. Therefore, the ABG test is one of the most common tests performed on patients in intensive-care units. In other levels of care, pulse oximetry plus transcutaneous carbon-dioxide measurement is a less invasive, alternative method of obtaining similar ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
D-dimer
D-dimer (or D dimer) is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two D fragments of the fibrin protein joined by a cross-link, hence forming a protein dimer. D-dimer concentration may be determined by a blood test to help diagnose thrombosis. Since its introduction in the 1990s, it has become an important test performed in people with suspected thrombotic disorders, such as venous thromboembolism. While a negative result practically rules out thrombosis, a positive result can indicate thrombosis, but does not exclude other potential causes. Its main use, therefore, is to exclude thromboembolic disease where the probability is low. D-dimer levels are used as a predictive biomarker for the blood disorder, disseminated intravascular coagulation and in the coagulation disorders associated with COVID-19 infection. A four-fold increase in the protein is an ind ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Ventilation/perfusion Scan
A ventilation/perfusion lung scan, also called a V/Q lung scan, or ventilation/perfusion scintigraphy, is a type of medical imaging using scintigraphy and medical isotopes to evaluate the circulation of air and blood within a patient's lungs, in order to determine the ventilation/perfusion ratio. The ventilation part of the test looks at the ability of air to reach all parts of the lungs, while the perfusion part evaluates how well blood circulates within the lungs. As Q in physiology is the letter used to describe bloodflow the term V/Q scan emerged. Uses This test is most commonly done in order to check for the presence of a blood clot or abnormal blood flow inside the lungs (such as a pulmonary embolism (PE) although computed tomography with radiocontrast is now more commonly used for this purpose. The V/Q scan may be used in some circumstances where radiocontrast would be inappropriate, as in Allergy to contrast agent or kidney failure. A V/Q lung scan may be performed in th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
CT Pulmonary Angiogram
A CT pulmonary angiogram (CTPA) is a medical diagnostic test that employs computed tomography (CT) angiography to obtain an image of the pulmonary arteries. Its main use is to diagnose pulmonary embolism (PE). It is a preferred choice of imaging in the diagnosis of PE due to its minimally invasive nature for the patient, whose only requirement for the scan is an intravenous line. Modern MDCT (multi-detector CT) scanners are able to deliver images of sufficient resolution within a short time period, such that CTPA has now supplanted previous methods of testing, such as direct pulmonary angiography, as the gold standard for diagnosis of pulmonary embolism. The patient receives an intravenous injection of an iodine-containing contrast agent at a high-rate using an injector pump. Images are acquired with the maximum intensity of radio-opaque contrast in the pulmonary arteries. This can be done using bolus tracking. A normal CTPA scan will show the contrast filling the pulmonary ves ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Archives Of Internal Medicine
''JAMA Internal Medicine'' is a monthly peer-reviewed medical journal published by the American Medical Association. It was established in 1908 as the ''Archives of Internal Medicine'' and obtained its current title in 2013. It covers all aspects of internal medicine, including cardiovascular disease, geriatrics, infectious disease, gastroenterology, endocrinology, allergy, and immunology. The editor in chief is Rita F. Redberg (University of California, San Francisco). According to ''Journal Citation Reports'', the journal's 2021 impact factor is 44.409, ranking it 7th out of 172 journals in the category "Medicine, General & Internal". Naming history Abstracting and indexing The journal is abstracted and indexed in Index Medicus/MEDLINE/PubMed. See also * List of American Medical Association journals A ''list'' is any set of items in a row. List or lists may also refer to: People * List (surname) Organizations * List College, an undergraduate division of the Jew ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Receiver Operating Characteristic
A receiver operating characteristic curve, or ROC curve, is a graphical plot that illustrates the diagnostic ability of a binary classifier system as its discrimination threshold is varied. The method was originally developed for operators of military radar receivers starting in 1941, which led to its name. The ROC curve is created by plotting the true positive rate (TPR) against the false positive rate (FPR) at various threshold settings. The true-positive rate is also known as sensitivity, recall or ''probability of detection''. The false-positive rate is also known as ''probability of false alarm'' and can be calculated as (1 − specificity). The ROC can also be thought of as a plot of the power as a function of the Type I Error of the decision rule (when the performance is calculated from just a sample of the population, it can be thought of as estimators of these quantities). The ROC curve is thus the sensitivity or recall as a function of fall-out. In general, if the ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Diagnostic Emergency Medicine
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engineering and computer science, it is typically used to determine the causes of symptoms, mitigations, and solutions. Computer science and networking * Bayesian networks * Complex event processing * Diagnosis (artificial intelligence) * Event correlation * Fault management * Fault tree analysis * Grey problem * RPR Problem Diagnosis * Remote diagnostics * Root cause analysis * Troubleshooting * Unified Diagnostic Services Mathematics and logic * Bayesian probability * Block Hackam's dictum * Occam's razor * Regression diagnostics * Sutton's law copy right remover block Medicine * Medical diagnosis * Molecular diagnostics Methods * CDR Computerized Assessment System * Computer-assisted diagnosis * Differential diagnosis * Medical diagnos ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
