Automated Pulmonary Embolism Risk Assessment Using the Wells Criteria: Validation Study

Electronic health record
DOI: 10.2196/32230 Publication Date: 2021-12-27T15:59:28Z
ABSTRACT
Computed tomography pulmonary angiography (CTPA) is frequently used in the emergency department (ED) for diagnosis of embolism (PE), while posing risk contrast-induced nephropathy and radiation-induced malignancy.We aimed to create an automated process calculate Wells score patients ED, which could potentially reduce unnecessary CTPA testing.We designed using electronic health records data elements, including a combinatorial keyword search method query free-text fields, calculated scores sample all adult ED encounters that resulted study PE at 2 tertiary care hospitals New York, over 2-month period. To validate process, were compared those derived from 2-clinician chart review.A total 202 completed form retrospective cohort. Patients classified as "PE likely" by (126/202, 62%) had prevalence 15.9%, whereas unlikely" (76/202, 38%; >4) 7.9%. With respect classification patient likely," achieved accuracy 92.1% when with review, sensitivity, specificity, positive predictive value, negative value 93%, 90.5%, 94.4%, 88.2%, respectively.This was successful development validation classify visits.
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