Simplification of the Revised Geneva Score for Assessing Clinical Probability of Pulmonary Embolism

Abstract

A clinical decision rule (CDR) can be defined as an instrument containing variables obtained from history, physical examination, and simple diagnostic tests quantifying the likelihood of a diagnosis, prognosis, or likely response to treatment in an individual patient.¹ Pulmonary embolism (PE) is clinically suspected in many patients who report respiratory or chest distress because of the nonspecific nature of the presenting signs and symptoms. Nevertheless, the prevalence of PE in this population is relatively low. Several CDRs have been developed to assist the clinician in diagnostic decision making.² Correct implementation of CDRs in diagnostic strategies has been proven to decrease the need for expensive, time-consuming, and invasive diagnostic imaging procedures. Moreover, the venous thromboembolism failure rate is acceptably low in patients in whom PE is ruled out by various diagnostic criteria including a CDR and when anticoagulant treatment is withheld.^3-5