Comparison of values between Wells score and YEARS algorithm in dignosis of pulmonary embolism / 吉林大学学报(医学版)

ABSTRACT

Objective:To explore the diagnostic values of Wells score and YEARS algorithm in the patients with pulmonary embolism and to compare the areas under receiver operating characteristic (ROC) curves (AUC) of Wells score and YEARS algorithm, and to find the more suitable score method for pulmonary embolism in clinic.Methods:A total of 139patients who were suspected with pulmonary embolism were collected, among them48patients were clinically as confirmed pulmonary embolism.The disease history, clinical manifestation and results of auxilliary examinations of the patients were collected.All the patients were assessed by Wells score and YEARS algorithm, respectively;the computed tomographic pulmonary angiography (CTPA) was considered as golden standard.The sensitivities, specificities, misdiagnosis rates and omission diagnostic rates, and the accuracies of Wells score and YEARS algorithm of the patients in two groups were analyzed with SPSS 22.0software;the conformities of results of Wells socre, YEARS algorithm, and CTPA were analyzed.Then ROC curves of Wells score and YEARS algorithm in diagnosis of pulmonary embolism were made, and the AUC was calculated and compared.Results:Compared with YEARS algorithm, the specificity and accuracy of Wells score in diagnosis of pulmonary embolism were markedly increased (P＜0.05) , the misdiagnosis rate was decreased (P=0.037) , however the sensitivity and the misdiagnosis rate had no significant differences (P＞0.05) .The Kappa value of Wells score and CTPA was 0.45, the conformity was moderate;the Kappa value of YEARS algorithm and CTPA was 0.22, the conformity was passable;the Kappa value of Wells score and YEARS algorithm was 0.11, the conformity was bad.The AUC of Wells score and YEARS algorithm were 0.753±0.044 (P＜0.01) and 0.585±0.049 (P=0.101) .Conclusion:The Wells score is superior to the YEARS algorithm in the diagnosis of pulmonary embolism.