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1. Long-term course of ambulatory patients with COVID-19 initially treated with enoxaparin vs no anticoagulation: final analysis of the OVID (enoxaparin for outpatients with COVID-19) randomized trial

Author

Barco, Stefano, Voci, Davide, Held, Ulrike, Sebastian, Tim, Bingisser, Roland, Colucci, Giuseppe, Duerschmied, Daniel, Frenk, André, Gerber, Bernhard, Götschi, Andrea, Konstantinides, Stavros V., Mach, François, Robert-Ebadi, Helia, Rosemann, Thomas, Simon, Noemi R., Spechbach, Hervé, Spirk, David, Stortecky, Stefan, Vaisnora, Lukas, Righini, Marc, Kucher, Nils, Zetzsche, Stéphanie Roth, Spescha, Rebecca, Leeger, Claudia, Butscheid, Yulia, Probst, Eliane, Micieli, Evy, Forgo, Gabor, Johner, Fabian, Grigorean, Alexandru, Vatsakis, Georgios, Lang, Dagmar Keller, Speck, Silvana Rampini, Hasse, Barbara, Rueegg, Marco, Arnold, Isabelle, Nickel, Christian, Busch, Jeannette, Blondon, Marc, Glauser, Frédéric, Cittone, Micol G., Kessler, Chiara, Gjermeni, Diona, Olivier, Christoph B., Gauchel, Nadine, Biever, Paul, Hobohm, Lukas, Becker, Dorothea, Schindewolf, Marc, Kuenzi, Arnaud, Ulrich, Silvia, Fumagalli, Riccardo M., Bikdeli, Behnood, Gerardi, Teresa, Klok, Frederikus A., Wolf, Simon, and Wyss, Dörte

Published
2024
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3. Enoxaparin for symptomatic COVID-19 managed in the ambulatory setting: An individual patient level analysis of the OVID and ETHIC trials

Author

Barco, Stefano, Virdone, Saverio, Götschi, Andrea, Ageno, Walter, Arcelus, Juan I., Bingisser, Roland, Colucci, Giuseppe, Cools, Frank, Duerschmied, Daniel, Gibbs, Harry, Fumagalli, Riccardo M., Gerber, Bernhard, Haas, Sylvia, Himmelreich, Jelle C.L., Hobbs, Richard, Hobohm, Lukas, Jacobson, Barry, Kayani, Gloria, Lopes, Renato D., MacCallum, Peter, Micieli, Evy, Righini, Marc, Robert-Ebadi, Helia, Rocha, Ana Thereza, Rosemann, Thomas, Sawhney, Jitendra, Schellong, Sebastian, Sebastian, Tim, Spirk, David, Stortecky, Stefan, Turpie, Alexander G.G., Voci, Davide, Kucher, Nils, Pieper, Karen, Held, Ulrike, and Kakkar, Ajay K.

Published
2023
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6. Noninvasive diagnostic work-up for suspected acute pulmonary embolism during pregnancy: a systematic review and meta-analysis of individual patient data

Author

Stals, Milou A.M., Moumneh, Thomas, Ainle, Fionnuala Ni, Aujesky, Drahomir, van Bemmel, Thomas, Bertoletti, Laurent, Bistervels, Ingrid M., Chauleur, Céline, Couturaud, Francis, van Dooren, Yordi P.A., Elias, Antoine, Faber, Laura M., Le Gall, Catherine, Hofstee, Herman M.A., van der Hulle, Tom, Kruip, Marieke J.H.A., Maignan, Maxime, Mairuhu, Albert T.A., Middeldorp, Saskia, Le Moigne, Emmanuelle, Nijkeuter, Mathilde, van der Pol, Liselotte M., Robert-Ebadi, Helia, Roy, Pierre-Marie, Sanchez, Olivier, Schmidt, Jeannot, van Smeden, Maarten, Tromeur, Cecile, Wolde, Marije ten, Righini, Marc, Le Gal, Grégoire, Huisman, Menno V., and Klok, Frederikus A.

Published
2023
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7. Risk of neonatal hypothyroidism in newborns from mothers exposed to CTPA during pregnancy: Ancillary data from a prospective outcome study

Author

Righini, Marc, Robert-Ebadi, Helia, Cremonesi, Alessio, Elias, Antoine, Sanchez, Olivier, Le Moigne, Emmanuelle, Schmidt, Jeannot, Le Gall, Catherine, Cornuz, Jacques, Aujesky, Drahomir, Roy, Pierre-Marie, Chauleur, Céline, Rouyer, Frédéric, Poletti, Pierre-Alexandre, Moreau, Caroline, and Le Gal, Grégoire

Published
2022
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8. Development of an international standard set of outcome measures for patients with venous thromboembolism: an International Consortium for Health Outcomes Measurement consensus recommendation

Author

Gwozdz, Adam M, de Jong, Cindy M M, Fialho, Luz Sousa, Likitabhorn, Theerawich, Sossi, Frieda, Jaber, Paula Blancarte, Højen, Anette Arbjerg, Arcelus, Juan I, Auger, William R, Ay, Cihan, Barco, Stefano, Gazzana, Marcelo B, Bayley, Julie, Bertoletti, Laurent, Cate-Hoek, Arina ten, Cohen, Alexander T, Connors, Jean M, Galanaud, Jean-Philippe, Labropoulos, Nicos, Langlois, Nicole, Meissner, Mark H, Noble, Simon, Nossent, Esther J, de León Lovatón, Paula Ponce, Robert-Ebadi, Helia, Rosovsky, Rachel P, Smolenaars, Noa, Toshner, Mark, Tromeur, Cécile, Wang, Kang-Ling, Westerlund, Eli, de Wit, Kerstin, Black, Stephen A, and Klok, Frederikus A

Published
2022
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9. Enoxaparin for primary thromboprophylaxis in symptomatic outpatients with COVID-19 (OVID): a randomised, open-label, parallel-group, multicentre, phase 3 trial

Author

Barco, Stefano, Voci, Davide, Held, Ulrike, Sebastian, Tim, Bingisser, Roland, Colucci, Giuseppe, Duerschmied, Daniel, Frenk, André, Gerber, Bernhard, Götschi, Andrea, Konstantinides, Stavros V, Mach, François, Robert-Ebadi, Helia, Rosemann, Thomas, Simon, Noemi R, Spechbach, Hervé, Spirk, David, Stortecky, Stefan, Vaisnora, Lukas, Righini, Marc, Kucher, Nils, Roth Zetzsche, Stéphanie, Spescha, Rebecca, Leeger, Claudia, Butscheid, Yulia, Probst, Eliane, Micieli, Evy, Forgo, Gabor, Johner, Fabian, Grigorean, Alexandru, Vatsakis, Georgios, Keller Lang, Dagmar, Rampini Speck, Silvana, Hasse, Barbara, Rueegg, Marco, Arnold, Isabelle, Nickel, Christian, Busch, Jeannette, Blondon, Marc, Glauser, Frédéric, Cittone, Micol G, Kessler, Chiara, Gjermeni, Diona, Olivier, Christoph B, Gauchel, Nadine, Biever, Paul, Hobohm, Lukas, Becker, Dorothea, Schindewolf, Marc, Kuenzi, Arnaud, and Ulrich, Silvia

Published
2022
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10. 2022 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer, including patients with COVID-19

Author

Ageno, Walter, Ajauro, Fernando, Alcindor, Thierry, Angchaisuksiri, Pantep, Arcelus, Juan I., Barba, Raquel, Bazarbachii, Ali, Bellesoeur, Audrey, Bensaoula, Okba, Benzidia, Ilham, Bita, Darius, Bitsadze, Viktoria, Blickstein, Dorit, Blostein, Mark, Bogalho, Isabel, Brandao, Antonio, Calado, Rodrigo, Carpentier, Antoine, Ceresetto, Jose Manuel, Chitsike, Rufaro, Connault, Jérôme, Correia, Catarina Jacinto, Crichi, Benjamin, De Paula, Erich V., Demir, Ahmet M., Deville, Laure, Doucet, Ludovic, Dounaevskaia, Vera, Durant, Cécile, Ellis, Martin, Emmerich, Joseph, Falanga, Anna, Font, Carme, Gallardo, Enrique, Gary, Thomas, Gonçalves, Filipe, Gris, Jean-Christophe, Hayashi, Hiromi, Hij, Adrian, Jara-Palomares, Luis, Jiménez, David, Khizroeva, Jamilya, N'Guessan, Michel, Langer, Florian, Le Hello, Claire, Le Maignan, Christine, Lecumberri, Ramón, Lee, Lai Heng, Liederman, Zachary, Lopes dos Santos, Luisa, Machado, Duarte Henrique, Makatsariya, Alexander, Maneyro, Alberto, Marjanovic, Zora, Milhaileanu, Serban, Monreal, Manuel, Morais, Sara, Moreira, Antonio, Mukai, Mikio, Ndour, Arlette, Correa Oliveira, Luciana, Otero-Candelara, Remedios, Tostes Pintao, Maria Carolina, Posch, Florian, Prilollet, Pascal, Rafii, Hanadi, Dias Ribeiro, Daniel, Riess, Hanno, Righini, Marc, Robert-Ebadi, Helia, Rothschild, Cynthia, Roussin, Andre, Rueda Camino, José Antonio, Ruiz-Artacho, Pedro, Saharov, Gleb, Santos, Joana, Sebuhyan, Maxime, Shamseddine, Ali, Spectre, Galia Spectre, Taher, Ali, Trujillo-Santos, Javier, Tzoran, Inna, Villiers, Stéphane, Wong, Raymond, Yamashita, Yugo, Yannoutsos, Alexandra, Yasuda, Chikao, Farge, Dominique, Frere, Corinne, Connors, Jean M, Khorana, Alok A, Kakkar, Ajay, Ay, Cihan, Muñoz, Andres, Brenner, Benjamin, Prata, Pedro H, Brilhante, Dialina, Antic, Darko, Casais, Patricia, Guillermo Esposito, María Cecilia, Ikezoe, Takayuki, Abutalib, Syed A, Meillon-García, Luis A, Bounameaux, Henri, Pabinger, Ingrid, and Douketis, James

Published
2022
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11. Therapeutic anticoagulation to prevent thrombosis, coagulopathy, and mortality in severe COVID‐19: The Swiss COVID‐HEP randomized clinical trial

Author

Blondon, Marc, Cereghetti, Sara, Pugin, Jérôme, Marti, Christophe, Darbellay Farhoumand, Pauline, Reny, Jean‐Luc, Calmy, Alexandra, Combescure, Christophe, Mazzolai, Lucia, Pantet, Olivier, Ltaief, Zied, Méan, Marie, Manzocchi Besson, Sara, Jeanneret, Séverin, Stricker, Hans, Robert‐Ebadi, Helia, Fontana, Pierre, Righini, Marc, and Casini, Alessandro

Published
2022
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15. Comparative clinical prognosis of massive and non‐massive pulmonary embolism: A registry‐based cohort study

Author

Blondon, Marc, Jimenez, David, Robert‐Ebadi, Helia, Del Toro, Jorge, Lopez‐Jimenez, Luciano, Falga, Conxita, Skride, Andris, Font, Llorenç, Vazquez, Fernando Javier, Bounameaux, Henri, Monreal, Manuel, Prandoni, Paolo, Brenner, Benjamin, Farge‐Bancel, Dominique, Barba, Raquel, Di Micco, Pierpaolo, Bertoletti, Laurent, Schellong, Sebastian, Tzoran, Inna, Reis, Abilio, Bosevski, Marijan, Malý, Radovan, Verhamme, Peter, Caprini, Joseph A, My Bui, Hanh, Adarraga, MD, Agud, M, Aibar, J, Aibar, MA, Alfonso, J, Amado, C, Arcelus, JI, Baeza, C, Ballaz, A, Barba, R, Barbagelata, C, Barrón, M, Barrón‐Andrés, B, Blanco‐Molina, A, Botella, E, Camon, AM, Castro, J, Caudevilla, MA, Cerdà, P, Chasco, L, Criado, J, de Ancos, C, de Miguel, J, Demelo‐Rodríguez, P, Díaz‐Peromingo, JA, Díez‐Sierra, J, Díaz‐Simón, R, Domínguez, IM, Encabo, M, Escribano, JC, Falgá, C, Farfán, AI, Fernández‐Capitán, C, Fernández‐Reyes, JL, Fidalgo, MA, Flores, K, Font, C, Francisco, I, Gabara, C, Galeano‐Valle, F, García, MA, García‐Bragado, F, García‐Mullor, MM, Gavín‐Blanco, O, Gavín‐Sebastián, O, Gil‐Díaz, A, Gómez‐Cuervo, C, González‐Martínez, J, Grau, E, Guirado, L, Gutiérrez, J, Hernández‐Blasco, L, Jara‐Palomares, L, Jaras, MJ, Jiménez, D, Joya, MD, Jou, I, Lacruz, B, Lecumberri, R, Lima, J, Lobo, JL, López‐Brull, H, López‐Jiménez, L, López‐Miguel, P, López‐Núñez, JJ, López‐Reyes, R, López‐Sáez, JB, Lorente, MA, Lorenzo, A, Loring, M, Madridano, O, Maestre, A, Marchena, PJ, Martín del Pozo, M, Martín‐Martos, F, Martínez‐Baquerizo, C, Mella, C, Mellado, M, Mercado, MI, Moisés, J, Morales, MV, Muñoz‐Blanco, A, Muñoz‐Guglielmetti, D, Muñoz‐Rivas, N, Nart, E, Nieto, JA, Núñez, MJ, Olivares, MC, Ortega‐Michel, C, Ortega‐Recio, MD, Osorio, J, Otalora, S, Otero, R, Parra, P, Parra, V, Pedrajas, JM, Pellejero, G, Pérez‐Jacoiste, A, Peris, ML, Pesántez, D, Porras, JA, Portillo, J, Reig, L, Riera‐Mestre, A, Rivas, A, Rodríguez‐Cobo, A, Rodríguez‐Matute, C, Rogado, J, Rosa, V, Rubio, CM, Ruiz‐Artacho, P, Ruiz‐Giménez, N, Ruiz‐Ruiz, J, Ruiz‐Sada, P, Sahuquillo, JC, Salgueiro, G, Sampériz, A, Sánchez‐Muñoz‐Torrero, JF, Sancho, T, Sigüenza, P, Sirisi, M, Soler, S, Suárez, S, Suriñach, JM, Tiberio, G, Torres, MI, Tolosa, C, Trujillo‐Santos, J, Uresandi, F, Usandizaga, E, Valle, R, Vela, JR, Vidal, G, Vilar, C, Villares, P, Zamora, C, Gutiérrez, P, Vázquez, FJ, Vanassche, T, Vandenbriele, C, Verhamme, P, Hirmerova, J, Malý, R, Salgado, E, Benzidia, I, Bertoletti, L, Bura‐Riviere, A, Crichi, B, Debourdeau, P, Espitia, O, Farge‐Bancel, D, Helfer, H, Mahé, I, Moustafa, F, Poenou, G, Schellong, S, Braester, A, Brenner, B, Tzoran, I, Amitrano, M, Bilora, F, Bortoluzzi, C, Brandolin, B, Ciammaichella, M, Colaizzo, D, Dentali, F, Di Micco, P, Giammarino, E, Grandone, E, Mangiacapra, S, Mastroiacovo, D, Maida, R, Mumoli, N, Pace, F, Pesavento, R, Pomero, F, Prandoni, P, Quintavalla, R, Rocci, A, Siniscalchi, C, Tufano, A, Visonà, A, Vo Hong, N, Zalunardo, B, Kalejs, RV, Maķe, K, Ferreira, M, Fonseca, S, Martins, F, Meireles, J, Bosevski, M, Zdraveska, M, Mazzolai, L, Caprini, JA, Tafur, AJ, Weinberg, I, Wilkins, H, and Bui, HM

Published
2021
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17. Age-Adjusted and Clinical Probability Adapted D-Dimer Cutoffs to Rule Out Pulmonary Embolism: A Narrative Review of Clinical Trials.

Author

Righini, Marc, Robert-Ebadi, Helia, and Le Gal, Grégoire

Subjects
*PULMONARY embolism, *FIBRIN fragment D, *CLINICAL trials, *COMPUTED tomography, *DISEASE prevalence, *PROBABILITY theory
Abstract

Diagnosis of pulmonary embolism remains a challenge for clinicians as its differential diagnosis is wide. The use of sequential diagnostic strategies based on the assessment of clinical probability, D-dimer measurement, and computed tomography pulmonary angiography have been validated in large prospective outcome studies. D-dimer measurement at a standard cutoff of 500 μg/L has gained wide acceptance to rule out pulmonary embolism in around 20 to 30% of patients with a clinically suspected pulmonary embolism. To improve the efficiency of D-dimer measurement, different ways of selecting a higher, albeit safe cutoff were explored: the age-adjusted D-dimer cutoff and the clinical adapted D-dimer cutoff. While both have been prospectively validated in large studies, some differences do exist. In particular, the prevalence of pulmonary embolism in these different validation studies was very different. Overall, the age-adjusted cutoff seems to be safer and less efficient, while the clinical probability adapted cutoff seems more efficient and less safe. Here, we report the available data regarding these two different ways to increase the diagnostic yield of D-dimer. Also, well beyond the accuracy of these adjusted/adapted cutoffs, some external factors, such as the prevalence of pulmonary embolism in the tested population and the clinical setting, have an important impact of the negative predictive value and on the overall efficiency of these cutoffs. Therefore, we also discuss which cutoff should be used according to the expected prevalence of the disease and according to the clinical setting. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Venous thromboembolism in critically Ill patients with COVID‐19: Results of a screening study for deep vein thrombosis

Author

Longchamp, Alban, Longchamp, Justine, Manzocchi‐Besson, Sara, Whiting, Livia, Haller, Claude, Jeanneret, Séverin, Godio, Manoelle, Garcia Martinez, Juan Jose, Bonjour, Thierry, Caillat, Mary, Maitre, Guillaume, Thaler, Julian Matthias, Pantet, Rémy, Donner, Viviane, Dumoulin, Alexis, Emonet, Stéphane, Greub, Gilbert, Friolet, Raymond, Robert‐Ebadi, Helia, Righini, Marc, Sanchez, Bienvenido, Delaloye, Julie, and Cannegieter, Suzanne

Published
2020
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20. Long‐term risk of postthrombotic syndrome after symptomatic distal deep vein thrombosis: The CACTUS‐PTS study

Author

Galanaud, Jean‐Philippe, Righini, Marc, Le Collen, Lorris, Douillard, Aymeric, Robert‐Ebadi, Helia, Pontal, Daniel, Morrison, David, Barrellier, Marie‐Thérèse, Diard, Antoine, Guénnéguez, Hervé, Brisot, Dominique, Faïsse, Pascale, Accassat, Sandrine, Martin, Myriam, Delluc, Aurélien, Solymoss, Susan, Kassis, Jeannine, Carrier, Marc, Quéré, Isabelle, and Kahn, Susan R.

Published
2020
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26. Ruling out pulmonary embolism across different healthcare settings: A systematic review and individual patient data meta-analysis

Author

Geersing, Geert-Jan, Takada, Toshihiko, Klok, Frederikus A., Büller, Harry R., Courtney, D. Mark, Freund, Yonathan, Galipienzo, Javier, Le Gal, Gregoire, Ghanima, Waleed, Kline, Jeffrey A., Huisman, Menno V., Moons, Karel G. M., Perrier, Arnaud, Parpia, Sameer, Robert-Ebadi, Helia, Righini, Marc, Roy, Pierre-Marie, van Smeden, Maarten, Stals, Milou A. M., Wells, Philip S., de Wit, Kerstin, Kraaijpoel, Noémie, and van Es, Nick

Subjects
Pulmonary embolism -- Diagnosis, Diagnosis -- Comparative analysis -- Evaluation, Biological sciences
Abstract

Background The challenging clinical dilemma of detecting pulmonary embolism (PE) in suspected patients is encountered in a variety of healthcare settings. We hypothesized that the optimal diagnostic approach to detect these patients in terms of safety and efficiency depends on underlying PE prevalence, case mix, and physician experience, overall reflected by the type of setting where patients are initially assessed. The objective of this study was to assess the capability of ruling out PE by available diagnostic strategies across all possible settings. Methods and findings We performed a literature search (MEDLINE) followed by an individual patient data (IPD) meta-analysis (MA; 23 studies), including patients from self-referral emergency care (n = 12,612), primary healthcare clinics (n = 3,174), referred secondary care (n = 17,052), and hospitalized or nursing home patients (n = 2,410). Multilevel logistic regression was performed to evaluate diagnostic performance of the Wells and revised Geneva rules, both using fixed and adapted D-dimer thresholds to age or pretest probability (PTP), for the YEARS algorithm and for the Pulmonary Embolism Rule-out Criteria (PERC). All strategies were tested separately in each healthcare setting. Following studies done in this field, the primary diagnostic metrices estimated from the models were the 'failure rate' of each strategy-i.e., the proportion of missed PE among patients categorized as 'PE excluded' and 'efficiency'-defined as the proportion of patients categorized as 'PE excluded' among all patients. In self-referral emergency care, the PERC algorithm excludes PE in 21% of suspected patients at a failure rate of 1.12% (95% confidence interval [CI] 0.74 to 1.70), whereas this increases to 6.01% (4.09 to 8.75) in referred patients to secondary care at an efficiency of 10%. In patients from primary healthcare and those referred to secondary care, strategies adjusting D-dimer to PTP are the most efficient (range: 43% to 62%) at a failure rate ranging between 0.25% and 3.06%, with higher failure rates observed in patients referred to secondary care. For this latter setting, strategies adjusting D-dimer to age are associated with a lower failure rate ranging between 0.65% and 0.81%, yet are also less efficient (range: 33% and 35%). For all strategies, failure rates are highest in hospitalized or nursing home patients, ranging between 1.68% and 5.13%, at an efficiency ranging between 15% and 30%. The main limitation of the primary analyses was that the diagnostic performance of each strategy was compared in different sets of studies since the availability of items used in each diagnostic strategy differed across included studies; however, sensitivity analyses suggested that the findings were robust. Conclusions The capability of safely and efficiently ruling out PE of available diagnostic strategies differs for different healthcare settings. The findings of this IPD MA help in determining the optimum diagnostic strategies for ruling out PE per healthcare setting, balancing the trade-off between failure rate and efficiency of each strategy., Author(s): Geert-Jan Geersing 1,*, Toshihiko Takada 1,2, Frederikus A. Klok 3, Harry R. Büller 4, D. Mark Courtney 5, Yonathan Freund 6, Javier Galipienzo 7, Gregoire Le Gal 8, Waleed [...]

Published
2022
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27. Enoxaparin versus Placebo to Prevent Symptomatic Venous Thromboembolism in Hospitalized Older Adult Medical Patients

Author

Mottier, Dominique, primary, Girard, Philippe, additional, Couturaud, Francis, additional, Lacut, Karine, additional, Le Moigne, Emmanuelle, additional, Paleiron, Nicolas, additional, Guellec, Dewi, additional, Sanchez, Olivier, additional, Cogulet, Virginie, additional, Laporte, Silvy, additional, Marhic, Gisèle, additional, Mismetti, Patrick, additional, Presles, Emilie, additional, Robert-Ebadi, Helia, additional, Mahé, Isabelle, additional, Plaisance, Ludovic, additional, Reny, Jean-Luc, additional, Darbellay Farhoumand, Pauline, additional, Cuvelier, Clémence, additional, Le Henaff, Catherine, additional, Lambert, Yannick, additional, Danguy des Deserts, Marc, additional, Rousseau Legrand, Claire, additional, Boutreux, Sébastien, additional, Bleher, Yves, additional, Decours, Romain, additional, Trinh-Duc, Albert, additional, Armengol, Guillaume, additional, Benhamou, Ygal, additional, Daumas, Aurélie, additional, Guyot, Sarah-Lou, additional, De Carvalho, Hugo, additional, Lamia, Bouchra, additional, Righini, Marc, additional, Meyer, Guy, additional, and Le Gal, Grégoire, additional

Published
2023
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28. Diagnostic management of acute pulmonary embolism: a prediction model based on a patient data meta-analysis

Author

van Es, Nick, primary, Takada, Toshihiko, additional, Kraaijpoel, Noémie, additional, Klok, Frederikus A, additional, Stals, Milou A M, additional, Büller, Harry R, additional, Courtney, D Mark, additional, Freund, Yonathan, additional, Galipienzo, Javier, additional, Le Gal, Grégoire, additional, Ghanima, Waleed, additional, Huisman, Menno V, additional, Kline, Jeffrey A, additional, Moons, Karel G M, additional, Parpia, Sameer, additional, Perrier, Arnaud, additional, Righini, Marc, additional, Robert-Ebadi, Helia, additional, Roy, Pierre-Marie, additional, Wells, Phil S, additional, de Wit, Kerstin, additional, van Smeden, Maarten, additional, and Geersing, Geert-Jan, additional

Published
2023
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29. Covariate-specific ROC curve analysis can accommodate differences between covariate subgroups in the evaluation of diagnostic accuracy

Author

Lee, Jenny, primary, van Es, Nick, additional, Takada, Toshihiko, additional, Klok, Frederikus A., additional, Geersing, Geert-Jan, additional, Blume, Jeffrey, additional, Bossuyt, Patrick M., additional, Büller, Harry R., additional, Courtney, D Mark, additional, Freund, Yonathan, additional, Galipienzo, Javier, additional, Le Gal, Gregoire, additional, Ghanima, Waleed, additional, Kline, Jeffrey A., additional, Huisman, Menno V., additional, Moons, Karel G.M., additional, Perrier, Arnaud, additional, Parpia, Sameer, additional, Robert-Ebadi, Helia, additional, Righini, Marc, additional, Roy, Pierre-Marie, additional, van Smeden, Maarten, additional, Stals, Milou A.M., additional, Wells, Philip S., additional, de Wit, Kerstin, additional, and Kraaijpoel, Noémie, additional

Published
2023
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33. Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a randomised, double-blind, placebo-controlled trial

Author

Righini, Marc, Galanaud, Jean-Philippe, Guenneguez, Hervé, Brisot, Dominique, Diard, Antoine, Faisse, Pascale, Barrellier, Marie-Thérèse, Hamel-Desnos, Claudine, Jurus, Christine, Pichot, Olivier, Martin, Myriam, Mazzolai, Lucia, Choquenet, Clarisse, Accassat, Sandrine, Robert-Ebadi, Helia, Carrier, Marc, Le Gal, Grégoire, Mermilllod, Bernadette, Laroche, Jean-Pierre, Bounameaux, Henri, Perrier, Arnaud, Kahn, Susan R, and Quere, Isabelle

Published
2016
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34. Impact of intravascular thrombosis on failure of radial arterial catheters in critically ill patients: a nested case-control study

Author

Fleury, Yvan, Arroyo, Diego, Couchepin, Caroline, Robert-Ebadi, Helia, Righini, Marc, Lobrinus, Johannes A., and Ricou, Bara

Subjects
Blood -- Medical examination, Medical research -- Analysis, Medicine, Experimental -- Analysis, Blood clot -- Research, Thrombosis -- Research, Blood pressure -- Measurement, Fibrin -- Analysis -- Research, Health care industry, University of Geneva. University Hospitals of Geneva
Abstract

Purpose The patency of arterial catheters is essential for reliable invasive blood pressure monitoring. We sought to determine whether radial catheter failures were associated with intravascular thrombosis in critically ill adult patients. Methods This unmatched case-control study was conducted within a prospective cohort of patients admitted to an intensive care unit. The arterial catheter failure was the main outcome, which identified cases. Controls were patients with patent catheter until removal or 28 days of follow-up. The prevalence of intravascular thrombosis in cases and controls was determined by ultrasonography of the cannulated radial artery. Assessors were blinded to clinical findings. Failing catheters were removed and examined microscopically. Results Catheter failures occurred in 25.5% of 200 patients during 584 catheter-days (incidence rate, 87/1000 catheter-days). The median patency duration was 13.1 days. An intravascular thrombosis located in front of the catheter tip was diagnosed in 42 of 50 cases (84.0%) and 24 of 139 controls (17.3%). In multivariable logistic regression analysis, the probability of catheter failure was higher in patients with intravascular thrombosis [odds ratio (OR), 36.52; 95% confidence interval (CI), 12.86-103.74] and females (OR, 3.45; 95% CI 1.32-9.05), increased proportionally to arterial blood sampling frequency (OR, 1.20; 95% CI 1.04-1.38), and decreased in thrombocytopenia (OR, 0.28; 95% CI 0.10-0.78). After removal, 15.7% of failing catheters had some luminal fibrin deposits, but none were occluded. Conclusions Most failing radial arterial catheters had no luminal obstruction, but were associated with an intravascular thrombosis. Among predictive factors, arterial blood sampling frequency is the most susceptible to intervention., Author(s): Yvan Fleury [sup.1] [sup.2], Diego Arroyo [sup.1] [sup.3], Caroline Couchepin [sup.4] [sup.5], Helia Robert-Ebadi [sup.6], Marc Righini [sup.6], Johannes A. Lobrinus [sup.7], Bara Ricou [sup.1] [sup.8], Nathalie Delieuvin Schmitt [...]

Published
2018
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35. Effect of therapeutic anticoagulation on gas exchange in mechanically ventilated COVID-19 patients: A secondary analysis of the COVID-HEP trial

Author

Pantet, Olivier, primary, Combescure, Christophe, additional, Ltaief, Zied, additional, Mazzolai, Lucia, additional, Jeanneret, Séverin, additional, Manzocchi-Besson, Sara, additional, Stricker, Hans, additional, Cereghetti, Sara, additional, Pugin, Jérôme, additional, Calmy, Alexandra, additional, Marti, Christophe, additional, Robert-Ebadi, Helia, additional, Fontana, Pierre, additional, Righini, Marc, additional, Casini, Alessandro, additional, and Blondon, Marc, additional

Published
2023
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36. Diagnostic management of acute pulmonary embolism: a prediction model based on a patient data meta-analysis

Author

HAG Trombose, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Epi Methoden Team 3, Infection & Immunity, Circulatory Health, van Es, Nick, Takada, Toshihiko, Kraaijpoel, Noémie, Klok, Frederikus A, Stals, Milou A M, Büller, Harry R, Courtney, D Mark, Freund, Yonathan, Galipienzo, Javier, Le Gal, Grégoire, Ghanima, Waleed, Huisman, Menno V, Kline, Jeffrey A, Moons, Karel G M, Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre-Marie, Wells, Phil S, de Wit, Kerstin, van Smeden, Maarten, Geersing, Geert-Jan, HAG Trombose, Epi Methoden, Cancer, JC onderzoeksprogramma Methodologie, Epi Methoden Team 3, Infection & Immunity, Circulatory Health, van Es, Nick, Takada, Toshihiko, Kraaijpoel, Noémie, Klok, Frederikus A, Stals, Milou A M, Büller, Harry R, Courtney, D Mark, Freund, Yonathan, Galipienzo, Javier, Le Gal, Grégoire, Ghanima, Waleed, Huisman, Menno V, Kline, Jeffrey A, Moons, Karel G M, Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre-Marie, Wells, Phil S, de Wit, Kerstin, van Smeden, Maarten, and Geersing, Geert-Jan

Published
2023

37. Enoxaparin for symptomatic COVID-19 managed in the ambulatory setting: An individual patient level analysis of the OVID and ETHIC trials

Author

Barco, Stefano; https://orcid.org/0000-0002-2618-347X, Virdone, Saverio, Götschi, Andrea, Ageno, Walter, Arcelus, Juan I, Bingisser, Roland, Colucci, Giuseppe, Cools, Frank, Duerschmied, Daniel, Gibbs, Harry, Fumagalli, Riccardo M, Gerber, Bernhard, Haas, Sylvia, Himmelreich, Jelle C L, Hobbs, Richard, Hobohm, Lukas, Jacobson, Barry, Kayani, Gloria, Lopes, Renato D, MacCallum, Peter, Micieli, Evy, Righini, Marc, Robert-Ebadi, Helia, Rocha, Ana Thereza, Rosemann, Thomas, Sawhney, Jitendra, Schellong, Sebastian, Sebastian, Tim, Spirk, David, Stortecky, Stefan, Held, Ulrike, et al, Barco, Stefano; https://orcid.org/0000-0002-2618-347X, Virdone, Saverio, Götschi, Andrea, Ageno, Walter, Arcelus, Juan I, Bingisser, Roland, Colucci, Giuseppe, Cools, Frank, Duerschmied, Daniel, Gibbs, Harry, Fumagalli, Riccardo M, Gerber, Bernhard, Haas, Sylvia, Himmelreich, Jelle C L, Hobbs, Richard, Hobohm, Lukas, Jacobson, Barry, Kayani, Gloria, Lopes, Renato D, MacCallum, Peter, Micieli, Evy, Righini, Marc, Robert-Ebadi, Helia, Rocha, Ana Thereza, Rosemann, Thomas, Sawhney, Jitendra, Schellong, Sebastian, Sebastian, Tim, Spirk, David, Stortecky, Stefan, Held, Ulrike, and et al

Abstract

Methods: We performed an individual patient-level analysis of the OVID and ETHIC randomized controlled trials, which compared enoxaparin thromboprophylaxis for either 14 (OVID) or 21 days (ETHIC) vs. no thromboprophylaxis for outpatients with symptomatic COVID-19 and at least one additional risk factor. The primary efficacy outcome included all-cause hospitalization and all-cause death within 30 days from randomization. Both studies were prematurely stopped for futility. Secondary efficacy outcomes were major symptomatic venous thromboembolic events, arterial cardiovascular events, or their composite occurring within 30 days from randomization. The same outcomes were assessed over a 90-day follow-up. The primary safety outcome was major bleeding (ISTH criteria). Results: A total of 691 patients were randomized: 339 to receive enoxaparin and 352 to the control group. Over 30-day follow-up, the primary efficacy outcome occurred in 6.0 % of patients in the enoxaparin group vs. 5.8 % of controls for a risk ratio (RR) of 1.05 (95%CI 0.57-1.92). The incidence of major symptomatic venous thromboembolic events and arterial cardiovascular events was 0.9 % vs. 1.8 %, respectively (RR 0.52; 95%CI 0.13-2.06). Most cardiovascular thromboembolic events were represented by symptomatic venous thromboembolic events, occurring in 0.6 % vs. 1.5 % of patients, respectively. A similar distribution of outcomes between the treatment groups was observed over 90 days. No major bleeding occurred in the enoxaparin group vs. one (0.3 %) in the control group. Conclusions: We found no evidence for the clinical benefit of early administration of enoxaparin thromboprophylaxis in outpatients with symptomatic COVID-19. These results should be interpreted taking into consideration the relatively low occurrence of events.

Published
2023

38. Enoxaparin for outpatients with COVID-19: 90-day results from the randomised, open-label, parallel-group, multinational, phase III OVID trial

Author

Voci, Davide; https://orcid.org/0000-0001-9573-7029, Götschi, Andrea, Held, Ulrike; https://orcid.org/0000-0003-3105-5840, Bingisser, Roland; https://orcid.org/0000-0001-8223-9792, Colucci, Giuseppe, Duerschmied, Daniel, Fumagalli, Riccardo M; https://orcid.org/0000-0002-6794-1986, Gerber, Bernhard; https://orcid.org/0000-0001-5418-0949, Hasse, Barbara; https://orcid.org/0000-0001-7196-3734, Keller, Dagmar I, Konstantinides, Stavros V; https://orcid.org/0000-0001-6359-7279, Mach, François; https://orcid.org/0000-0003-3178-9131, Rampini, Silvana K; https://orcid.org/0000-0002-4788-438X, Righini, Marc; https://orcid.org/0000-0003-1211-2969, Robert-Ebadi, Helia, Rosemann, Thomas; https://orcid.org/0000-0002-6436-6306, Roth-Zetzsche, Stéphanie, Sebastian, Tim; https://orcid.org/0000-0003-0446-2862, Simon, Noemi R, Spirk, David, Stortecky, Stefan, Vaisnora, Lukas, Kucher, Nils; https://orcid.org/0000-0002-7352-8709, Barco, Stefano; https://orcid.org/0000-0002-2618-347X, Voci, Davide; https://orcid.org/0000-0001-9573-7029, Götschi, Andrea, Held, Ulrike; https://orcid.org/0000-0003-3105-5840, Bingisser, Roland; https://orcid.org/0000-0001-8223-9792, Colucci, Giuseppe, Duerschmied, Daniel, Fumagalli, Riccardo M; https://orcid.org/0000-0002-6794-1986, Gerber, Bernhard; https://orcid.org/0000-0001-5418-0949, Hasse, Barbara; https://orcid.org/0000-0001-7196-3734, Keller, Dagmar I, Konstantinides, Stavros V; https://orcid.org/0000-0001-6359-7279, Mach, François; https://orcid.org/0000-0003-3178-9131, Rampini, Silvana K; https://orcid.org/0000-0002-4788-438X, Righini, Marc; https://orcid.org/0000-0003-1211-2969, Robert-Ebadi, Helia, Rosemann, Thomas; https://orcid.org/0000-0002-6436-6306, Roth-Zetzsche, Stéphanie, Sebastian, Tim; https://orcid.org/0000-0003-0446-2862, Simon, Noemi R, Spirk, David, Stortecky, Stefan, Vaisnora, Lukas, Kucher, Nils; https://orcid.org/0000-0002-7352-8709, and Barco, Stefano; https://orcid.org/0000-0002-2618-347X

Abstract

INTRODUCTION The benefits of early thromboprophylaxis in symptomatic COVID-19 outpatients remain unclear. We present the 90-day results from the randomised, open-label, parallel-group, investigator-initiated, multinational OVID phase III trial. METHODS Outpatients aged 50 years or older with acute symptomatic COVID-19 were randomised to receive enoxaparin 40 mg for 14 days once daily vs. standard of care (no thromboprophylaxis). The primary outcome was the composite of untoward hospitalisation and all-cause death within 30 days from randomisation. Secondary outcomes included arterial and venous major cardiovascular events, as well as the primary outcome within 90 days from randomisation. The study was prematurely terminated based on statistical criteria after the predefined interim analysis of 30-day data, which has been previously published. In the present analysis, we present the final, 90-day data from OVID and we additionally investigate the impact of thromboprophylaxis on the resolution of symptoms. RESULTS Of the 472 patients included in the intention-to-treat population, 234 were randomised to receive enoxaparin and 238 no thromboprophylaxis. The median age was 57 (Q1-Q3: 53-62) years and 217 (46 %) were women. The 90-day primary outcome occurred in 11 (4.7 %) patients of the enoxaparin arm and in 11 (4.6 %) controls (adjusted relative risk 1.00; 95 % CI: 0.44-2.25): 3 events per group occurred after day 30. The 90-day incidence of cardiovascular events was 0.9 % in the enoxaparin arm vs. 1.7 % in controls (relative risk 0.51; 95 % CI: 0.09-2.75). Individual symptoms improved progressively within 90 days with no difference between groups. At 90 days, 42 (17.9 %) patients in the enoxaparin arm and 40 (16.8 %) controls had persistent respiratory symptoms. CONCLUSIONS In adult community patients with COVID-19, early thromboprophylaxis with enoxaparin did not improve the course of COVID-19 neither in terms of hospitalisation and death nor considering COVID-19-rel

Published
2023

39. Multiple arteriovenous malformations caused by RASA1 gene mutation presenting during pregnancy – a case report and review of the literature

Author

Manzocchi Besson, Sara, Jastrow Meyer, Nicole, Bounameaux, Henri, La Scala, Giorgio C., Calza, Anne-Marie, Yilmaz, Hasan, Righini, Marc, and Robert-Ebadi, Helia

Abstract

Abstract.Pregnancy can influence the development and progression of congenital arteriovenous malformations (AVM) and thus lead to life-threatening complications for the mother and fetus like high output cardiac failure and premature delivery. The simultaneous presence of a capillary malformation and AVM strongly suggests a RASA1 related disorder.Keywords:Arteriovenous malformations, capillary malformation-arteriovenous malformation, capillaries/abnormalities, port-wine stain, pregnancy, RASA1 protein

Published
2024
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41. Enoxaparin for outpatients with COVID-19: 90-day results from the randomised, open-label, parallel-group, multinational, phase III OVID trial

Author

Voci, Davide, primary, Götschi, Andrea, additional, Held, Ulrike, additional, Bingisser, Roland, additional, Colucci, Giuseppe, additional, Duerschmied, Daniel, additional, Fumagalli, Riccardo M., additional, Gerber, Bernhard, additional, Hasse, Barbara, additional, Keller, Dagmar I., additional, Konstantinides, Stavros V., additional, Mach, François, additional, Rampini, Silvana K., additional, Righini, Marc, additional, Robert-Ebadi, Helia, additional, Rosemann, Thomas, additional, Roth-Zetzsche, Stéphanie, additional, Sebastian, Tim, additional, Simon, Noemi R., additional, Spirk, David, additional, Stortecky, Stefan, additional, Vaisnora, Lukas, additional, Kucher, Nils, additional, and Barco, Stefano, additional

Published
2023
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44. Non-invasive diagnostic work-up for suspected acute pulmonary embolism during pregnancy: a systematic review and meta-analysis of individual patient data

Author

Stals, Milou A.M., primary, Moumneh, Thomas, additional, Ainle, Fionnuala Ni, additional, Aujesky, Drahomir, additional, van Bemmel, Thomas, additional, Bertoletti, Laurent, additional, Bistervels, Ingrid M., additional, Chauleur, Céline, additional, Couturaud, Francis, additional, van Dooren, Yordi P.A., additional, Elias, Antoine, additional, Faber, Laura M., additional, Le Gall, Catherine, additional, Hofstee, Herman M.A., additional, van der Hulle, Tom, additional, Kruip, Marieke J.H.A., additional, Maignan, Maxime, additional, Mairuhu, Albert T.A., additional, Middeldorp, Saskia, additional, Le Moigne, Emmanuelle, additional, Nijkeuter, Mathilde, additional, van der Pol, Liselotte M., additional, Robert-Ebadi, Helia, additional, Roy, Pierre-Marie, additional, Sanchez, Olivier, additional, Schmidt, Jeannot, additional, van Smeden, Maarten, additional, Tromeur, Cecile, additional, ten Wolde, Marije, additional, Righini, Marc, additional, Le Gal, Grégoire, additional, Huisman, Menno V., additional, and Klok, Frederikus A., additional

Published
2022
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46. Obesity as a Predictor for Pulmonary Embolism and Performance of the Age-Adjusted D-Dimer Strategy in Obese Patients with Suspected Pulmonary Embolism

Author

Gaugler, Jan O, Righini, Marc, Robert-Ebadi, Helia, Sanchez, Olivier, Roy, Pierre-Marie, Verschuren, Franck, Miranda, Sebastien, Delluc, Aurélien, Le Gal, Grégoire, and Tritschler, Tobias

Subjects
610 Medicine & health
Abstract

INTRODUCTION Obesity is a risk factor for venous thromboembolism, but studies evaluating its association with pulmonary embolism (PE) in patients with suspected PE are lacking. OBJECTIVES To evaluate whether body mass index (BMI) and obesity (i.e., BMI ≥30 kg/m2) are associated with confirmed PE in patients with suspected PE and to assess the efficiency and safety of the age-adjusted D-dimer strategy in obese patients. METHODS We conducted a secondary analysis of a multinational, prospective study, in which patients with suspected PE were managed according to the age-adjusted D-dimer strategy and followed for 3 months. Outcomes were objectively confirmed PE at initial presentation, and efficiency and failure rate of the diagnostic strategy. Associations between BMI and obesity, and PE were examined using a log-binomial model that was adjusted for clinical probability and hypoxia. RESULTS We included 1,593 patients (median age: 59 years; 56% women; 22% obese). BMI and obesity were not associated with confirmed PE. The use of the age-adjusted instead of the conventional D-dimer cut-off increased the proportion of obese patients in whom PE was considered ruled out without imaging from 28 to 38%. The 3-month failure rate in obese patients who were left untreated based on a negative age-adjusted D-dimer cut-off test was 0.0% (95% confidence interval: 0.0-2.9%). CONCLUSION BMI on a continuous linear scale and obesity were not predictors of confirmed PE among patients presenting with a clinical suspicion of PE. The age-adjusted D-dimer strategy appeared safe in ruling out PE in obese patients with suspected PE.

Published
2023
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47. Enoxaparin for outpatients with COVID-19: 90-day results from the randomised, open-label, parallel-group, multinational, phase III OVID trial

Author

Voci, Davide, Götschi, Andrea, Held, Ulrike, Bingisser, Roland, Colucci, Giuseppe, Duerschmied, Daniel, Fumagalli, Riccardo M, Gerber, Bernhard, Hasse, Barbara, Keller, Dagmar I, Konstantinides, Stavros V, Mach, François, Rampini, Silvana K, Righini, Marc, Robert-Ebadi, Helia, Rosemann, Thomas, Roth-Zetzsche, Stéphanie, Sebastian, Tim, Simon, Noemi R, Spirk, David, Stortecky, Stefan, Vaisnora, Lukas, Kucher, Nils, Barco, Stefano, University of Zurich, and Barco, Stefano

Subjects
10234 Clinic for Infectious Diseases, 10031 Clinic for Angiology, 2720 Hematology, 610 Medicine & health, Hematology, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), 10029 Clinic and Policlinic for Internal Medicine, 610 Medizin und Gesundheit
Abstract

INTRODUCTION The benefits of early thromboprophylaxis in symptomatic COVID-19 outpatients remain unclear. We present the 90-day results from the randomised, open-label, parallel-group, investigator-initiated, multinational OVID phase III trial. METHODS Outpatients aged 50 years or older with acute symptomatic COVID-19 were randomised to receive enoxaparin 40 mg for 14 days once daily vs. standard of care (no thromboprophylaxis). The primary outcome was the composite of untoward hospitalisation and all-cause death within 30 days from randomisation. Secondary outcomes included arterial and venous major cardiovascular events, as well as the primary outcome within 90 days from randomisation. The study was prematurely terminated based on statistical criteria after the predefined interim analysis of 30-day data, which has been previously published. In the present analysis, we present the final, 90-day data from OVID and we additionally investigate the impact of thromboprophylaxis on the resolution of symptoms. RESULTS Of the 472 patients included in the intention-to-treat population, 234 were randomised to receive enoxaparin and 238 no thromboprophylaxis. The median age was 57 (Q1-Q3: 53-62) years and 217 (46 %) were women. The 90-day primary outcome occurred in 11 (4.7 %) patients of the enoxaparin arm and in 11 (4.6 %) controls (adjusted relative risk 1.00; 95 % CI: 0.44-2.25): 3 events per group occurred after day 30. The 90-day incidence of cardiovascular events was 0.9 % in the enoxaparin arm vs. 1.7 % in controls (relative risk 0.51; 95 % CI: 0.09-2.75). Individual symptoms improved progressively within 90 days with no difference between groups. At 90 days, 42 (17.9 %) patients in the enoxaparin arm and 40 (16.8 %) controls had persistent respiratory symptoms. CONCLUSIONS In adult community patients with COVID-19, early thromboprophylaxis with enoxaparin did not improve the course of COVID-19 neither in terms of hospitalisation and death nor considering COVID-19-related symptoms.

Published
2023
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49. Diagnostic management of acute pulmonary embolism: a prediction model based on a patient data meta-analysis.

Author

Es, Nick van, Takada, Toshihiko, Kraaijpoel, Noémie, Klok, Frederikus A, Stals, Milou A M, Büller, Harry R, Courtney, D Mark, Freund, Yonathan, Galipienzo, Javier, Gal, Grégoire Le, Ghanima, Waleed, Huisman, Menno V, Kline, Jeffrey A, Moons, Karel G M, Parpia, Sameer, Perrier, Arnaud, Righini, Marc, Robert-Ebadi, Helia, Roy, Pierre-Marie, and Wells, Phil S

Subjects
PULMONARY embolism, CLINICAL prediction rules, NURSING home residents, PREDICTION models, VENOUS thrombosis, THROMBOEMBOLISM, SYMPTOMS
Abstract

Aims Risk stratification is used for decisions regarding need for imaging in patients with clinically suspected acute pulmonary embolism (PE). The aim was to develop a clinical prediction model that provides an individualized, accurate probability estimate for the presence of acute PE in patients with suspected disease based on readily available clinical items and D-dimer concentrations. Methods and results An individual patient data meta-analysis was performed based on sixteen cross-sectional or prospective studies with data from 28 305 adult patients with clinically suspected PE from various clinical settings, including primary care, emergency care, hospitalized and nursing home patients. A multilevel logistic regression model was built and validated including ten a priori defined objective candidate predictors to predict objectively confirmed PE at baseline or venous thromboembolism (VTE) during follow-up of 30 to 90 days. Multiple imputation was used for missing data. Backward elimination was performed with a P -value <0.10. Discrimination (c-statistic with 95% confidence intervals [CI] and prediction intervals [PI]) and calibration (outcome:expected [O:E] ratio and calibration plot) were evaluated based on internal-external cross-validation. The accuracy of the model was subsequently compared with algorithms based on the Wells score and D-dimer testing. The final model included age (in years), sex, previous VTE, recent surgery or immobilization, haemoptysis, cancer, clinical signs of deep vein thrombosis, inpatient status, D-dimer (in µg/L), and an interaction term between age and D-dimer. The pooled c-statistic was 0.87 (95% CI, 0.85–0.89; 95% PI, 0.77–0.93) and overall calibration was very good (pooled O:E ratio, 0.99; 95% CI, 0.87–1.14; 95% PI, 0.55–1.79). The model slightly overestimated VTE probability in the lower range of estimated probabilities. Discrimination of the current model in the validation data sets was better than that of the Wells score combined with a D-dimer threshold based on age (c-statistic 0.73; 95% CI, 0.70–0.75) or structured clinical pretest probability (c-statistic 0.79; 95% CI, 0.76–0.81). Conclusion The present model provides an absolute, individualized probability of PE presence in a broad population of patients with suspected PE, with very good discrimination and calibration. Its clinical utility needs to be evaluated in a prospective management or impact study. Registration PROSPERO ID 89366. [ABSTRACT FROM AUTHOR]

Published
2023
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