To explore the application in diagnosis of YEARS method, modified Geneva score and simplified Wells score on pulmonary embolism.

This study is a diagnostic experimental study.The non-random sampling method was used to collect the clinical data.A total of 364 inpatients with suspected pulmonary embolism admitted Daxing Teaching Hospital of Capital Medical University from January 2018 to March 2021were enrolled.All patients received computed tomography pulmonary angiography (CTPA) and D-dimer test; and the YEARS method, the modified Geneva score and the simplified Wells score were used for evaluation.With CTPA as the diagnostic gold standard, the consistency analysis was performed with CTPA to obtain the sensitivity, specificity and accuracy of the 3 scoring methods for the diagnosis of pulmonary embolism.The receiver operating characteristic curve (ROC) was used to analyze the application value of the three scoring methods in the diagnosis of pulmonary embolism.

The positive detection rate were 39.29% (143/364) for CTPA, 49.45% (180/364) for YEARS method, 58.24% (212/364) for modified Geneva score, 55.77% (203/364) for simplified Wells score.Compared with CTPA, the positive detection rate of pulmonary embolism of the three scoring methods was higher (χ² values were 7.619, 26.175, 19.829, all P<0.05). No difference was found among the three scoring methods (χ²=5.70, P=0.058). Taking CTPA results as the gold standard, the sensitivity and specificity were 77.6% and 68.8% for YEARS method, 76.2% and 53.4% for modified Geneva score, 71.3% and 54.4% for simplified Wells score, there was no significant difference in the diagnostic sensitivity of the three scoring methods (χ²=1.69, P=0.434). The specificity and accuracy by YEARS method were higher than those of the modified Geneva score (χ² values were 11.00, 8.09, respectively, all P<0.05) and the simplified Wells score (χ² values were 19.79, and 10.38, respectively, all P<0.05), but the difference was not statistically significant in the diagnostic specificity and accuracy between the modified Geneva score and the simplified Wells score (χ² values were 0.04 and 0.15, respectively, all P>0.05). Kappa consistency test showed that consistence between YEARS method and CTPA results was average, while modified Geneva score, simplified Wells score was poor (Kappa values are 0.44, 0.27, 0.24, respectively). The ROC showed that the area under curve (AUC) of YEARS method, modified Geneva score and simplified Wells score in the diagnosis of pulmonary embolism were 0.732, 0.648, and 0.628, respectively.

Among the three scoring methods, YEARS method can avoid over-examination and over-treatment, which has relatively higher application value.

Pulmonary embolism; YEARS method; Modified Geneva score; Simplified Wells score