| Rodger M et al, 2000, Canada | 212 consecutive patients referred for V/Q or pulmonary angiogram for suspected PE | Prospective validation of previously derived scoring system | Prevalence of 28 ECG abnormalities in those subsequently diagnosed as PE positive (49) or negative (163) | Only 2 abnormalities (tachycardia and incomplete RBBB) significantly more prevalent in PE positive than PE negative patients | Small numbers (possibility of false negative results) |
| Diagnostic utility of ECG scoring system (previously derived in patients diagnosed as PE positive) assessed for validation | Positive and negative predictive values of scoring system 57.1 and 81.7, respectively |
| Stollberger C et al, 2000, Austria | 168 (derivation) and 139 (validation) inpatients suspected of PE | Prospective derivation/validation study | Risk factors, objective clinical signs, LDH, ECG (‘signs of right heart strain’), arterial blood gases, venography/plethysmography results and chest x ray recorded | Individual signs 16–48% sensitive for PE, 83–94% specific | Small sample size |
| Multivariate logistic regression established those associated with the diagnosis of PE | PE score performance is reported for 17 different scores in paper. Examples are given below: | Inpatient population only |
| ‘PE score’ (including ECG signs of right heart strain) developed and validated in second group | PE score >0.3 Sn 100%, Sp 79% | |
| | | | PE Score >0.5 Sn 70%, Sp 99% | |
| Miniati M et al, 2003, Italy | 1100 consecutive patients referred for investigation for PE | Derivation/cross validation study | Objective signs, risk factors, ECG and CXR recorded. Multivariate logistic regression established those associated with the diagnosis of PE | Scoring system (included ECG signs of right heart strain) developed that divides patients into low, intermediate, moderately high, and high groups | Subjective inclusion criteria |
| Pre-test probability by group | No prospective validation study (cross validation only |
| Low 4% | |
| Intermediate 22% | |
| Moderately high 74% | |
| High 98% | |
| Richman PB et al, 2004, USA | Patients assessed for PE over 1 year. 49 with PE compared with 49 without | Observational | ECG changes classically associated with PE | Sinus tachycardia (18.8% v 11.8%), incomplete RBBB (4.2% v 0%), | Incomplete cohort used in that 252 patients investigated for PE were not used in analysis |
| S1Q3T3 (2.1% v 0%) |
| S1Q3 (0 v 0) |
| Sinha N et al, 2005, USA | Patients undergoing CT pulmonary angiography at a tertiary hospital over 30 months | Retrospective cohort | ECG changes significantly associated with PE | Sinus tachycardia (39% v 24%) | |
| S1Q3T3 (12% v 3%) |
| Atrial tachyarhythmias (15% v 4%) |
| Q3 (40% v 26%) |
| Q3T3 (8% v 1%) |