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| Name | Class |
|---|---|
| Cliniques universitaires Saint-Luc- Université Catholique de Louvain | OTHER |
PERC rule was created to rule out pulmonary embolism (PE) without further exams, with residual PE risk <2%. Its safety is currently confirmed in low PE prevalence populations as north-American. In European high PE prevalence population, it has been showed that PERC rule used alone or associated with low clinical probability assessed by revised Geneva score (RGS) was not safe. In retrospective study, we suggest that the combination of PERC rule with implicit clinical probability (gestalt) could allow the use of the PERC rule.
PERCEPIC, an observational prospective multicenter study performed in France and Belgium, will test this hypothesis. Therefore, 3000 patients will be included in 12 centers. Primary outcome will be the rate of thromboembolic events or death related or possibly related to PE in patients with low implicit clinical probability and negative PERC rule (8 criteria absents). Upper limit of confidence interval of this rate must be equal or lower than 3% to consider PERC rule as safe in this combination.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gestalt estimation | Other |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the accuracy of the combination of low implicit clinical probability (gestalt) and negative PERC rule (8 criteria absents) | Rate of thromboembolic events or death related or possibly related to PE in patients with low implicit clinical probability and negative PERC rule. Upper limit of confidence interval of this rate must be equal or lower than 3% to consider PERC rule as safe in this combination | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| To assess usefulness of PERC and implicit low clinical probability combination to reduce the use of further exams | Mean number of further exams performed per diagnostic strategy | During emergency managment |
| To assess the accuracy of PERC and low clinical probability combination depending of clinical probability assessment method (implicit assessment, revised Geneva Score, Wells Score and implicit overridden Geneva Score) |
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Inclusion Criteria:
- Patients admitted to the emergency department for one of the following criteria :
Exclusion Criteria:
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All patients admitted to the emergency department for dyspnea or thoracic pain without another obvious cause or suspected PE
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| Name | Affiliation | Role |
|---|---|---|
| Pierre-Marie ROY, MD-PhD | UH Angers | Study Chair |
| Andréa PENALOZA, MD-PhD | Clinique Universitaire Saint-Luc, Bruxelles | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinique Universitaire Saint-Luc | Brussels | Belgium | ||||
| UH Erasme |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29150390 | Derived | Penaloza A, Soulie C, Moumneh T, Delmez Q, Ghuysen A, El Kouri D, Brice C, Marjanovic NS, Bouget J, Moustafa F, Trinh-Duc A, Le Gall C, Imsaad L, Chretien JM, Gable B, Girard P, Sanchez O, Schmidt J, Le Gal G, Meyer G, Delvau N, Roy PM. Pulmonary embolism rule-out criteria (PERC) rule in European patients with low implicit clinical probability (PERCEPIC): a multicentre, prospective, observational study. Lancet Haematol. 2017 Dec;4(12):e615-e621. doi: 10.1016/S2352-3026(17)30210-7. Epub 2017 Nov 14. |
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| ID | Term |
|---|---|
| D011655 | Pulmonary Embolism |
| D004417 | Dyspnea |
| D002637 | Chest Pain |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D004617 | Embolism |
| D016769 | Embolism and Thrombosis |
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For each methods, AUC in receiver operating characteristic analyses of the 3-level classification scheme will be compared. |
| 3 months |
| To compare performances of clinical probability assessment methods : implicit assessment, revised Geneva Score, Wells Score and implicit overridden Geneva Score | For each methods, AUC in receiver operating characteristic analyses of the 3-level classification scheme will be compared | 3 months |
| Brussels |
| Belgium |
| UH Liège | Liège | Belgium |
| Hospital of Agen | Agen | France |
| UH Angers | Angers | France |
| Hospital of Argenteuil | Argenteuil | France |
| UH Clermont-Ferrand | Clermont-Ferrand | France |
| Hospital of Le Mans | Le Mans | France |
| UH Nantes | Nantes | France |
| UH Poitiers | Poitiers | France |
| UH Rennes | Rennes | France |
| Hospital of Saint-Brieuc | Saint-Brieuc | France |
| D014652 |
| Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D012120 | Respiration Disorders |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |