Evidence map›Paper›PMID 42656957›Full record

ArticleEuropean journal of radiology open2026

Concordance of the modified wells score with CTPA-confirmed pulmonary embolism in an imaging-selected cohort: A retrospective single-center study.

Pietro Costantini, Eleonora Ostillio, Davide Razzini, Rita Spagnolo, Davide Fabbricatore, Anna Carmen Leonetti, Pierluca Minelli, Giorgia Angela Agata Leocata, Alessandro Carriero, Anna Colarieti

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In one paragraph

Article in European journal of radiology open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Pietro CostantiniRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Eleonora OstillioRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Davide RazziniRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Rita SpagnoloRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Davide FabbricatoreRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Anna Carmen LeonettiRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Pierluca MinelliRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Giorgia Angela Agata LeocataRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Alessandro CarrieroRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.
Anna ColarietiRadiology Department, Azienda Ospedaliera Maggiore della Caritá di Novara, University of Eastern Piedmont, Via Solaroli 18, Novara 28100, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pulmonary embolism (PE) is a major diagnostic challenge in emergency medicine. Computed tomography pulmonary angiography (CTPA) is the gold standard but is frequently overused. The modified Wells Score (mWS) estimates pre-test probability and may reduce inappropriate imaging at triage. We evaluated the concordance between mWS and CTPA-confirmed PE in a tertiary emergency department. Methods: We retrospectively analyzed all patients undergoing CTPA for suspected PE over 24 months. As all patients had already undergone CTPA, this design reflects concordance within an imaging-selected cohort, not triage performance. mWS values were assigned by consensus between two readers, blinded to CTPA results; D-dimer was not incorporated. AUC was computed from the full ordinal mWS range; sensitivity, specificity, PPV and NPV were calculated at the conventional mWS ≥ 4 threshold. Spearman's correlation assessed the mWS-PE severity association. Results: Among 691 patients, 103 (14.9%) had CTPA-confirmed PE. At mWS ≥ 4, sensitivity was 86.4%, specificity 98.6%, AUC 0.943 (95% CI: 0.91-0.97). The Youden index identified mWS ≥ 3 as optimal (sensitivity 89.3%, specificity 95.7%); ≥ 4 was retained for analysis. Under this threshold, 594 patients (86.0%) fell below the cut-off, suggesting avoidable imaging, though unconfirmed in non-imaged patients. Fourteen false-negative (3 central PE) and eight false-positive cases were identified. Higher mWS correlated moderately with PE burden (ρ = 0.578, p < 0.01). Conclusion: mWS showed strong concordance with CTPA-confirmed PE; diagnostic accuracy exceeding pooled meta-analytic estimates likely reflects consensus-scoring methodology rather than genuine superiority. Prospective, multicentre validation incorporating D-dimer testing and independent scoring is warranted before routine implementation.

Indexed as

Computed tomography pulmonary angiographyEmergency departmentModified wells scorePulmonary embolism

Identifiers

PMID42656957
PMCPMC13507798

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.