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Comment & Response
October 13, 2021

Safety of the 4PEPS in Patients With a Very Low Prevalence of Pulmonary Embolism—Need for More Than a Point Estimate

Author Affiliations
  • 1Sorbonne Université, Paris, France
  • 2Emergency Department, Hôpital Pitié-Salpêtrière, Paris, France
  • 3Emergency Department, CHU Charles Nicole, Rouen, France
  • 4Emergency Department, University of Jena, Jena, Germany
JAMA Cardiol. 2021;6(12):1468. doi:10.1001/jamacardio.2021.4014

To the Editor We read with great interest the article by Roy et al1 describing a new 4-Level Pulmonary Embolism Clinical Probability Score (4PEPS) to rule out pulmonary embolism (PE). As recommended by the Scientific and Standardization Committee of the International Society of Thrombosis and Hemostasis,2 the authors predefined the acceptable upper limits of the 95% CI of failure rate at 1.93% and 1.88% for their 2 external validation cohorts. The authors found the failure rates and 95% CI of the 4PEPS below these predefined limits and concluded that the safety of the 4PEPS strategy was confirmed.

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