Therefore, models derived in hospital or acute care settings cannot simply be implemented in primary care.8 9 10 11 12 13 14 Reasons for this poorer performance include differences in the case mix and the prevalence of pulmonary embolism due to the unselected population, as well as differences in physicians’ experience of patients with suspected pulmonary embolism.9 10 15 16 Hence, when transferring diagnostic models or strategies across healthcare settings https://www.pandora-charm-uk.com/, evaluation of their performance in this other setting is necessary first. This form of external validation is referred to as domain or setting validation,8 10 17 or as quantification of the transportability of prediction models.13 18The recent AMUSE 2 study (Amsterdam, Maastricht, Utrecht Study on thrombo Embolism)19 has been the first to prospectively quantify the transportability of the, perhaps best known, secondary care derived diagnostic prediction model for pulmonary embolism (that is, the Wells pulmonary embolism rule,20 combined with point of care D dimer testing) in a primary care setting. Various other diagnostic pulmonary embolism prediction models that may also be valuable for primary care have been developed but have not been validated in a primary care population.The aim of this study was therefore to assess the clinical performance in a primary care setting of all existing diagnostic models developed for patients with suspected pulmonary embolism.
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