If a patient has a symptom such as abnormal bleeding, they no longer fit into the population with a low pretest probability
for having cervical cancer.
Iles et al, (7) evaluated the effect of clinical experience on pretest probability
calculated by Wells and Geneva score.
It is recommended that when there is high pretest probability
, patients with a normal test result should be referred to the endocrinologist for further assessment .
The HM pathway is successful largely because the physicians working within the SDC identify patients for HM with a high pretest probability
for mild or moderate OSA.
We hope to continue in the long term with the new referral procedure which provides practical real-life support of the recent ACCP statement: "In patients who have a low pretest probability
of VTE, as defined by the Wells prediction criteria, a negative, high-sensitivity D-dimer assay for VTE has sufficiently high negative predictive value to reduce the need for further imaging studies".
Having taken approval from hospital research ethical committee and informed consent, patients presenting into emergency department of AFIC, with suspicion of acute coronary syndrome, were categorized into low, intermediate and high pretest probability
of acute coronary syndrome, based on history, examination, findings of initial ECG and results of cardiac biomarkers (Troponin T or CK MB).
[sup],,,,, As a result, in 2013 European Society of Cardiology Guidelines on the Management of SCAD (2013G), [sup] importance was given to systematical testing with the consideration of pretest probability
and the updated Diamond-Forrester model (UDFM) [sup] was recommended as the clinical algorithm.
Although many physicians estimate pretest probability
of malignancy intuitively, validated tools are readily available and can help in clinical decision-making.
An individualized estimate of pretest probability
(PPD) was based on estimates of the prevalence of disease by symptom, age and gender established by Diamond and Forrestor (2).
The posttest probability for disease associated with a particular test result can be estimated based on the pretest probability
and the LR for that particular test result [25, 27].
Clinical practice guidelines indicate that the potential harms of CT angiography outweigh the benefits for patients with a low pretest probability
of pulmonary embolism.
HIV/heart experts advise first figuring the pretest probability
that a person has CHD.