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'The Emperor Is Incompletely Attired'

Roger C. Bone, MD

JAMA. 1990;263(20):2794-2795.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

One of the most difficult diagnoses to make in medicine today is that of pulmonary embolic disease. In a study done in the early 1970s,¹ evidence of pulmonary embolism at autopsy correlated poorly to antemortem diagnosis of pulmonary embolic disease; in only one third of cases were emboli correctly identified. A batting average of.333 may be terrific for a professional baseball player, but for a physician attempting to make a diagnosis of a potentially lethal disease, such a statistic is unsatisfactory.

In this week's issue of THE JOURNAL, an investigation of major importance, giving us information on the sensitivity and specificity of ventilation/perfusion scans in pulmonary embolism, is published.² Nearly all patients with acute pulmonary embolism had abnormal scans (high, intermediate, or low probability), but so did most patients without emboli (sensitivity, 98%; specificity, 10%). This study of more than 900 patients shows that the sensitivity of this . . . [Full Text PDF of this Article]

Author Affiliations
From the Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush-Presbyterian—St Luke's Medical Center, Chicago, III.

Footnotes
Reprint requests to Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush-Presbyterian—St Luke's Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612 (Dr Bone).

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