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A Kinder Simpler Geneva Score

August 22, 2017

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A simplified Geneva Score is safe to use in place of the Geneva score and is straightforward, with each criterion being worth one point.  Low to Intermediate pretest probability plus negative D-dimer with the simplified Geneva ruled out PE as well as the regular Geneva score.

Why does this matter?
In the era of MDCalc, memorizing scores and prediction rules is less important than in the past.  But if a simpler scoring system is as good as a complex score, it’s reasonable to use a simpler version.

Swiss chocolate and Swiss prediction rules
In the ADJUST-PE study, age-adjusted D-dimer was studied. As part of this, a simplified Geneva Score was studied compared to the Geneva Score.  They found that the simplified Geneva Score, which gave 1-point for each clinical criterion, instead of 1,2,3, or 5-points, performed as well as the more complex Geneva Score.

Here they are side by side.

From cited article

From cited article

Classification into low, intermediate, and high pretest probability groupings was nearly identical, and no patients classified as low or intermediate with a negative age-adjusted D-dimer had recurrent DVT/PE in 3-month follow up.

Assessing clinical probability of pulmonary embolism: prospective validation of the simplified geneva score in outpatients.  J Thromb Haemost. 2017 Jul 8. doi: 10.1111/jth.13770. [Epub ahead of print]

Peer reviewed by Thomas Davis, MD.

What are your thoughts?