DIET & NUTRITION 
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GUIDELINES/RECOMMENDATIONS ✅ Clinical Decision Support / Validated Tool
Pulmonary embolism is uncommon in children but often prompts laboratory testing and imaging when suspected. Investigators prospectively evaluated the PERC-Peds clinical prediction rule across 21 pediatric emergency departments in 3,988 children with complete data.
Clinical Considerations
- PERC-Peds achieved 99.6% sensitivity and a 99.9% negative predictive value for pulmonary embolism or proximal DVT.
- Only 18.4% of patients were PERC-Peds negative, reflecting limited specificity despite excellent rule-out performance.
- The observed false-negative rate was 0.1%, remaining below the predefined safety threshold.
- Investigators suggested the rule may reduce low-value laboratory testing and pulmonary vascular imaging when used in appropriate clinical contexts.
Practice Applications
- Consider PERC-Peds when assessing children with suspected pulmonary embolism.
- Interpret negative results within the broader clinical presentation and pretest probability.
- Recognize that high sensitivity came with relatively low specificity.
- Monitor future validation and implementation studies before broader protocol adoption.
