• A Perrier and T Perneger.
• Clinique de Médecine 1, Département de Médecine, Hôpitaux Universitaires de Genève, Suisse. Arnaud.perrier@medecine.unige.ch
• Rev Mal Respir. 2003 Apr 1; 20 (2 Pt 1): 249-56.

IntroductionClinical prediction rules or scores are instruments that allow to quantify the respective contributions of medical history, clinical examination and laboratory tests to a diagnosis or a prognosis in a given patient.State Of The ArtThe development of clinical prediction rules requires three steps: 1) derivation of the rule from a population with known clinical characteristics and diagnosis or prognosis; 2) validation of the rule in a population distinct from the derivation sample; and 3) evaluation of the impact of the rule on clinician behavior and patient outcomes.PerspectivesThis paper provides a guide for the critical appraisal of a prediction rule illustrated by two clinical scores for the assessment of the clinical probability of pulmonary embolism.ConclusionsClinical prediction rules or scores have become indispensable components of the clinician's toolbox.

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