Letters to the Editor

Methodological Considerations in Assessing Mental Health Burden Among Caregivers of Special Needs Children

Harikrishnan Balakrishna

Abstract

To the Editor,

We commend Cohen et al. for introducing a pragmatic composite—Padua score × D-dimer (PaDd)—designed to refine pulmonary embolism (PE) exclusion in adults aged ≥65 years, a population often characterized by multimorbidity, physiological het-erogeneity, and atypical presentations. Their single-center retrospective cohort (2021–2023) provides a compelling, hypothesis-generating signal: combining a validated venous thromboembolism risk score with D-dimer may enhance specificity without compromising safety.

Rambam Maimonides Med J 2026;17(1):e0011