Letters to the Editor

A PaDd-informed, Assay-calibrated Diagnostic Pathway for Suspected Pulmonary Embolism in Older Adults: From Signal to Strategy

Mulavagili Vijayasimha and Sivaji Ganesh Adusumalli

Abstract

To the Editor,

We commend Cohen et al. for introducing a prag-matic 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 heterogeneity, 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):e0009