Invited comment:

In a letter to the editor of the Annals of Family Medicine, Marie Barais, Erik Stolper and Paul Van Royen give their comments on an article comparing the results of the Wells rule with the Gestalt. Their main criticism is that what the authors called Gestalt did not differ from what they measured in item 2 of the Wells rule. The first step in the diagnostic reasoning process of GPs when faced with a patient with dyspnoe and thoracic pain may be a gut feeling that there is something wrong. The Gestalt is the next step: recognizing a possible pattern of pulmonary embolisme and estimating its likelihood. The third step is applying the Wells rule.

See Letter to editor