Pulmonary embolism: Making sense of the diagnostic evaluation

Despite the publication of the Prospective Investigation of Pulmonary Embolism Diagnosis in 1990, the diagnostic evaluation of pulmonary embolism continues to be approached in an inconsistent fashion. The reasons for this are unclear but likely have to do with inadequate methods for predicting prete...

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Bibliographic Details
Published in:Annals of emergency medicine 2001-05, Vol.37 (5), p.504-514
Main Authors: Wolfe, Timothy Robert, Hartsell, Stephen C.
Format: Article
Language:English
Subjects:
Algorithms
Angiography - adverse effects
Angiography - standards
Biological and medical sciences
Clinical Protocols - standards
Decision Trees
Emergency Treatment - methods
Emergency Treatment - standards
Evidence-Based Medicine
Humans
Medical sciences
Pneumology
Predictive Value of Tests
Prospective Studies
Pulmonary Embolism - diagnosis
Pulmonary Embolism - etiology
Pulmonary Embolism - mortality
Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases
Reproducibility of Results
Risk Factors
Safety
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography - standards
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Description
Summary:Despite the publication of the Prospective Investigation of Pulmonary Embolism Diagnosis in 1990, the diagnostic evaluation of pulmonary embolism continues to be approached in an inconsistent fashion. The reasons for this are unclear but likely have to do with inadequate methods for predicting pretest probability of disease and the inconvenience and perceived risk of pulmonary angiography. Because pulmonary embolism and its treatment carry substantial risk of morbidity and mortality, a consistent approach to evaluation is desirable. This article reviews large, prospective studies that suggest that it may be unnecessary to diagnose pulmonary embolism with the certainty that pulmonary angiography allows. Finally, the article proposes an algorithm that may be acceptable to patients and clinicians alike if safety is confirmed in future prospective studies. [Wolfe TR, Hartsell SC. Pulmonary embolism: making sense of the diagnostic evaluation. Ann Emerg Med. May 2001;37:504-514.]
ISSN:0196-0644
1097-6760
DOI:10.1067/mem.2001.111764