A better approach to the diagnosis of PE
A better approach to the diagnosis of PE: A simple diagnostic algorithm is all that’s needed to safely and effectively reduce our reliance on CT pulmonary angiography to diagnose PE. PRACTICE CHANGER: Do not order computed tomography pulmonary angiography when evaluating patients for suspected pulmonary embolism unless: (1) the patient has a d-dimer concentration ≥ 1000 ng/mL; or (2) the patient has a d-dimer concentration ≥ 500 ng/mL, PLUS: (A) clinical signs of deep vein thrombosis, (B) hemoptysis, or (C) you think pulmonary embolism is the most likely diagnosis. STRENGTH OF RECOMMENDATION A: Based on a prospective, multicenter, cohort study of 3616 patients with clinically suspected pulmonary embolism.
Journal of Family Practice, 68(05) 2019: 286-287, 295.