Age and sex-dependent trends in pulmonary embolism testing and derivation of a clinical decision rule for young patients

Emergency Medicine Journal

Volumn 32, Issue 11, 2015, Pages 840-845

  Mongan, John ^a   Kline, Jeffrey ^b   Smith Bindman, Rebecca ^a,c  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b INDIANA UNIVERSITY   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; CLINICAL DECISION MAKING; CLINICAL EXAMINATION; CLINICAL INDICATOR; COHORT ANALYSIS; EMERGENCY WARD; FEMALE; FEVER; HUMAN; INVESTIGATIVE PROCEDURES; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; PREVALENCE; PRIORITY JOURNAL; RISK FACTOR; TACHYCARDIA; TREND STUDY; ADOLESCENT; AGE DISTRIBUTION; COMPUTER ASSISTED TOMOGRAPHY; DECISION SUPPORT SYSTEM; EMERGENCY HEALTH SERVICE; MIDDLE AGED; PULMONARY EMBOLISM; SEX RATIO; STATISTICS AND NUMERICAL DATA; VERY ELDERLY; YOUNG ADULT;

ADOLESCENT; ADULT; AGE DISTRIBUTION; AGED; AGED, 80 AND OVER; DECISION SUPPORT TECHNIQUES; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; MALE; MIDDLE AGED; PREVALENCE; PULMONARY EMBOLISM; SEX DISTRIBUTION; TOMOGRAPHY, X-RAY COMPUTED; YOUNG ADULT;

EID: 84946553013     PISSN: 14720205     EISSN: 14720213     Source Type: Journal    
DOI: 10.1136/emermed-2014-204531     Document Type: Article

References (24)

1. Le Gal G, Bounameaux H. Diagnosing pulmonary embolism: running after the decreasing prevalence of cases among suspected patients. J Thromb Haemost 2004;2:1244-6.
2. Smith-Bindman R, Miglioretti DL, Johnson E, et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA 2012;307:2400-9.
3. Torbicki A, Perrier A, Konstantinides S, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 2008;29:2276-315.
4. Venkatesh AK, Kline JA, Courtney DM, et al. Evaluation of pulmonary embolism in the emergency department and consistency with a national quality measure: quantifying the opportunity for improvement. Arch Intern Med 2012;172:1028-32.
5. Smith-Bindman R, Lipson J, Marcus R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 2009;169:2078-86.
6. Mitchell AM, Jones AE, Tumlin JA, et al. Prospective study of the incidence of contrast-induced nephropathy among patients evaluated for pulmonary embolism by contrast-enhanced computed tomography. Acad Emerg Med 2012;19:618-25.
7. American College of Chest Physicians ATS. Five Things Physicians and Patients Should Question. http://www.choosingwisely.org/wp-content/uploads/2013/11/ACCP-ATS-5things-112013.pdf (accessed 28 Feb. 2014).
8. American College of Radiology. Five Things Physicians and Patients Should Question. http://www.choosingwisely.org/wp-content/uploads/2013/01/5things-12-factsheet-Amer-Coll-Radiology.pdf (accessed 28 Feb. 2014).
9. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med 2001;135:98-107.
10. Le Gal G, Righini M, Roy P-M, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 2006;144:165-71.
11. Kline JA, Nelson RD, Jackson RE, et al. Criteria for the safe use of D-dimer testing in emergency department patients with suspected pulmonary embolism: a multicenter US study. Ann Emerg Med 2002;39:144-52.
12. Kline JA, Courtney DM, Than MP, et al. Accuracy of very low pretest probability estimates for pulmonary embolism using the method of attribute matching compared with the Wells score. Acad Emerg Med 2010;17:133-41.
13. Kline JA, Mitchell AM, Kabrhel C, et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost 2004;2:1247-55.
14. HCUP Nationwide Emergency Department Sample (NEDS). Healthcare Cost and Utilization Project (HCUP). Rockville, MD: Agency for Healthcare Research and Quality, 2009.
15. Kline JA, Courtney DM, Kabrhel C, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost 2008;6:772-80.
16. Elixhauser A, Steiner C, Harris DR, et al. Comorbidity measures for use with administrative data. Med Care 1998;36:8-27.
17. R Development Core Team. R: A Language and Environment for Statistical Computing [program]. 2.14.0 version. Vienna, Austria: R Foundation for Statistical Computing, 2011.
18. Lumley T. Analysis of complex survey samples. J Stat Soft 2004;9:1-19.
19. Ten Cate-Hoek AJ, Prins MH. Management studies using a combination of D-dimer test result and clinical probability to rule out venous thromboembolism: a systematic review. J Thromb Haemost 2005;3:2465-70.
20. Kokturk N, Demir N, Oguzulgen IK, et al. Fever in pulmonary embolism. Blood Coagul Fibrinolysis 2005;16:341-7.
21. Calvo-Romero JM, Lima-Rodriguez EM, Perez-Miranda M, et al. Low-grade and high-grade fever at presentation of acute pulmonary embolism. Blood Coagul Fibrinolysis 2004;15:331-3.
22. Courtney DM, Kline JA, Kabrhel C, et al. Clinical features from the history and physical examination that predict the presence or absence of pulmonary embolism in symptomatic emergency department patients: results of a prospective, multicenter study. Ann Emerg Med 2010;55:307-15.e1.
23. Weir ID, Drescher F, Cousin D, et al. Trends in use and yield of chest computed tomography with angiography for diagnosis of pulmonary embolism in a Connecticut hospital emergency department. Conn Med 2010;74:5-9.
24. Costantino MM, Randall G, Gosselin M, et al. CT angiography in the evaluation of acute pulmonary embolus. AJR Am J Roentgenol 2008;191:471-4.