About this trial
It is important to diagnose pulmonary embolism in a timely manner to prevent death and long-term disability. More than half a million people (4-5% of emergency department patients) are tested for pulmonary embolism, although the positive rate is low. Imaging for PE testing exposes patients to radiation, is expensive, adds time to the emergency visit, and can lead to a false positive diagnoses. Existing protocols aimed at reducing unnecessary pulmonary embolism imaging are complex and seldom used by emergency physicians. Too many patients undergo unnecessary pulmonary embolism imaging.
A new tool (called Adjust-Unlikely) could safely reduce pulmonary embolism imaging in Canada. A research group composed of researchers, emergency physicians, and patients developed the Adjust-Unlikely clinical decision rule: a rule which has been customized for emergency physicians and emergency patients. Adjust-Unlikely is highly sensitive at the bedside, meaning there are very few false negative results.
The study aim is to prospectively validate Adjust-Unlikely pulmonary embolism testing in emergency patients with suspected pulmonary embolism.
Eligibility criteria
Qualifiers
Emergency department patient who is tested by an emergency physician for PE
Disqualifiers
Patient is < 18 years of age
No documentation of whether PE is the most likely diagnosis
D-dimer is not tested or else not resulted during the emergency visit
The D-dimer level is known before documentation of whether PE is the most likely diagnosis
Trial design
Treatments tested in this trial
- Adjust-Unlikely
Treatment groups
Sponsors and collaborators
Dr. Kerstin de Wit
Lead sponsor
Queen's University
Sponsor institution
Canadian Institutes of Health Research (CIHR)
Collaborator