Characteristics of included cohorts
| Author, year, country | N (% female) | Age, mean (SD) or median (IQR) | Subject selection | Outcome definition | PE prevalence | Duration of follow-up, days |
|---|---|---|---|---|---|---|
| Wolf, 2008, USA | 134 (54.0) | 58 (43–72) | Adults 18–85 years with clinically suspected PE, chest radiograph and ECG included.Exclusion: pregnant, haemodynamically unstable, known D-dimer level in recent past | Combination of: ▸ high probability V/Q scan using modified prospective investigation of PE diagnosis criteria intermediate probability V/Q scan with a high pretest clinical suspicion ▸ contrast-enhanced CT scan chest pulmonary angiogram ▸ diagnosis of VTE | 11.9 | 90 |
| Hogg, 2005, UK | 425 (51.1) | 38.3 (15.0) | Adults (>18 years) presented to ED with pleuritic chest pain. Exclusion: pneumothorax, ECG changes of myocardial infarction, ischaemia or pericarditis, pregnancy or trauma within 4 weeks | Combination of: ▸ high probability V/Q scan with high clinical probability ▸ CT-pulmonary angiography ▸ digital subtraction angiography | 5.4 | 90 |
| Kline, 2004, USA, LR | 1427 (60.0) | 47 (17) | Adults (>18 years) with clinical suspicion for PE that emergency physicians believed were at LR to justify exclusion of PE on the basis of a negative D-dimer | Combination of: ▸ CT angiography ▸ CT angiography-venography ▸ V/Q scan (followed by duplex ultrasound of the extremities) | 8.0 | 90 |
| Kline, 2004, USA, VLR | 382 (56.0) | 56 (18) | Adults (>18 years) presenting with shortness of breath but emergency physician stated PE not the most likely diagnosis | Combination of: ▸ CT angiography ▸ CT angiography-venography ▸ V/Q scan (followed by duplex ultrasound of the extremities) | 2.4 | 90 |
| Dachs, 2010, USA | 213 | All the ED patients who underwent a CT scan to rule out PE | CT chest | 8.5 | 90 | |
| Hugli, 2011, Switzerland, France, Belgium | 1675 (56.7) | 61 (45–76) | Adult outpatients treated in the ED with a clinical suspicion of PE. Exclusion: contraindication to multidetector CT (MDCT) (ie, allergy to iodine contrast agents, creatine clearance < 30 ml/min or pregnancy), a terminal illness with an expected survival of <3 months, a previous documented diagnosis of PE or were receiving anticoagulant therapy at presentation | Combination of: ▸ positive MDCT or pulmonary angiography ▸ high probability V/Q scan ▸ proximal deep vein thrombosis documented by compression ultrasonography | 21.3 | 90 |
| Beam, 2007, USA | 189 | Adults (>18 years) with clinical suspicion for PE for whom emergency physicians considered formal PE evaluation necessary | Combination of: ▸ CT scan and V/Q scan | 4.2 | 45 | |
| Righini, 2005, Switzerland | 762 (58.0) | 61 (19) | Consecutive outpatients suspected of PE | Combination of: ▸ clinical probability assessment ▸ D-dimer measurement ▸ venous ultrasonography (USA) ▸ helical CT ▸ pulmonary angiogram | 25.7 | |
| Crichlow, 2011, USA | 110 (74) | 46.4 (30.8–62.0) | Patients who received CTpulmonary angiography or lower-extremity duplex ultrasonography | Combination of: ▸ CT-pulmonary angiography ▸ Lower-extremity duplex ▸ Ultrasonography | 5.26 | 90 |
| Kline, 2010, USA | 110 | ED patients (>17 years) admitted with chief complaints: chest pain, shortness of breath, respiratory distress, syncope, hypotension,palpitations, cough, altered mental status or syntax indicating that the patient was sent from outside facility for PE evaluation | Combination of: ▸ D-dimer ▸ pulmonary vasculature imaging ▸ venous ultrasonography | 1.74 | 14 | |
| Courtney, 2006, USA | 315 | ED patients with any testing (V/Q scan, CTscan or D-dimer test) to evaluate for PE | Combination of: ▸ V/Q scan ▸ CT scan ▸ D-dimer test | 4.44 | 45 | |
| Kline, 2008, USA, New Zealand | 8138 (67.0) | 49.1 | Adults (≥18 years) with clinical suspicion for PE on ED physician's evaluation. Exclusion: (1) positive pulmonary vascular imaging study in last 7 days, (2) patient indicated that the enrolment hospital was not his or her choice for follow-up or (3) patient would be lost to follow-up (eg, homeless, psychiatric disorders, international travellers, person arrested for felonies) | Combination of: ▸ either a high probability V/Q scan or ▸ CT angiogram or ▸ conventional pulmonary angiogram or ▸ PE on autopsy | 7.7 | 45 |
| Penaloza, 2012, Belgium, France | 959 (62.0) | 63.9 (0.6) | Consecutive patients with suspected PE who presented to EDs. Exclusion: (1) the diagnosis of thromboembolic disease wasdocumented before admission; (2) PE was suspected during a hospital stay of more than 2 days duration; or (3) diagnostic testing was cancelled for ethical reasons, because of rapid death or because the patient decided to leave the hospital against medical advice | Combination of: ▸ either a high probability V/Q scan or spiral CT ▸ venous compression ultrasonography ▸ pulmonary angiogram ▸ PE on autopsy | 29.8 | 90 |
ED, emergency department; LR, low risk; PE, pulmonary embolism; V/Q scan, ventilation-perfusion scan; VLR, very low risk; VTE, venous thromboembolism.