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Editorials |

Simplifying the Evaluation of Pulmonary Embolism

Peter B. Richman, MD, MBA
Author and Funding Information

Affiliations: Phoenix, AZ
 ,  Dr. Richman is Vice-Chairman, Division of Research, Department of Emergency Medicine, Mayo Clinic Hospital.

Correspondence to: Peter B. Richman, MD, MBA, Department of Emergency Medicine, Mayo Clinic Hospital, Phoenix, AZ 85054; e-mail: PRichmanMD@aol.com



Chest. 2006;129(6):1400-1402. doi:10.1378/chest.129.6.1400
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Extract

In the 16 years since the first Prospective Investigation of Pulmonary Embolism Diagnosis report,1 clinicians have gained numerous diagnostic tools beyond ventilation-perfusion imaging and conventional pulmonary angiography to rule out pulmonary embolism. Many still consider angiography, an invasive modality, the reference standard to diagnose the condition. However, a recent metaanalysis2 of 15 studies (3,500 patients) revealed that negative CT angiographic findings of the chest alone might be sufficient to safely rule out pulmonary embolism. Quiroz et al2 reported that CT angiography had a negative predictive value for the disease of 99.1% (95% confidence interval [CI], 98.7 to 99.5%) and a negative predictive value for fatal pulmonary embolism of 99.4% (95% CI, 98.7 to 99.9%).

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