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Objectives.  Diagnostic strategies in patients with suspected pulmonary embolism have been extensively studied in outpatients; their value in hospitalized patients has not been well established. Our aim was to determine the safety and clinical utility of a simple diagnostic strategy in hospitalized patients with suspected pulmonary embolism.

Design.  Prospective management study.

Setting.  Twelve teaching hospitals (five academic, seven general hospitals).

Subject.  A total of 605 hospitalized patients with clinically suspected pulmonary embolism. All patients completed the study.

Interventions.  First the clinical decision rule (CDR)‐score was calculated. An unlikely CDR‐score in combination with a normal D‐dimer excluded pulmonary embolism. All other patients underwent helical computed tomography (CT). CT either diagnosed or excluded pulmonary embolism, in which case anticoagulants were started …