View article

The diagnostic work‐up of patients with suspected pulmonary embolism (PE) has been optimized and simplified by the use of clinical decision rules (CDR), D‐dimer (DD) testing and spiral computed tomography (s‐CT). Whether this strategy is equally safe and efficient in specific subgroups of patients is evaluated in this study. A diagnostic strategy including a CDR, DD test and s‐CT was evaluated in patients with malignancy, previous venous thromboembolism (VTE), chronic obstructive pulmonary disease or heart failure and in older patients. PE was ruled out by either an unlikely CDR and a normal DD or a s‐CT negative for PE. The safety of these tests was assessed by the 3‐month incidence rate of symptomatic VTE in those without PE at baseline. The efficiency was evaluated by calculating the numbers needed to test for the different subgroups. The venous thromboembolic …