CT and D-dimer testing are overused in patients with suspected pulmonary embolism, US college says

BMJ 2015; 351 doi: (Published 02 October 2015) Cite this as: BMJ 2015;351:h5261
  1. Michael McCarthy
  1. 1Seattle

Patients with suspected acute pulmonary embolism (PE) should be stratified based on their likelihood of having a PE before having a D-dimer test or computer tomography (CT), guidelines have said.

New “best practice” guidelines from the clinical guidelines committee of the American College of Physicians were published online on 28 September.1 “With the rising cost of PE evaluations, along with increasing awareness of potential harm and doubts about mortality benefits, a more focused strategy is needed,” the committee said.

CT exposes patients to potentially hazardous radiation and is associated with risk of nephropathy from contrast agents. Although use of CT for the evaluation of PE was increasing, there was no evidence that increased use …

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