Diagnostic modalities for detection of pulmonary embolism in clinical routine: a European survey

A questionnaire asking for routinely performed modalities to diagnose deep venous thrombosis (DVT) and pulmonary embolism (PE) was sent to 2,500 departments in 23 European countries. Five-hundred-seventy (23%) were received back and evaluated according to hospital size and regional differences. Countries were grouped into: Anglo-Scandinavian (a), German-speaking (g), and Roman (r). Contrast venography is most frequently performed (94%) to diagnose DVT, independent of hospital size and without regional differences. With exception of Doppler ultrasound (71%), noninvasive DVT tests are rarely performed (6-28%). To diagnose PE, pulmonary angiography (PA) and ventilation-perfusion (V-P) scintigraphy are performed in 71%, digital subtraction angiography in only 50%. Frequencies of PE tests strongly depend on hospital size (PA: small hospitals 53-66%, large 83-89%; V-P: small hosp. greater than 80%, large greater than 90%, with 2 exceptions: small German hospitals = 48%, primarily performing only P-scans and large Roman hospitals = 59%, primarily performing PA). Regional differences were also significant (PA: r = 85%, a = 74%, g = 63%, V-P: a = 95%, r = 66%, g = 63%, respectively).