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Related Experiment Videos

Diagnostic variability in suspected pulmonary embolism.

D M Becker1, M T O'Connell, M A Gelbard

  • 1Department of Medicine, University of Miami School of Medicine, Fla.

Southern Medical Journal
|August 1, 1988
PubMed
Summary
This summary is machine-generated.

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Pulmonary embolism diagnosis using lung scans often yields inconclusive results, necessitating further testing. Improved methods are needed to link clinical judgment with scan findings for accurate diagnosis.

Area of Science:

  • Medical Diagnostics
  • Radiology
  • Cardiology

Background:

  • Pulmonary embolism (PE) diagnosis relies on imaging, with lung scans frequently used.
  • Variability exists in the diagnostic process for suspected PE.
  • Predetermined criteria aim to standardize lung scan necessity.

Purpose of the Study:

  • To assess variability in the diagnostic process for suspected pulmonary embolism.
  • To evaluate the utility and outcomes of lung scans in PE diagnosis.
  • To identify challenges in confirming PE after inconclusive lung scans.

Main Methods:

  • Prospective observation of adult patients with suspected PE over 12 months.
  • Analysis of 269 lung scan studies based on predetermined necessity criteria.

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  • Review of subsequent diagnostic steps, including pulmonary angiography, for inconclusive scans.

    • Main Results:

    • 157 out of 269 lung scans were deemed necessary.
    • 93 patients (59%) had inconclusive lung scan results.
    • Pulmonary angiography was performed in 42 patients (45%) with inconclusive scans, revealing 10 positive cases.
    • In 55% of cases with necessary but inconclusive scans, the PE question remained unanswered.

    Conclusions:

    • Lung scan results for pulmonary embolism are frequently inconclusive.
    • A significant proportion of patients undergo invasive testing (pulmonary angiography) after inconclusive scans.
    • There is a need for better integration of clinical judgment with lung scan results to optimize confirmatory testing strategies for PE.