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• W2081776781 endingPage "332.e10" @default.
• W2081776781 startingPage "321" @default.
• W2081776781 abstract "Study objective Symptoms associated with pulmonary embolism can be nonspecific and similar to many competing diagnoses, leading to excessive costly testing and treatment, as well as missed diagnoses. Objective studies are essential for diagnosis. This study evaluates the cost-effectiveness of different diagnostic strategies in an emergency department (ED) for patients presenting with undifferentiated symptoms suggestive of pulmonary embolism. Methods Using a probabilistic decision model, we evaluated the incremental costs and effectiveness (quality-adjusted life-years gained) of 60 testing strategies for 5 patient pretest categories (distinguished by Wells score [high, moderate, or low] and whether deep venous thrombosis is clinically suspected). We performed deterministic and probabilistic sensitivity analyses. Results In the base case, for all patient pretest categories, the most cost-effective diagnostic strategy is to use an initial enzyme-linked immunosorbent assay D-dimer test, followed by compression ultrasonography of the lower extremities if the D-dimer is above a specified cutoff. The level of the preferred cutoff varies with the Wells pretest category and whether a deep venous thrombosis is clinically suspected. D-dimer cutoffs higher than the current recommended cutoff were often preferred for patients with even moderate and high Wells categories. Compression ultrasonography accuracy had to decrease below commonly cited levels in the literature before it was not part of a preferred strategy. Conclusion When pulmonary embolism is suspected in the ED, use of an enzyme-linked immunosorbent assay D-dimer assay, often at cutoffs higher than those currently in use (for patients in whom deep venous thrombosis is not clinically suspected), followed by compression ultrasonography as appropriate, can reduce costs and improve outcomes. Symptoms associated with pulmonary embolism can be nonspecific and similar to many competing diagnoses, leading to excessive costly testing and treatment, as well as missed diagnoses. Objective studies are essential for diagnosis. This study evaluates the cost-effectiveness of different diagnostic strategies in an emergency department (ED) for patients presenting with undifferentiated symptoms suggestive of pulmonary embolism. Using a probabilistic decision model, we evaluated the incremental costs and effectiveness (quality-adjusted life-years gained) of 60 testing strategies for 5 patient pretest categories (distinguished by Wells score [high, moderate, or low] and whether deep venous thrombosis is clinically suspected). We performed deterministic and probabilistic sensitivity analyses. In the base case, for all patient pretest categories, the most cost-effective diagnostic strategy is to use an initial enzyme-linked immunosorbent assay D-dimer test, followed by compression ultrasonography of the lower extremities if the D-dimer is above a specified cutoff. The level of the preferred cutoff varies with the Wells pretest category and whether a deep venous thrombosis is clinically suspected. D-dimer cutoffs higher than the current recommended cutoff were often preferred for patients with even moderate and high Wells categories. Compression ultrasonography accuracy had to decrease below commonly cited levels in the literature before it was not part of a preferred strategy. When pulmonary embolism is suspected in the ED, use of an enzyme-linked immunosorbent assay D-dimer assay, often at cutoffs higher than those currently in use (for patients in whom deep venous thrombosis is not clinically suspected), followed by compression ultrasonography as appropriate, can reduce costs and improve outcomes." @default.
• W2081776781 created "2016-06-24" @default.
• W2081776781 creator A5018649444 @default.
• W2081776781 creator A5085954747 @default.
• W2081776781 date "2010-10-01" @default.
• W2081776781 modified "2023-10-18" @default.
• W2081776781 title "Cost-Effectiveness of Strategies for Diagnosing Pulmonary Embolism Among Emergency Department Patients Presenting With Undifferentiated Symptoms" @default.
• W2081776781 cites W115069151 @default.
• W2081776781 cites W1480413091 @default.
• W2081776781 cites W1515043489 @default.
• W2081776781 cites W1536191587 @default.
• W2081776781 cites W1560392060 @default.
• W2081776781 cites W1785292754 @default.
• W2081776781 cites W1838119231 @default.
• W2081776781 cites W1965275931 @default.
• W2081776781 cites W1968098708 @default.
• W2081776781 cites W1968856774 @default.
• W2081776781 cites W1970359815 @default.
• W2081776781 cites W1970598617 @default.
• W2081776781 cites W1971318998 @default.
• W2081776781 cites W1972970018 @default.
• W2081776781 cites W1973811865 @default.
• W2081776781 cites W1974397202 @default.
• W2081776781 cites W1974789939 @default.
• W2081776781 cites W1976722079 @default.
• W2081776781 cites W1978017270 @default.
• W2081776781 cites W1980150722 @default.
• W2081776781 cites W1980835422 @default.
• W2081776781 cites W1985184637 @default.
• W2081776781 cites W1986424084 @default.
• W2081776781 cites W1987314584 @default.
• W2081776781 cites W1991771021 @default.
• W2081776781 cites W1992938878 @default.
• W2081776781 cites W1993750880 @default.
• W2081776781 cites W1996208114 @default.
• W2081776781 cites W1997277648 @default.
• W2081776781 cites W1998588782 @default.
• W2081776781 cites W1999789157 @default.
• W2081776781 cites W2001071467 @default.
• W2081776781 cites W2001576756 @default.
• W2081776781 cites W2004613006 @default.
• W2081776781 cites W2004651027 @default.
• W2081776781 cites W2005134939 @default.
• W2081776781 cites W2006320546 @default.
• W2081776781 cites W2006357536 @default.
• W2081776781 cites W2006415452 @default.
• W2081776781 cites W2008734679 @default.
• W2081776781 cites W2009094994 @default.
• W2081776781 cites W2011953413 @default.
• W2081776781 cites W2012791416 @default.
• W2081776781 cites W2016870621 @default.
• W2081776781 cites W2017591128 @default.
• W2081776781 cites W2018625652 @default.
• W2081776781 cites W2021419564 @default.
• W2081776781 cites W2024437323 @default.
• W2081776781 cites W2030138838 @default.
• W2081776781 cites W2031127066 @default.
• W2081776781 cites W2032091618 @default.
• W2081776781 cites W2033156884 @default.
• W2081776781 cites W2034244277 @default.
• W2081776781 cites W2035121479 @default.
• W2081776781 cites W2036590735 @default.
• W2081776781 cites W2039862980 @default.
• W2081776781 cites W2040324827 @default.
• W2081776781 cites W2044290819 @default.
• W2081776781 cites W2044534173 @default.
• W2081776781 cites W2044982129 @default.
• W2081776781 cites W2045201722 @default.
• W2081776781 cites W2045695182 @default.
• W2081776781 cites W2048050998 @default.
• W2081776781 cites W2049326193 @default.
• W2081776781 cites W2049522215 @default.
• W2081776781 cites W2051171361 @default.
• W2081776781 cites W2053780698 @default.
• W2081776781 cites W2057121999 @default.
• W2081776781 cites W2064423248 @default.
• W2081776781 cites W2066538496 @default.
• W2081776781 cites W2067143182 @default.
• W2081776781 cites W2068256592 @default.
• W2081776781 cites W2074151704 @default.
• W2081776781 cites W2075409030 @default.
• W2081776781 cites W2076188830 @default.
• W2081776781 cites W2077242552 @default.
• W2081776781 cites W2078285144 @default.
• W2081776781 cites W2082791162 @default.
• W2081776781 cites W2083343322 @default.
• W2081776781 cites W2083612976 @default.
• W2081776781 cites W2083819269 @default.
• W2081776781 cites W2084270771 @default.
• W2081776781 cites W2085265911 @default.
• W2081776781 cites W2085752133 @default.
• W2081776781 cites W2087444896 @default.
• W2081776781 cites W2088962171 @default.
• W2081776781 cites W2091528299 @default.
• W2081776781 cites W2091691613 @default.
• W2081776781 cites W2092045194 @default.
• W2081776781 cites W2093628468 @default.
• W2081776781 cites W2093644525 @default.

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