FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2890959213> ?p ?o ?g. }

• W2890959213 endingPage "230" @default.
• W2890959213 startingPage "1" @default.
• W2890959213 abstract "Background Pulmonary embolism (PE) is a leading cause of death in pregnancy and post partum, but the symptoms of PE are common in normal pregnancy. Simple diagnostic tests are needed to select women for diagnostic imaging. Objective To estimate the accuracy, effectiveness and cost-effectiveness of clinical features, decision rules and biomarkers for selecting pregnant or postpartum women with a suspected PE for imaging. Design An expert consensus study to develop new clinical decision rules, a case–control study of women with a diagnosed PE or a suspected PE, a biomarker study of women with a suspected PE or diagnosed deep-vein thrombosis (DVT) and decision-analysis modelling. Setting Emergency departments and consultant-led maternity units. Participants Pregnant/postpartum women with a diagnosed PE from any hospital reporting to the UK Obstetric Surveillance System research platform and pregnant/postpartum women with a suspected PE or diagnosed DVT at 11 prospectively recruiting sites. Interventions Clinical features, decision rules and biomarkers. Main outcome measures Sensitivity, specificity, area under receiver operating characteristic (AUROC) curve, quality-adjusted life-years (QALYs) and health-care costs. Results The primary analysis involved 181 women with PE and 259 women without PE in the case–control study and 18 women with DVT, 18 with PE and 247 women without either in the biomarker study. Most clinical features showed no association with PE. The AUROC curves for the clinical decision rules were as follows: primary consensus, 0.626; sensitive consensus, 0.620; specific consensus, 0.589; PE rule-out criteria, 0.621; simplified Geneva score, 0.579; Wells’s PE criteria (permissive), 0.577; and Wells’s PE criteria (strict), 0.732. The sensitivities and specificities of the D-dimer measurement were 88.4% and 8.8%, respectively, using a standard threshold, and 69.8% and 32.8%, respectively, using a pregnancy-specific threshold. Previous venous thromboembolism, long-haul travel, multiple pregnancy, oxygen saturation, recent surgery, temperature and PE-related chest radiograph abnormality were predictors of PE on multivariable analysis. We were unable to derive a rule through multivariable analysis or recursive partitioning with adequate accuracy. The AUROC curves for the biomarkers were as follows: activated partial thromboplastin time – 0.669, B-type natriuretic peptide – 0.549, C-reactive protein – 0.542, Clauss fibrinogen – 0.589, enzyme-linked immunosorbent assay D-dimer – 0.668, Innovance D-dimer (Siemens Healthcare Diagnostics Products GmbH, distributed by Sysmex UK Ltd, Milton Keynes, UK) – 0.651, mid-regional pro-atrial natriuretic peptide (MRproANP) – 0.524, prothrombin fragment 1 + 2 – 0.562, plasmin-antiplasmin – 0.639, Prothombin time – 0.613, thrombin generation lag time – 0.702, thrombin generation endogenous potential – 0.559, thrombin generation peak – 0.596, thrombin generation time to peak – 0.655, tissue factor – 0.531 and troponin – 0.597. The repeat analysis excluding women who had received anticoagulation was limited by the small number of women with PE ( n = 4). The health economic analysis showed that a strategy of scanning all women with a suspected PE accrued more QALYs and incurred fewer costs than any selective strategy based on a clinical decision rule and was therefore the dominant strategy. Limitations The findings apply specifically to the diagnostic assessment of women with a suspected PE in secondary care. Conclusions Clinical features, decision rules and biomarkers do not accurately, effectively or cost-effectively select pregnant or postpartum women with a suspected PE for diagnostic imaging. Future work New diagnostic technologies need to be developed to detect PE in pregnancy. Trial registration Current Controlled Trials ISRCTN21245595. Funding details This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 22, No. 47. See the NIHR Journals Library website for further project information." @default.
• W2890959213 created "2018-09-27" @default.
• W2890959213 creator A5012946537 @default.
• W2890959213 creator A5016293787 @default.
• W2890959213 creator A5030995035 @default.
• W2890959213 creator A5031831436 @default.
• W2890959213 creator A5032411762 @default.
• W2890959213 creator A5043208701 @default.
• W2890959213 creator A5054508518 @default.
• W2890959213 creator A5066259567 @default.
• W2890959213 creator A5082290424 @default.
• W2890959213 creator A5084682363 @default.
• W2890959213 creator A5091395329 @default.
• W2890959213 date "2018-08-01" @default.
• W2890959213 modified "2023-10-12" @default.
• W2890959213 title "Selecting pregnant or postpartum women with suspected pulmonary embolism for diagnostic imaging: the DiPEP diagnostic study with decision-analysis modelling" @default.
• W2890959213 cites W1525595715 @default.
• W2890959213 cites W1572285456 @default.
• W2890959213 cites W1592091620 @default.
• W2890959213 cites W1936477295 @default.
• W2890959213 cites W1952025755 @default.
• W2890959213 cites W1968036356 @default.
• W2890959213 cites W1968098708 @default.
• W2890959213 cites W1968376486 @default.
• W2890959213 cites W1971348077 @default.
• W2890959213 cites W1973346175 @default.
• W2890959213 cites W1977999037 @default.
• W2890959213 cites W1979178117 @default.
• W2890959213 cites W1980621470 @default.
• W2890959213 cites W1981156855 @default.
• W2890959213 cites W1982967337 @default.
• W2890959213 cites W1993518681 @default.
• W2890959213 cites W1996018199 @default.
• W2890959213 cites W1998643818 @default.
• W2890959213 cites W1998969239 @default.
• W2890959213 cites W2011521740 @default.
• W2890959213 cites W2013364969 @default.
• W2890959213 cites W2019242730 @default.
• W2890959213 cites W2019300001 @default.
• W2890959213 cites W2031524099 @default.
• W2890959213 cites W2040412094 @default.
• W2890959213 cites W2042439695 @default.
• W2890959213 cites W2046042797 @default.
• W2890959213 cites W2046808071 @default.
• W2890959213 cites W2055147211 @default.
• W2890959213 cites W2058948365 @default.
• W2890959213 cites W2062465793 @default.
• W2890959213 cites W2065264999 @default.
• W2890959213 cites W2067855848 @default.
• W2890959213 cites W2070230130 @default.
• W2890959213 cites W2071602068 @default.
• W2890959213 cites W2073918761 @default.
• W2890959213 cites W2076621544 @default.
• W2890959213 cites W2082315647 @default.
• W2890959213 cites W2085797065 @default.
• W2890959213 cites W2091528299 @default.
• W2890959213 cites W2102389725 @default.
• W2890959213 cites W2102714729 @default.
• W2890959213 cites W2105270941 @default.
• W2890959213 cites W2110134277 @default.
• W2890959213 cites W2110580571 @default.
• W2890959213 cites W2114253432 @default.
• W2890959213 cites W2116205803 @default.
• W2890959213 cites W2122317738 @default.
• W2890959213 cites W2132203116 @default.
• W2890959213 cites W2133619004 @default.
• W2890959213 cites W2134190163 @default.
• W2890959213 cites W2140011409 @default.
• W2890959213 cites W2152406414 @default.
• W2890959213 cites W2167101610 @default.
• W2890959213 cites W2168909631 @default.
• W2890959213 cites W2169875394 @default.
• W2890959213 cites W2171670432 @default.
• W2890959213 cites W2192816303 @default.
• W2890959213 cites W2260766877 @default.
• W2890959213 cites W2261574050 @default.
• W2890959213 cites W2289872081 @default.
• W2890959213 cites W2317082550 @default.
• W2890959213 cites W2326001218 @default.
• W2890959213 cites W2327467731 @default.
• W2890959213 cites W2339809491 @default.
• W2890959213 cites W2487770199 @default.
• W2890959213 cites W2559793636 @default.
• W2890959213 cites W2786907443 @default.
• W2890959213 cites W3175417087 @default.
• W2890959213 cites W4211177544 @default.
• W2890959213 cites W4300858224 @default.
• W2890959213 doi "https://doi.org/10.3310/hta22470" @default.
• W2890959213 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6139476" @default.
• W2890959213 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/30178738" @default.
• W2890959213 hasPublicationYear "2018" @default.
• W2890959213 type Work @default.
• W2890959213 sameAs 2890959213 @default.
• W2890959213 citedByCount "12" @default.
• W2890959213 countsByYear W28909592132019 @default.
• W2890959213 countsByYear W28909592132020 @default.
• W2890959213 countsByYear W28909592132021 @default.
• W2890959213 countsByYear W28909592132022 @default.

• next