Safe exclusion of pulmonary embolism using the Wells rule and qualitative D-dimer testing in primary care: prospective cohort study.

ABSTRACT:

Objective

To validate the use of the Wells clinical decision rule combined with a point of care D-dimer test to safely exclude pulmonary embolism in primary care.

Design

Prospective cohort study.

Setting

Primary care across three different regions of the Netherlands (Amsterdam, Maastricht, and Utrecht).

Participants

598 adults with suspected pulmonary embolism in primary care.

Interventions

Doctors scored patients according to the seven variables of the Wells rule and carried out a qualitative point of care D-dimer test. All patients were referred to secondary care and diagnosed according to local protocols. Pulmonary embolism was confirmed or refuted on the basis of a composite reference standard, including spiral computed tomography and three months' f

SUBMITTER: Geersing GJ 

PROVIDER: S-EPMC3464185 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature