Emergency Medicine Pulmonary Embolism Testing Multicentre Study

Launched by DR. KERSTIN DE WIT · Mar 13, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a new tool called Adjust-Unlikely, which aims to help emergency doctors safely diagnose pulmonary embolism (PE), a serious condition where blood clots block blood flow to the lungs. Currently, many patients are tested for PE in emergency departments, but most tests return negative results. The goal of this trial is to see if the Adjust-Unlikely tool can reduce the number of unnecessary imaging tests, which can be costly, expose patients to radiation, and sometimes lead to incorrect diagnoses.

To participate in this study, patients must be 18 years or older and be evaluated for PE by an emergency physician. However, those who have had recent imaging for PE, have specific medical conditions, or do not have valid health insurance in Ontario are not eligible. Participants can expect to have their symptoms assessed and may undergo a D-dimer test, which helps determine if a blood clot is likely. The study is currently recruiting patients, and the researchers hope that by validating this new tool, they can improve the way PE is diagnosed in emergency settings, leading to safer and more efficient care.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Emergency department patient who is tested by an emergency physician for PE
• Exclusion Criteria:
• • Patient is \< 18 years of age
• • No documentation of whether PE is the most likely diagnosis
• • D-dimer is not tested or else not resulted during the emergency visit
• • The D-dimer level is known before documentation of whether PE is the most likely diagnosis
• • The D-dimer is ordered prior to the physician assessing the patient
• • The patient has previously registered that they opt out of all research at the participating site
• • The patient leaves against medical advice
• • The patient has had PE or deep vein thrombosis imaging (CT pulmonary angiogram, ventilation-perfusion scan or lower limb ultrasound) within prior 30 days
• • There is a new (non-PE) indication for anticoagulation
• • The patient was initiated on treatment for presumed PE prior to PE testing
• • The patient has previously been enrolled into the study
• • The patient has a prior history of lower extremity deep vein thrombosis without availability of a baseline ultrasound scan
• • The patient was transferred from another hospital organization
• • The patient does not reside in Ontario
• • The patient has no valid Ontario Health Insurance Plan card