OVERDIAGNOSIS OF ACUTE PULMONARY EMBOLISM DETECTED ON CTPA - A RETROSPECTIVE STUDY
Journal
Academic Medical Journal
Date Issued
2024
Author(s)
DOI
https://www.doi.org/10.53582/AMJ2443017d
Abstract
Aim: To evaluate the prevalence of overdiagnosis of pulmonary embolism (PTE) by computed tomography pulmonary angiography (CTPA) and assess the clinical justification for CTPA use.
Methods: A retrospective study was conducted on 200 patients who presented with symptoms of PTE between 2023 and 2024. CTPA was performed, and results were analyzed to determine diagnostic yield and identify factors contributing to over diagnosis.
Results: Out of 200 patients, 22.5% were diagnosed with PTE, while 77.5% had negative results. Common symptoms included dyspnea (45%) and chest pain (42.5%). Elevated D-dimer levels were found in 92.5% of patients. For those with negative CTPA results, alternative diagnoses included pneumonia (29.03%) and pleural effusion (16.13%).
Conclusion: The study highlights a significant issue of overdiagnosis due to excessive reliance on CTPA. The low positive yield suggests overuse of this imaging modality, potentially driven by inadequate application of clinical decision rules and the D-dimer test. Recommendations include improving adherence to clinical guidelines and optimizing the use of diagnostic tools to reduce unnecessary imaging and radiation exposure.
Methods: A retrospective study was conducted on 200 patients who presented with symptoms of PTE between 2023 and 2024. CTPA was performed, and results were analyzed to determine diagnostic yield and identify factors contributing to over diagnosis.
Results: Out of 200 patients, 22.5% were diagnosed with PTE, while 77.5% had negative results. Common symptoms included dyspnea (45%) and chest pain (42.5%). Elevated D-dimer levels were found in 92.5% of patients. For those with negative CTPA results, alternative diagnoses included pneumonia (29.03%) and pleural effusion (16.13%).
Conclusion: The study highlights a significant issue of overdiagnosis due to excessive reliance on CTPA. The low positive yield suggests overuse of this imaging modality, potentially driven by inadequate application of clinical decision rules and the D-dimer test. Recommendations include improving adherence to clinical guidelines and optimizing the use of diagnostic tools to reduce unnecessary imaging and radiation exposure.
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