Studies in Top Clinical Journals Agree:
CT for Pulmonary Embolism Can Substitute for More Invasive and More Costly Procedures
CT scans can reduce the need for invasive procedures and additional imaging tests in helping physicians diagnose pulmonary embolism, according to studies in the New England Journal of Medicine and the Journal of the American Medical Association.
Researchers found that, when CT scans were used, patient outcomes were little changed from those when more intensive and invasive procedures were used that are commonly viewed as the "gold standard" for diagnosing the condition. Authors of the studies pointed to advances in CT that reduce the need for invasive pulmonary angiography, which involves threading a catheter through the heart, and leg ultrasound tests, which have been used in the past to confirm the CT diagnosis.
- The JAMA study analyzed the findings of 15 other studies that involved evaluation of 3,500 patients from 1994 - 2002. The authors concluded that using CT for pulmonary embolisms "may minimize radiation exposure, invasive procedures, and health care costs."
- The NEJM study, which combined CT with use of a blood test to rule out pulmonary embolism, involved 756 consecutive patients at three medical centers between 2002 and 2003. Although the study validated using CT and the blood test as part of a clinical probability assessment in ruling out pulmonary embolism, the authors also said that the findings should be confirmed in a larger outcomes study.
A separate editorial in the NEJM called CT for pulmonary embolism "a technological marvel."
1Multidetector-Row Computed Tomography in Suspected Pulmonary Embolism," Perrier, et. al., New England Journal of Medicine, Vol 352, No 17; pp1760-1768, April 28, 2005.
2 "Clinical Validity of a Negative Computed Tomography Scan in Patients with Suspected Pulmonary Embolism: A Systematic Review," Quiroz, et al., Journal of the American Medical Association, Vol 293, No 16; pp. 2012-2017, April 27, 2005.
|
