New tool for diagnosing pulmonary embolism in emergency departments

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This observational study aims to evaluate the effectiveness of the Adjust-Unlikely clinical decision rule in reducing unnecessary imaging for pulmonary embolism (PE) in emergency department patients. The Adjust-Unlikely tool, developed by a team of researchers and emergency physicians, is designed to be highly sensitive and user-friendly for emergency settings. By implementing this decision rule, the study seeks to minimize the exposure of patients to radiation and reduce healthcare costs associated with unnecessary imaging. The study will involve patients who are tested for PE in emergency departments across Canada.

Why it matters

Who can join: the full rules

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

Where it's running

• Hamilton Health Sciences Corporation
  Hamilton, Ontario, Canada Recruiting
• Kingston Health Sciences Centre
  Kingston, Ontario, Canada Recruiting
• London Health Sciences Centre Research Inc
  London, Ontario, Canada Active not recruiting
• Ottawa Hospital Research Institute
  Ottawa, Ontario, Canada Active not recruiting

Study contacts

• Principal investigator: Kerstin de Wit, MD — Queens University
• Study coordinator: Natasha S Clayton
• Email: natasha.clayton@queensu.ca
• Phone: 416-566-3590

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.