PERC and YEARS approaches for diagnosing pulmonary embolism in the emergency department.
Evaluation of the PERC Score and the YEARS Algorithm in the Diagnosis of Pulmonary Embolism in the Emergency Department: a Retrospective Observational Study in the Emergency Department of the Strasbourg University Hospital
This project will test whether using the PERC score and the YEARS algorithm helps emergency doctors decide which adults need D-dimer blood tests or chest CT scans to diagnose pulmonary embolism.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 500 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University Hospital, Strasbourg, France Academic / other |
| Locations | 1 site (Strasbourg) |
| Trial ID | NCT07313501 on ClinicalTrials.gov |
What this trial studies
Current diagnosis of pulmonary embolism typically uses clinical judgment followed by D-dimer testing and chest CT angiography, which can lead to overuse of imaging. The PERC rule and the YEARS algorithm are clinical decision tools designed to stratify risk and reduce unnecessary imaging by guiding when D-dimer or CT should be used. This observational analysis will include adults (≥18 years) seen in the Strasbourg University Hospital emergency department from January to June 2024 who had D-dimer testing and chest imaging, and will apply PERC and YEARS to those encounters. Main outcomes include potential reductions in CT angiography use, changes in emergency department waiting times, and the diagnostic yield of imaging when these algorithms are applied.
Who should consider this trial
Good fit: Adults (age ≥18) presenting to the Strasbourg University Hospital emergency department with suspected pulmonary embolism who had D-dimer testing and chest imaging performed are the ideal candidates.
Not a fit: Patients on long-term anticoagulation, those without D-dimer testing or chest imaging, or individuals whose presentation clearly requires imaging are unlikely to benefit.
Why it matters
Potential benefit: If successful, this approach could reduce unnecessary CT scans, lower radiation exposure, and shorten emergency department wait times.
How similar studies have performed: Previous research has shown that both PERC and YEARS can safely reduce imaging use in some settings, though results vary by population and implementation.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adult patient (≥18 years) * Patient admitted to the adult emergency department of the Strasbourg University Hospital over a 6-month period (January to June 2024), for whom a D-dimer test and chest imaging (thoracic CT angiography or ventilation/perfusion scintigraphy) were performed Exclusion Criteria: \- No D-dimer test or test performed for another indication, no chest imaging (CT angiography or scintigraphy), long-term anticoagulant treatment.
Where this trial is running
Strasbourg
- Service d'Urgences Médico-Chirurgicales Adules - CHU de Strasbourg - France — Strasbourg, France (Recruiting)
Study contacts
- Study coordinator: François WEILL, MD
- Email: francois.weill@chru-strasbourg.fr
- Phone: 33 3.88.11.54.67
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.