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When pulmonary embolism (PE) is suspected, clinical decision rules combined with D-dimer testing can help clinicians identify low-risk patients who do not require advanced imaging (i.e., chest computed tomography). Researchers conducted a patient-level meta-analysis of >20,000 patients in 16 studies to evaluate the Wells score and the revised Geneva score) in conjunction with fixed D-dimer (<500 µg/L) or adjusted D-dimer (i.e., age-adjusted or pretest-probability–adjusted) levels. The YEARS algorithm (which uses a fixed D-dimer level of <1000 µg/L) also was assessed.
During the 3 months after PE had been excluded based on clinical decision rules plus D-dimer testing, failure rates (i.e., confirmed venous thromboembolism [VTE]) ranged from 0.…