Ruling Out PE in Patients with Active Cancer

Current guidelines recommend using either an age-adjusted d-dimer level or the YEARS algorithm (or both) to rule out suspected pulmonary embolism (PE) in the general population, but they stop short of recommending this strategy in patients with active cancer. Instead, these patients are often sent directly to computed tomography pulmonary angiography (CTPA), which can be inconvenient and costly and is not without risks. To determine whether the YEARS algorithm can be used safely in patients with cancer and suspected PE, researchers conducted a randomized trial involving 700 such patients across 21 European hospitals.

Patients were randomized to the YEARS algorithm or to CTPA alone. In the YEARS group, treating physicians assessed thre…