Our nondiagnostic rate of 1.98% is significantly lower than the
PIOPED study (5) (6.2%, P = 0.038) and comparable to Lou et al.
In part this has been due to rather negative results from the
PIOPED III study.
This is significantly lower than the 44% proportion noted in the
PIOPED I cohort [14] but is comparable to the percentage of indeterminate or limited results at CTPA, which is reported to be between 5% and 25% [15-18].
(20.) Stein PD, Woodward PK, Weg JG, et al.;
PIOPED II Investigators.
Gottschalk et al., using
PIOPED II data, proposed that normal lung perfusion, with low probability clinical assessment could rule out PE.
The most common symptoms of PE determined by the Prospective Investigation of Pulmonary Embolism Diagnosis (
PIOPED) study were dyspnea, occurring either while active or at rest (73% of the patients), and pleuritic chest pain, which often mimics a heart attack (66% of the patients).
Chapter 22 on pulmonary embolism does not mention the
PIOPED study, which certainly would be of interest to the emergency department physician.
This result was higher than that of the adult multicenter Prospective Investigation of Pulmonary Embolism Diagnosis (
PIOPED) II study.
(41,46-48) When CTV was added to CTPA, the sensitivity for VTE increased from 83% to 90% in the
PIOPED II study, although the absolute increase in VTE was small.
Chest radiographic findings in patients with acute pulmonary embolism: Observations from the
PIOPED Study.