Robbert J. Goekoop

TL;DR: A systematic review and IPD meta-analysis combining patient-level data from 6 large, prospective outcome studies in which diagnostic management of clinically suspected PE had been guided by the Wells rule and d-dimer testing is done.

TL;DR: In this article, a review of the use of the Wells rule with D-dimer testing to make decisions about imaging in patients with suspected pulmonary embolism is presented. But this review is limited to the case of lung cancer.

TL;DR: Acute PE can be safely excluded in patients with clinically suspected acute PE who have an "unlikely" probability and a negative D-dimer test and anticoagulant treatment can be withheld, and there is no need for additional radiological tests in these patients.

TL;DR: This study prospectively established the safety of a combination of a dichotomized clinical decision rule and D-dimer test in ruling out PE, and proved highly efficient, since more than 50% of patients could be managed without the need for more invasive and expensive tests.

TL;DR: Among cancer patients with clinically suspected pulmonary embolism, imaging and anticoagulant treatment can be withheld in 1 out of every 8 patients by the original Wells rule and age-adjusted D-dimer testing.