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July 27, 2011

Excluding Pulmonary Embolism With Computed Tomographic Pulmonary Angiography or Ventilation-Perfusion Lung Scanning

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2008;299(14):1664-1665. doi:10.1001/jama.299.14.1664-a

To the Editor: In their randomized trial, Dr Anderson and colleagues1 investigated computed tomographic pulmonary angiography (CTPA) vs ventilation-perfusion (/) lung scanning in patients with suspected pulmonary embolism. They dichotomized the Wells score into pulmonary embolism likely vs unlikely. Because of the characteristics of / scanning, however, they still had to allocate a nondiagnostic (nonhigh probability) category. In their algorithm, patients in this category were excluded for pulmonary embolism if repeat leg vein ultrasonography was negative in 1 week, even with a likely clinical probability and a positive D-dimer.