A multi-center collaborative study to determine the sensitivity, specificity, positive predictive value and negative predictive value of contrast enhanced spiral computed tomography (spiral CT) for diagnosis of acute pulmonary embolism (PE). Pulmonary embolism is common, yet frequently undiagnosed and fatal. Ventilation/perfusion lung scans are the most commonly used test. However, they are non-diagnostic in 72% of patients with suspected PE and in 57% of patients with proven PE. Currently, Pulmonary Angiography is the definitive diagnostic test, but, there is hesitancy to use it because of morbidity, discomfort, discomfort, cost and lack of availability in community hospitals. Contrast enhanced spiral CT is a nearly non-invasive test that offers the possibility of a definitive diagnosis of PE by showing the outline of the thrombus in a pulmonary artery. However, its utility in the diagnosis of PE is unknown. Although spatial CT has not been adequately validated, physicians at many hospitals now use it as a definitive and only diagnostic test for PE, or as a definitive test in patients in whom the ventilation/perfusion lung scan is non-diagnostic. This could lead to over-treatment or under- treatment, of which, both have potential for serious complications. The role of spiral CT in the diagnosis of PE requires an accurate angiography. The strengths of this proposal are: 1) the importance of the problem of PE in terms of lives lost from under-diagnosis 2) the potential applicability of a new technology for the diagnosis of PE that will have widespread availability 3) the investigation team.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
1U01HL063940-01A1
Application #
6167701
Study Section
Clinical Trials Review Committee (CLTR)
Project Start
2000-09-01
Project End
2004-07-31
Budget Start
2000-09-01
Budget End
2001-07-31
Support Year
1
Fiscal Year
2000
Total Cost
$141,055
Indirect Cost
Name
University of Calgary
Department
Type
DUNS #
207663915
City
Calgary
State
AB
Country
Canada
Zip Code
T2 1-N4
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Stein, Paul D; Sostman, H Dirk; Hull, Russell D et al. (2009) Diagnosis of pulmonary embolism in the coronary care unit. Am J Cardiol 103:881-6
Stein, Paul D; Beemath, Afzal; Matta, Fadi et al. (2008) Enlarged right ventricle without shock in acute pulmonary embolism: prognosis. Am J Med 121:34-42
Sostman, H Dirk; Stein, Paul D; Gottschalk, Alexander et al. (2008) Acute pulmonary embolism: sensitivity and specificity of ventilation-perfusion scintigraphy in PIOPED II study. Radiology 246:941-6
Stein, Paul D; Beemath, Afzal; Matta, Fadi et al. (2007) Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med 120:871-9
Stein, Paul D; Woodard, Pamela K; Weg, John G et al. (2007) Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II Investigators. Radiology 242:15-21
Stein, Paul D; Beemath, Afzal; Quinn, Deborah A et al. (2007) Usefulness of multidetector spiral computed tomography according to age and gender for diagnosis of acute pulmonary embolism. Am J Cardiol 99:1303-5
Stein, Paul D; Woodard, Pamela K; Weg, John G et al. (2006) Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators. Am J Med 119:1048-55
Stein, Paul D; Beemath, Afzal; Goodman, Lawrence R et al. (2006) Outcome studies of pulmonary embolism versus accuracy: they do not equate. Thromb Haemost 96:107-8
Stein, Paul D; Fowler, Sarah E; Goodman, Lawrence R et al. (2006) Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 354:2317-27