Multicenter Study Validating the Adjust-Unlikely Tool for Emergency Pulmonary Embolism Testing in Adults

What this Trial Is About

Researchers are evaluating a new clinical decision tool called Adjust-Unlikely to improve the testing process for pulmonary embolism in emergency department patients suspected of having this condition. Pulmonary embolism diagnosis is critical to prevent death and long-term disability, but current imaging tests expose patients to radiation, are costly, time-consuming, and sometimes lead to false positives. This observational study aims to validate the Adjust-Unlikely rule, which has been developed with input from physicians and patients to reduce unnecessary imaging safely and effectively. The Adjust-Unlikely tool combines physician judgment with D-dimer blood test results and imaging scans when needed. It categorizes patients based on whether pulmonary embolism is considered the most likely diagnosis and uses age-adjusted D-dimer thresholds to decide if imaging is necessary. Local laboratory D-dimer assays will be used for testing. The study includes emergency department patients tested for pulmonary embolism and will observe their outcomes without assigning treatments. Participants will be monitored for 30 and 90 days to track venous thrombosis events and the accuracy of the Adjust-Unlikely testing at the time of their emergency visit. Data collection involves recording physician assessments, D-dimer test results, and any imaging done. The study will help determine if this decision rule can safely reduce unnecessary imaging and improve care during emergency visits. The study is expected to continue until September 2027.

Emergency Medicine Pulmonary Embolism Testing Multicentre Study