Análisis crítico de un artículo: ¿Es seguro no tratar a pacientes con sospecha de tromboembolismo pulmonar y tomografía axial computarizada negativa?

Juan Abarza, Gabriel Rada
2007 Revista médica de Chile (Impresa)  
Context: The clinical validity of using computed tomography (CT) to diagnose peripheral pulmonary embolism is uncertain. Insufficient sensitivity for peripheral pulmonary embolism is considered the principal limitation of CT. Objective: To review studies that used a CT-based approach to rule out a diagnosis of pulmonary embolism. Data sources: The medical literature databases of PubMed, MEDLINE, EMBASE, CRISP, metaRegister of Controlled Trials, and Cochrane were searched for articles published
more » ... articles published in the English language from January 1990 to May 2004. Study selection: We included studies that used contrastenhanced chest CT to rule out the diagnosis of acute pulmonary embolism, had a minimum follow-up of 3 months, and had study populations of more than 30 patients. Data extraction: Two reviewers independently abstracted patient demographics, frequency of venous thromboembolic events (VTEs), CT modality (single-slice CT, multidetector-row CT, or electronbeam CT), false-negative results, and deaths attributable to pulmonary embolism. To calculate the overall negative likelihood ratio (NLR) of a VTE after a negative or inconclusive chest CT Rev Méd Chile 2007; 135: 539-543
doi:10.4067/s0034-98872007000400019 fatcat:7lalq4vdjfdolhwyfqmpu3x6ju