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