Table 1.

Summary of included studies for the diagnosis of suspected pulmonary embolism

Study author, year (reference)PopulationClinical settingIndex testReference standard
1. Abcarian et al, 2004 (19) Patients with suspected PE Inpatient and outpatient D-dimer Pulmonary CT angiography 
2. Anderson et al, 2007 (53) Patients with suspected PE Inpatient and outpatient Pulmonary CT angiography V/Q scan 
3. Bajc et al, 2002 (54) Patients with suspected PE Inpatient and outpatient V/Q scan and helical computed tomography (CT) V/Q scan and helical CT 
4. Blachere et al, 2000 (69) Patients with suspected PE Inpatient Helical CT angiography, V/Q scan Doppler sonography of the veins of the legs 
Pulmonary angiography 
5. Bounameaux et al, 1991 (70) Patients with suspected PE Inpatient and outpatient V/Q scan CTPA 
6. Bosson et al, 2005 (20) Patients with suspected PE Inpatient and outpatient D-dimer Doppler sonography of the veins of the legs 
V/Q scan 
HCT 
Pulmonary angiography 
7. Crane et al, 2018 (49) Patients with suspected PE Emergency department D-dimer CTPA 
V/Q scan 
CUS 
8. de Monyé et al, 2002 (22) Patients with suspected PE Inpatient and outpatient D-dimer CTPA 
V/Q scan 
CUS 
9. den Exter et al, 2013 (23) Patients with suspected PE Inpatient and outpatient D-dimer CTPA 
10. Di Nisio et al, 2005 (24) Cancer patients with suspected PE Inpatient and outpatient D-dimer Normal spiral CT scan and normal ultrasonography, or spiral CT or pulmonary angiography V/Q scan 
11. Dunn et al, 2002 (25) Patients with suspected PE Outpatient D-dimer V/Q scan, chest CT, or pulmonary angiography 
12. Elias et al, 2004 (26) Patients with suspected PE Inpatients and outpatients Lower limb venous ultrasound V/Q scan 
D-dimer 
CT scan 
13. Emet et al, 2007 (27) Patient with prediagnosed PE Outpatient CT pulmonary angiogram V/Q scan 
D-dimer 
14. Eng et al, 2009 (28) Patients with suspected PE Inpatient D-dimer CTPA 
15. Freitas et al, 1995 (71) Patients with suspected PE Unclear V/Q scan Pulmonary angiography 
16. Friera-Reyes et al, 2005 (29) Patients with suspected PE Outpatient D-dimer Chest radiograph, perfusion scintigraphy, venous ultrasound of lower limbs, spiral CT, and pulmonary arteriography 
17. Froehling et al, 2007 (30) Patients with suspected PE Inpatients and outpatients D-dimer CT angiography 
18. Garcia Bolado et al, 2003 (63) Patients with suspected PE Emergency department CUS CTPA 
19. Ghanima et al, 2006 (31) Patients with suspected PE Outpatients D-dimer Multislice CT 
20. Goekoop et al, 2007 (32) Patients with suspected PE Outpatients D-dimer CT scan 
VQ scan 
21. Guilabert et al, 2007 (67) Patients with suspected PE Inpatient Multislice CT VQ scan 
Doppler US 
22. Hantous-Zannad et al, 2010 (55) Patients with suspected PE Inpatient CTPA Unclear 
23. Jiménez et al, 2006 (56) Patients with suspected PE Unclear CT angiogram VQ scan 
Doppler US 
24. Kabrhel, 2008 (51) Patients with suspected PE Emergency department D-dimer CT angiogram 
VQ scan 
Doppler US of leg veins 
25. Kim et al, 1999 (64) Patients with suspected PE Inpatient and outpatient Spiral CT scan V/Q scan 
Doppler US of leg veins 
Pulmonary angiography 
26. Le Gal et al, 2006 (77) Patient with clinically suspected recurrent acute PE Outpatient Doppler ultrasound of lower limbs Multislice CT 
27. Leclercq et al, 2003 (33) Patients with suspected PE Inpatient and outpatient D-dimer VQ Scan Doppler Ultrasonography and pulmonary angiography 
28. Mac Gillavry et al, 2000 (65) Patients with suspected PE Inpatient and outpatient Doppler ultrasonography Perfusion lung scintigraph 
Pulmonary angiography 
29. Macdonald et al, 2005 (57) Patients with suspected PE Unclear VQ scan CT pulmonary angiography 
30. Megyeri et al, 2014 (59) Patients with suspected PE Unclear CT pulmonary angiography VQ scan 
Doppler ultrasonography 
31. Miron et al, 1999 (72) Patients with suspected PE Inpatients D-dimer V/Q scan 
Doppler ultrasonography 
Pulmonary angiography 
32. de Moerloose et al, 1996 (21) Patients with suspected PE Outpatient D-dimer V/Q scan 
Doppler ultrasonography 
Pulmonary angiography 
33. Moores et al, 2016 (58) Patients with suspected PE Outpatient CTPA V/Q scan 
Venous ultrasonograph 
Pulmonary angiograph 
34. Mos et al, 2014 (78) Patient with clinically suspected recurrent acute PE Inpatient D-dimer CTPA 
35. Nijkeuter et al, 2007 (79) Patients with clinical suspicion of recurrent PE Inpatient and outpatient D-dimer CTPA 
36. Oger et al, 1998 (34) Patients with suspected PE Outpatient D-dimer V/Q scan 
Venous ultrasonograph 
Pulmonary angiography 
37. Pacouret et al, 2002 (35) Patients with suspected PE Outpatient D-dimer Helicoidal thoracic scanner 
Venous Doppler of the lower limbs 
Pulmonary scintigraphy 
38. Palud et al, 2004 (36) Patients with suspected PE Unclear D-dimer CTPA 
Pulmonary angiogram 
Doppler US 
39. Parent et al, 2007 (37) Patients with suspected PE Inpatient and outpatient D-dimer CTPA 
Doppler US 
Pulmonary angiogram 
V/Q lung scan 
40. Pérez de Llano et al, 2006 (60) Patients with suspected PE Outpatient Helical CT Venous ultrasonography 
41. Pernod et al, 2017 (50) Patients with suspected PE Outpatient D-dimer CTPA 
V/Q scan 
Pulmonary arteriography 
42. Perrier et al, 1996 (68) Patients with suspected PE Outpatient V/Q scan, D-dimer and Doppler ultrasonography Pulmonary angiography 
43. Perrier et al, 1999 (39) Patients with suspected PE Outpatient D-dimer, lower-limb venous compression ultrasonography, and V/Q scan Phlebography and pulmonary angiography 
44. Perrier et al, 2004 (40) Patients with suspected PE Outpatient D-dimer, lower limb venous ultrasonography, and helical CT Pulmonary angiography 
45. Perrier et al, 2005 (38) Patients with suspected PE Outpatient D-dimer measurement and multidetector-row CT Lower-limb ultrasonography 
46. Quinn et al, 1999 (41) Patients with suspected PE Unclear D-dimer Pulmonary angiography 
47. Righini et al, 2008 (42) Patients with suspected PE Outpatient D-dimer Venous ultrasonography 
48. Righini et al, 2014 (43) Patients with suspected PE Outpatient D-dimer V/Q scan, CTPA, angiography 
49. Sijens et al, 2000 (44) Patients with suspected PE Inpatient D-dimer Pulmonary angiography 
50. Söderberg et al, 2009 (45) Patients with suspected PE Outpatient D-dimer CTPA, angiography 
51. Spies et al, 1986 (73) Patients with suspected PE Unclear V/Q scan Pulmonary angiography 
52. Stein et al, 2006 (61) Patients with suspected PE Inpatient and outpatient Multidetector CTPA V/Q scan, ultrasonography, pulmonary digital-subtraction angiography 
53. Subramaniam et al, 2007 (62) Patients with suspected PE Unclear CTPA Unclear 
54. Szturmowicz et al, 2015 (46) Patients with suspected PE Unclear D-dimer CTPA 
55. Toulon et al, 2004 (47) Patients with suspected PE Outpatient D-dimer V/Q scan, spiral CT, pulmonary digital-subtraction angiography. 
56. Turan et al, 2017 (52) Patients with suspected PE Outpatient CTPA D-dimer 
57. Turkstra et al, 1997 (66) Patients with suspected PE Inpatient and outpatient Compression ultrasonography V/Q scan and angiography 
58. van Rossum et al, 1996 (75) Patients with suspected PE Unclear Spiral volumetric computed tomographic V/Q scan, ultrasonography of the legs 
59. van Rossum et al, 1998 (74) Patients with suspected PE Mostly outpatient Helical CT V/Q scan 
60. Verschuren et al, 2003 (48) Patients with suspected PE Emergency department D-dimer CTPA 
V/Q scan 
CUS 
Pulmonary arteriography 
61. Wells et al, 2000 (76) Patients with suspected PE Unclear D-dimer V/Q scan, compression ultrasonography 
Study author, year (reference)PopulationClinical settingIndex testReference standard
1. Abcarian et al, 2004 (19) Patients with suspected PE Inpatient and outpatient D-dimer Pulmonary CT angiography 
2. Anderson et al, 2007 (53) Patients with suspected PE Inpatient and outpatient Pulmonary CT angiography V/Q scan 
3. Bajc et al, 2002 (54) Patients with suspected PE Inpatient and outpatient V/Q scan and helical computed tomography (CT) V/Q scan and helical CT 
4. Blachere et al, 2000 (69) Patients with suspected PE Inpatient Helical CT angiography, V/Q scan Doppler sonography of the veins of the legs 
Pulmonary angiography 
5. Bounameaux et al, 1991 (70) Patients with suspected PE Inpatient and outpatient V/Q scan CTPA 
6. Bosson et al, 2005 (20) Patients with suspected PE Inpatient and outpatient D-dimer Doppler sonography of the veins of the legs 
V/Q scan 
HCT 
Pulmonary angiography 
7. Crane et al, 2018 (49) Patients with suspected PE Emergency department D-dimer CTPA 
V/Q scan 
CUS 
8. de Monyé et al, 2002 (22) Patients with suspected PE Inpatient and outpatient D-dimer CTPA 
V/Q scan 
CUS 
9. den Exter et al, 2013 (23) Patients with suspected PE Inpatient and outpatient D-dimer CTPA 
10. Di Nisio et al, 2005 (24) Cancer patients with suspected PE Inpatient and outpatient D-dimer Normal spiral CT scan and normal ultrasonography, or spiral CT or pulmonary angiography V/Q scan 
11. Dunn et al, 2002 (25) Patients with suspected PE Outpatient D-dimer V/Q scan, chest CT, or pulmonary angiography 
12. Elias et al, 2004 (26) Patients with suspected PE Inpatients and outpatients Lower limb venous ultrasound V/Q scan 
D-dimer 
CT scan 
13. Emet et al, 2007 (27) Patient with prediagnosed PE Outpatient CT pulmonary angiogram V/Q scan 
D-dimer 
14. Eng et al, 2009 (28) Patients with suspected PE Inpatient D-dimer CTPA 
15. Freitas et al, 1995 (71) Patients with suspected PE Unclear V/Q scan Pulmonary angiography 
16. Friera-Reyes et al, 2005 (29) Patients with suspected PE Outpatient D-dimer Chest radiograph, perfusion scintigraphy, venous ultrasound of lower limbs, spiral CT, and pulmonary arteriography 
17. Froehling et al, 2007 (30) Patients with suspected PE Inpatients and outpatients D-dimer CT angiography 
18. Garcia Bolado et al, 2003 (63) Patients with suspected PE Emergency department CUS CTPA 
19. Ghanima et al, 2006 (31) Patients with suspected PE Outpatients D-dimer Multislice CT 
20. Goekoop et al, 2007 (32) Patients with suspected PE Outpatients D-dimer CT scan 
VQ scan 
21. Guilabert et al, 2007 (67) Patients with suspected PE Inpatient Multislice CT VQ scan 
Doppler US 
22. Hantous-Zannad et al, 2010 (55) Patients with suspected PE Inpatient CTPA Unclear 
23. Jiménez et al, 2006 (56) Patients with suspected PE Unclear CT angiogram VQ scan 
Doppler US 
24. Kabrhel, 2008 (51) Patients with suspected PE Emergency department D-dimer CT angiogram 
VQ scan 
Doppler US of leg veins 
25. Kim et al, 1999 (64) Patients with suspected PE Inpatient and outpatient Spiral CT scan V/Q scan 
Doppler US of leg veins 
Pulmonary angiography 
26. Le Gal et al, 2006 (77) Patient with clinically suspected recurrent acute PE Outpatient Doppler ultrasound of lower limbs Multislice CT 
27. Leclercq et al, 2003 (33) Patients with suspected PE Inpatient and outpatient D-dimer VQ Scan Doppler Ultrasonography and pulmonary angiography 
28. Mac Gillavry et al, 2000 (65) Patients with suspected PE Inpatient and outpatient Doppler ultrasonography Perfusion lung scintigraph 
Pulmonary angiography 
29. Macdonald et al, 2005 (57) Patients with suspected PE Unclear VQ scan CT pulmonary angiography 
30. Megyeri et al, 2014 (59) Patients with suspected PE Unclear CT pulmonary angiography VQ scan 
Doppler ultrasonography 
31. Miron et al, 1999 (72) Patients with suspected PE Inpatients D-dimer V/Q scan 
Doppler ultrasonography 
Pulmonary angiography 
32. de Moerloose et al, 1996 (21) Patients with suspected PE Outpatient D-dimer V/Q scan 
Doppler ultrasonography 
Pulmonary angiography 
33. Moores et al, 2016 (58) Patients with suspected PE Outpatient CTPA V/Q scan 
Venous ultrasonograph 
Pulmonary angiograph 
34. Mos et al, 2014 (78) Patient with clinically suspected recurrent acute PE Inpatient D-dimer CTPA 
35. Nijkeuter et al, 2007 (79) Patients with clinical suspicion of recurrent PE Inpatient and outpatient D-dimer CTPA 
36. Oger et al, 1998 (34) Patients with suspected PE Outpatient D-dimer V/Q scan 
Venous ultrasonograph 
Pulmonary angiography 
37. Pacouret et al, 2002 (35) Patients with suspected PE Outpatient D-dimer Helicoidal thoracic scanner 
Venous Doppler of the lower limbs 
Pulmonary scintigraphy 
38. Palud et al, 2004 (36) Patients with suspected PE Unclear D-dimer CTPA 
Pulmonary angiogram 
Doppler US 
39. Parent et al, 2007 (37) Patients with suspected PE Inpatient and outpatient D-dimer CTPA 
Doppler US 
Pulmonary angiogram 
V/Q lung scan 
40. Pérez de Llano et al, 2006 (60) Patients with suspected PE Outpatient Helical CT Venous ultrasonography 
41. Pernod et al, 2017 (50) Patients with suspected PE Outpatient D-dimer CTPA 
V/Q scan 
Pulmonary arteriography 
42. Perrier et al, 1996 (68) Patients with suspected PE Outpatient V/Q scan, D-dimer and Doppler ultrasonography Pulmonary angiography 
43. Perrier et al, 1999 (39) Patients with suspected PE Outpatient D-dimer, lower-limb venous compression ultrasonography, and V/Q scan Phlebography and pulmonary angiography 
44. Perrier et al, 2004 (40) Patients with suspected PE Outpatient D-dimer, lower limb venous ultrasonography, and helical CT Pulmonary angiography 
45. Perrier et al, 2005 (38) Patients with suspected PE Outpatient D-dimer measurement and multidetector-row CT Lower-limb ultrasonography 
46. Quinn et al, 1999 (41) Patients with suspected PE Unclear D-dimer Pulmonary angiography 
47. Righini et al, 2008 (42) Patients with suspected PE Outpatient D-dimer Venous ultrasonography 
48. Righini et al, 2014 (43) Patients with suspected PE Outpatient D-dimer V/Q scan, CTPA, angiography 
49. Sijens et al, 2000 (44) Patients with suspected PE Inpatient D-dimer Pulmonary angiography 
50. Söderberg et al, 2009 (45) Patients with suspected PE Outpatient D-dimer CTPA, angiography 
51. Spies et al, 1986 (73) Patients with suspected PE Unclear V/Q scan Pulmonary angiography 
52. Stein et al, 2006 (61) Patients with suspected PE Inpatient and outpatient Multidetector CTPA V/Q scan, ultrasonography, pulmonary digital-subtraction angiography 
53. Subramaniam et al, 2007 (62) Patients with suspected PE Unclear CTPA Unclear 
54. Szturmowicz et al, 2015 (46) Patients with suspected PE Unclear D-dimer CTPA 
55. Toulon et al, 2004 (47) Patients with suspected PE Outpatient D-dimer V/Q scan, spiral CT, pulmonary digital-subtraction angiography. 
56. Turan et al, 2017 (52) Patients with suspected PE Outpatient CTPA D-dimer 
57. Turkstra et al, 1997 (66) Patients with suspected PE Inpatient and outpatient Compression ultrasonography V/Q scan and angiography 
58. van Rossum et al, 1996 (75) Patients with suspected PE Unclear Spiral volumetric computed tomographic V/Q scan, ultrasonography of the legs 
59. van Rossum et al, 1998 (74) Patients with suspected PE Mostly outpatient Helical CT V/Q scan 
60. Verschuren et al, 2003 (48) Patients with suspected PE Emergency department D-dimer CTPA 
V/Q scan 
CUS 
Pulmonary arteriography 
61. Wells et al, 2000 (76) Patients with suspected PE Unclear D-dimer V/Q scan, compression ultrasonography 
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