| Summary: | Acute pulmonary embolism (PE) is the third most common acute cardiovascular disease, after myocardial infarction and stroke. The optimal diagnostic strategy for suspected PE among experts remains controversial, and it can differ based on factors related to the health care setting (i.e., urban, rural, or remote) that may impact access to diagnostic technologies. For instance, provision of timely diagnosis may be more challenging in rural and remote facilities due to lack of access to certain testing and imaging modalities and specialist expertise, as well as geographical barriers to care. Inability to access optimal diagnostic testing in a timely manner could increase the risk for missed diagnoses, as well as unnecessary anticoagulation due to either false-positives or long wait times to receive a final diagnosis for patients who were treated on suspicion of PE. Additionally, certain strategies may not be suitable for all patients such as patients with known allergy to contrast media or pregnant women. Exposure to radiation is another consideration when selecting a diagnostic imaging modality. Patient safety concerns associated with exposure to radiation and contrast media that accompanies several imaging studies also disproportionately affect specific patient groups, including pregnant women, and young women for whom the risk of radiation-associated breast cancer ishigher. To facilitate decision-making, CADTH conducted a health technology assessment (HTA) on the clinical effectiveness and cost-effectiveness of strategies for the diagnosis of acute PE in adults. Patient perspectives and experiences, implementation issues, the environmental impact, and ethical considerations related to the diagnosis of PE were also assessed, as these are also considerations for selecting the optimal diagnostic strategy
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