ArticlePloS one2014
"I can't find anything wrong: it must be a pulmonary embolism": Diagnosing suspected pulmonary embolism in primary care, a qualitative study.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- A systematic review and meta-analysis of diagnostic delay in pulmonary embolism.The European journal of general practice · 2022Pooled it
- Understanding the role of GPs' gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- Diagnostic prediction models for suspected pulmonary embolism: systematic review and independent external validation in primary care.BMJ (Clinical research ed.) · 2015Pooled it
- Exploring Patterns of D-Dimer Assay Ordering at an Australian Rural Referral Hospital: A Retrospective Audit.Emergency medicine Australasia : EMA · 2026Article
- Delayed Venous Thromboembolism Diagnosis and Mortality Risk.JAMA network open · 2025Article
- Time to diagnostic certainty for saddle pulmonary embolism in hospitalized patients.Biomolecules & biomedicine · 2023Observational
- GPs' use of gut feelings when assessing cancer risk: a qualitative study in UK primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Real-life impact of clinical prediction rules for venous thromboembolism in primary care: a cross-sectional cohort study.BMJ open · 2020Article
- Observational
- A comparative analysis of the diagnostic performances of four clinical probability models for acute pulmonary embolism in a sub-Saharan African population: a cross-sectional study.BMC pulmonary medicine · 2019Article
- Article
- Qualitative Study to Understand Ordering of CT Angiography to Diagnose Pulmonary Embolism in the Emergency Room Setting.Journal of the American College of Radiology : JACR · 2018Article
- [Dyspnea].Der Internist · 2017Review
- [Prevalence and severity of pulmonary embolism are dependent on clinical and paraclinical parameters : Analysis of 1,943 consecutive patients with CT pulmonary angiography].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2017Article
- Diagnostic delay of pulmonary embolism in primary and secondary care: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
- Ruling Out Pulmonary Embolism in Primary Care: Comparison of the Diagnostic Performance of "Gestalt" and the Wells Rule.Annals of family medicine · 2016Article
- Observational
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBefore using any prediction rule oriented towards pulmonary embolism (PE), family physicians (FPs) should have some suspicion of this diagnosis. The diagnostic reasoning process leading to the suspicion of PE is not well described in primary care.
objectiveto explore the diagnostic reasoning of FPs when pulmonary embolism is suspected.
methodSemi-structured qualitative interviews with 28 FPs. The regional hospital supplied data of all their cases of pulmonary embolism from June to November 2011. The patient's FP was identified where he/she had been the physician who had sent the patient to the emergency unit. The first consecutive 14 FPs who agreed to participate made up the first group. A second group was chosen using a purposeful sampling method. The topic guide focused on the circumstances leading to the suspicion of PE. A thematic analysis was performed, by three researchers, using a grounded theory coding paradigm.
resultsIn the FPs' experience, the suspicion of pulmonary embolism arose out of four considerations: the absence of indicative clinical signs for diagnoses other than PE, a sudden change in the condition of the patient, a gut feeling that something was seriously wrong and an earlier failure to diagnose PE. The FPs interviewed did not use rules in their diagnostic process.
conclusionThis study illustrated the diagnostic role of gut feelings in the specific context of suspected pulmonary embolism in primary care. The FPs used the sense of alarm as a tool to prevent the diagnostic error of missing a PE. The diagnostic accuracy of gut feelings has yet to be evaluated.
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