ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2016
Diagnostic delay of pulmonary embolism in primary and secondary care: a retrospective cohort study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- A systematic review and meta-analysis of diagnostic delay in pulmonary embolism.The European journal of general practice · 2022Pooled it
- The diagnostic efficacy of unenhanced CT for detecting acute central pulmonary embolism.BMC cardiovascular disorders · 2025Article
- Knowledge, Attitudes, and Practices Among Thoracic Healthcare Professionals Toward Postoperative Pulmonary Embolism.Healthcare (Basel, Switzerland) · 2025Article
- A new nomogram prediction model for pulmonary embolism in older hospitalized patients.Heliyon · 2024Article
- The potential of virtual triage AI to improve early detection, care acuity alignment, and emergent care referral of life-threatening conditions.Frontiers in public health · 2024Article
- Diagnostic Blood Biomarkers for Acute Pulmonary Embolism: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- Testing of an Electronic Clinical Quality Measure for Diagnostic Delay of Venous Thromboembolism (DOVE) in Primary Care.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2023Article
- Management and Outcomes of Adults Diagnosed with Acute Pulmonary Embolism in Primary Care: Community-Based Retrospective Cohort Study.Journal of general internal medicine · 2022Article
- Prevalence of Hemorrhagic Complications in Hospitalized Patients with Pulmonary Embolism.Journal of personalized medicine · 2022Article
- Predictors and mortality of patients with delayed pulmonary embolism diagnosis: A cohort study.Caspian journal of internal medicine · 2022Article
- Venous thromboembolism management and the new NICE guidance: what the busy GP needs to know.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Comprehensive management of acute pulmonary embolism in primary care using telemedicine in the COVID-era.BMJ case reports · 2021Article
- Changes in performance during repeated in-situ simulations with different cases.BMJ simulation & technology enhanced learning · 2021Article
- Diagnostic Delay of Pulmonary Embolism in COVID-19 Patients.Frontiers in medicine · 2021Article
- Clinical characteristics associated with diagnostic delay of pulmonary embolism in primary care: a retrospective observational study.BMJ open · 2017Observational
- Prediction rules and POC D-dimer testing as a way to prevent diagnostic delay of fatal pulmonary embolism.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelayed diagnosis of pulmonary embolism (PE) is common because symptoms can be non-specific. The few studies that have investigated diagnostic delay have not taken into account the role of primary care physicians in the diagnostic process.
aimTo document and quantify the stages of diagnostic delay of PE and to identify clinical factors associated with this delay. DESIGN AND
settingA retrospective cohort study conducted in Zwolle and its surroundings in the Netherlands.
methodPrimary and secondary care records of all patients diagnosed with PE between January 2008 and December 2009 were reviewed for dates of symptom onset, date of presentation and diagnosis, and for clinical findings. Relationships between delay and clinical parameters were tested using multivariate regression analysis.
resultsThe 261 patients enrolled in the study had an average total delay of 8.6 days. Patient delay (4.2 days average) and delay in primary care (3.9 days) were the major contributors to this delay. Chest pain (odds ratio [OR] 0.51, 95% confidence interval [CI] = 0.28 to 0.92, P = 0.03) and symptoms of deep venous thrombosis (calf pain) (OR 0.49, 95% CI = 0.24 to 0.98, P = 0.05) were associated with an early diagnosis. Patient delay was shorter in patients with chest pain (OR 0.49, 95% CI = 0.25 to 0.95, P = 0.03) and longer in patients with dyspnoea (OR 2.95, 95% CI = 0.99 to 8.85, P = 0.05). In primary care, chest pain (OR 0.37, 95% CI = 0.17 to 0.84, P = 0.02) and rales (OR 0.22, 95% CI = 0.06 to 0.83, P = 0.03) were associated with an early referral, whereas comorbidity led to a delayed referral.
conclusionThis study shows that the diagnostic delay of PE is substantial, especially patient delay and delay in primary care. There is room to reduce this delay by increasing the awareness of both patients and GPs. Further research is needed on clinical factors that raise suspicion of PE in primary care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.