Observational studyBMJ open2017
Clinical characteristics associated with diagnostic delay of pulmonary embolism in primary care: a retrospective observational study.
Observational study in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- A systematic review and meta-analysis of diagnostic delay in pulmonary embolism.The European journal of general practice · 2022Pooled it
- Ruling out pulmonary embolism across different healthcare settings: A systematic review and individual patient data meta-analysis.PLoS medicine · 2022Pooled it
- Real-Time Artificial Intelligence Diagnostic Copilot in Simulated Primary Care Consultations: Randomized Simulation Study.JMIR formative research · 2026Trial
- Delayed Venous Thromboembolism Diagnosis and Mortality Risk.JAMA network open · 2025Article
- A novel multimodal computer-aided diagnostic model for pulmonary embolism based on hybrid transformer-CNN and tabular transformer.Physical and engineering sciences in medicine · 2025Article
- Vision-language model for report generation and outcome prediction in CT pulmonary angiogram.NPJ digital medicine · 2025Article
- Article
- A new nomogram prediction model for pulmonary embolism in older hospitalized patients.Heliyon · 2024Article
- Self-supervised learning for medical image classification: a systematic review and implementation guidelines.NPJ digital medicine · 2023Review
- 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
- Developing a Nomogram-Based Scoring Tool to Estimate the Risk of Pulmonary Embolism.International journal of general medicine · 2022Article
- Comprehensive management of acute pulmonary embolism in primary care using telemedicine in the COVID-era.BMJ case reports · 2021Article
- Point-of-Care Testing for D-Dimer in the Diagnosis of Venous Thromboembolism in Primary Care: A Narrative Review.Cardiology and therapy · 2021Review
- Effect of gender-affirming hormone use on coagulation profiles in transmen and transwomen.Journal of thrombosis and haemostasis : JTH · 2021Article
- Diagnostic Delay of Pulmonary Embolism in COVID-19 Patients.Frontiers in medicine · 2021Article
- Real-life impact of clinical prediction rules for venous thromboembolism in primary care: a cross-sectional cohort study.BMJ open · 2020Article
- Multimodal fusion with deep neural networks for leveraging CT imaging and electronic health record: a case-study in pulmonary embolism detection.Scientific reports · 2020Article
- Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the extent of delay in the diagnosis of pulmonary embolism (PE) in primary care, and to identify determinants that are associated with such diagnostic delay.
designRetrospective observational study.
setting6 primary care practices across the Netherlands.
participantsData from patients with an objectively confirmed diagnosis of PE (International Classification of Primary Care (ICPC) code K93) up to June 2015 were extracted from the electronic medical records. For all these PE events, we reviewed all consultations with their general practitioner (GP) and scored any signs and symptoms that could be attributed to PE in the 3 months prior to the event. Also, we documented actual comorbidity and the diagnosis considered initially. PRIMARY AND SECONDARY OUTCOME MEASURES: Delay was defined as a time gap of >7 days between the first potentially PE-related contact with the GP and the final PE diagnosis. Multivariable logistic regression analysis was performed to identify independent determinants for delay.
resultsIn total, 180 incident PE cases were identified, of whom 128 patients had 1 or more potential PE-related contact with their GP within the 3 months prior to the diagnosis. Based on our definition, in 33 of these patients (26%), diagnostic delay was observed. Older age (age >75 years; OR 5.1 (95% CI 1.8 to 14.1)) and the absence of chest symptoms (ie, chest pain or pain on inspiration; OR 5.4 (95% CI 1.9 to 15.2)) were independent determinants for diagnostic delay. A respiratory tract infection prior to the PE diagnosis was reported in 13% of cases without delay, and in 33% of patients with delay (p=0.008).
conclusionsDiagnostic delay of more than 7 days in the diagnosis of PE is common in primary care, especially in the elderly, and if chest symptoms, like pain on inspiration, are absent.
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