Cover Page
The handle
http://hdl.handle.net/1887/79518
holds various files of this Leiden University
dissertation.
Author: Pol, L.M. van der
ImprovIng effIcIency
of the dIagnostIc management of pulmonary embolIsm
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanic, photocopying, and recording or otherwise, without prior written by the author.
ISBN: 978-94-6361-299-9
Cover image: Annette Offereins-Dijkhuizen
ImprovIng effIcIency
of the dIagnostIc management of pulmonary embolIsm
Proefschrift
Ter verkrijging van de graad van Doctor aan de Universiteit van Leiden, op gezag van Rector Magnificus prof. Mr. C.J.J.M. Stolker,
volgens het besluit van het College voor Promoties te verdedigen op woensdag 16 oktober 2019
klokke 11.15 uur door
Liselotte Myrthe van der Pol geboren te Dirksland
Prof. dr. M.V. Huisman Co-promotores Dr. F.A. Klok
Dr. A.T.A. Mairuhu (HagaZiekenhuis, Den Haag) Overige commissieleden
Prof. Dr. H. ten Cate (Maastricht Universitair Medisch Centrum, Maastricht) Prof. Dr. H.C.J. Eikenboom
Prof. Dr. F.W.G. Leebeek (Erasmus Medisch Centrum, Rotterdam) Prof. Dr. J.E.A. Portielje
Financial support was kindly provided by Chipsoft, Boehringer-Ingelheim BV,
LEO Pharma B.V., @DigitalMedDoc, Federatie van Nederlandse Trombosediensten, Stago BNL, HagaZiekenhuis te Den Haag.
table of contents
PART I The diagnostic management of suspected PE in pregnancy
Chapter 1 General introduction 7
Chapter 2 Use of clinical prediction rules and D-dimer tests in the diagnostic management of pregnant patients with suspected pulmonary embolism
13
Chapter 3 Computed tomography pulmonary angiography versus ventilation-perfusion lung scan for pulmonary embolism diagnosis during pregnancy: a systematic review and meta-analysis
29
Chapter 4 Diagnostic management of suspected pulmonary embolism during pregnancy – The Artemis study
51
PART II The diagnostic management of suspected PE in unselected patients Chapter 5 Sex-specific performance of pre-imaging diagnostic algorithms for
pulmonary embolism
67 Chapter 6 No added value of the age-adjusted D-dimer cut-off to the YEARS
algorithm in patients with suspected pulmonary embolism
83 Chapter 7 Combination of pulmonary embolism rule-out criteria (PERC) and
YEARS algorithm in a European cohort of patients with suspected pulmonary embolism
99
Chapter 8 The YEARS algorithm for suspected pulmonary embolism: Shorter visit time and reduced costs at the Emergency department
113 Chapter 9 Chest X-ray not routinely indicated prior to the YEARS algorithm, in
the diagnostic management of suspected pulmonary embolism
129 Chapter 10 Lower prevalence of subsegmental pulmonary embolism after
application of the YEARS diagnostic algorithm
141
Chapter 11 General discussion and summary 155
Chapter 12 Nederlandse samenvatting 165
APPENDICES
List of publications 175
