Table 4.
Summary of Systematic Reviews of the Accuracy of Computed Tomography for the Diagnosis of Pulmonary Embolism
| Author, Year | Main Inclusion Criteria | No. of Patients | Prevalence of Pulmonary Embolism % | Pooled Sensitivity % (Range)or [95% CI] | Pooled Specificity % (Range)or [95% CI] |
| Harvey et al,60 2000 | Prospective and retrospective studies with PA as reference standard in most cases | 813 | 34 | 79 (47–100) | 89 (75–100) |
| Mullins et al,61 2000 | Diagnosis established by PA or a clinical reference standard* | 367 | 35 | 93 (50–100) | 97 (92–100) |
| Rathbun et al,62 2000 | Prospective studies evaluating use of CT for diagnosis of PE using any reference Standard | 1,330 | NR | (53–100) | (81–100) |
| Cueto et al,63 2001 | Prospective studies with positive and negative CT results; PA reference standard | 268 | NR | 80 [73–86] | 94 [91–98] |
| van Beek et al, 64 2001 | Prospective studies reporting sensitivity and specificity of CT relative to PA or V/Q scan | 1,171 | 39 | 88 [83–91] | 92 [89–94] |
| Safriel & Zinn,65 2002 | Diagnosis established by PA or high- probability V/Q scan | 1,250 | NR | 74 [57–100] | 90 [68–100] |
| Roy et al,66 2005 | Prospective studies; | 431 | NR | 24 (12–47)† | |
| consecutive patients; diagnosis established by PA for confirmation strategies, and PA or clinical follow-up for exclusion strategies | 1,197 | NR | 0.11 (0.06–0.19)‡ | ||
| Hayashino et al,67 2005 | Studies of helical CT compared to PA obtained within 48 hr | 520 | NR | 86 (80–92) | 94 (91–96) |
| Hogg et al,68 2006 | Prospective studies with 85% follow-up, with adequate reference standard, or clinical follow-up after negative CT | 749 | 19–79 | 89 (82–95) | 95 (91–98) |
CI = confidence interval; PA = pulmonary arteriography; CT = computed tomography; PE = pulmonary embolism; NR = not reported; V/Q = ventilation-perfusion.
* Results include only patients in whom pulmonary angiography was used as reference standard.
† Positive likelihood ratio.
‡ Negative likelihood ratio.