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Use of computed tomography pulmonary angiography in emergency departments: a literature review


Thurlow, LE and Van Dam, PJ and Prior, SJ and Tran, V, Use of computed tomography pulmonary angiography in emergency departments: a literature review, Healthcare, 10, (5) Article 753. ISSN 2227-9032 (2022) [Refereed Article]

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Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

DOI: doi:10.3390/healthcare10050753


Computed tomography pulmonary angiography (CTPA) has become the most widely used technique for diagnosis or exclusion of a pulmonary embolism (PE). It has been suggested that overuse of this imaging type may be prevalent, especially in emergency departments (EDs). The purpose of this literature review was to explore the use of CTPAs in EDs worldwide. A review following PRISMA guidelines was completed, with research published between September 2010 and August 2020 included. Five key topics emerged: use of CTPAs; explanations for overuse; use of D-dimer; variability in ordering practices between clinicians; and strategies to reduce overuse. This review found that CTPAs continue to be overused in EDs, leading to superfluous risks to patients. Published studies identify that while clinical practice guidelines (CPGs) have a strong effect on reducing unnecessary CTPAs with no significantly increased risk of missed diagnosis, the adoption of these tools by ED clinicians has remained low. This literature review highlights the need for further research into why CTPAs continue to be overused within EDs and why clinicians are hesitant to use CPGs in the clinical setting. Moreover, investigations into other potential strategies that may combat the overuse of this diagnostic tool are essential to reduce potential harm.

Item Details

Item Type:Refereed Article
Keywords:computed tomography angiography, emergency service, hospital, medical overuse, pulmonary embolism
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Emergency medicine
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Thurlow, LE (Ms Lauren Thurlow)
UTAS Author:Van Dam, PJ (Dr Pieter Van Dam)
UTAS Author:Prior, SJ (Dr Sarah Prior)
UTAS Author:Tran, V (Associate Professor Viet Tran)
ID Code:149852
Year Published:2022
Deposited By:Medicine
Deposited On:2022-04-19
Last Modified:2022-11-15
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