Table 4.

Summary of Systematic Reviews of the Accuracy of Computed Tomography for the Diagnosis of Pulmonary Embolism

Author, YearMain Inclusion CriteriaNo. of PatientsPrevalence of Pulmonary Embolism %Pooled Sensitivity % (Range)or [95% CI]Pooled Specificity % (Range)or [95% CI]
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.
Harvey et al,60 2000Prospective and retrospective studies with PA as reference standard in most cases8133479 (47–100)89 (75–100)
Mullins et al,61 2000Diagnosis established by PA or a clinical reference standard*3673593 (50–100)97 (92–100)
Rathbun et al,62 2000Prospective studies evaluating use of CT for diagnosis of PE using any reference Standard1,330NR(53–100)(81–100)
Cueto et al,63 2001Prospective studies with positive and negative CT results; PA reference standard268NR80 [73–86]94 [91–98]
van Beek et al, 64 2001Prospective studies reporting sensitivity and specificity of CT relative to PA or V/Q scan1,1713988 [83–91]92 [89–94]
Safriel & Zinn,65 2002Diagnosis established by PA or high- probability V/Q scan1,250NR74 [57–100]90 [68–100]
Roy et al,66 2005Prospective studies;431NR24 (12–47)
consecutive patients; diagnosis established by PA for confirmation strategies, and PA or clinical follow-up for exclusion strategies1,197NR0.11 (0.06–0.19)
Hayashino et al,67 2005Studies of helical CT compared to PA obtained within 48 hr520NR86 (80–92)94 (91–96)
Hogg et al,68 2006Prospective studies with 85% follow-up, with adequate reference standard, or clinical follow-up after negative CT74919–7989 (82–95)95 (91–98)