Clinical Research Directory
Browse clinical research sites, groups, and studies.
Diagnostic Strategy for Suspected Pulmonary Embolism Based on 4PEPS
Sponsor: University Hospital, Angers
Summary
The increased use of diagnostic imaging and especially computed tomography pulmonary angiography in patients suspected of pulmonary embolism (PE) is an important point of concerns. The goal of this pragmatic cluster-randomized trial is to compare the diagnostic strategy based on the four-level pulmonary embolism probability score (4PEPS) and current practices. The main questions it aims to answer is: "Does the diagnostic strategy based on 4PEPS significantly reduce the use of thoracic imaging without increasing the risk of serious adverse events as compared to current diagnostic practices?" Patients suspected of having PE in the participating emergency departments will be included and followed for 90 days. In ten centers, the emergency physicians will apply the 4PEPS strategy and in ten other centers, the emergency physicians will be free to do as they see fit. Researchers will compare the two groups of patients to see if the rate of diagnostic thoracic imaging tests and the rate of adverse events related to diagnostic strategies will differ.
Official title: Diagnostic Strategy for Suspected Pulmonary Embolism in Emergency Departments Based on the 4-Level Pulmonary Embolism Clinical Probability Score: SPEED&PEPS Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
3084
Start Date
2023-11-29
Completion Date
2025-11-10
Last Updated
2026-07-17
Healthy Volunteers
No
Conditions
Interventions
4PEPS strategy
Physicians of the participating centers in the intervention group will have the recommendation to apply the 4PEPS strategy. Using 12 variables, 4PEPS defines four levels of CP that rule out a PE, namely 1. based only on clinical data (very low CP: PEPS \< 0), 2. based on a D-dimer level \< 1000 μg/L (low CP: PEPS ≥ 0 and \< 5), 3. based on a D-dimer level with an age-adjusted cut-off value (moderate CP: PEPS ≥ 5 and \<12), or 4. the diagnosis cannot reliably be ruled out based on a D-dimer test (high CP: PEPS ≥ 12)
Locations (23)
Cliniques Bruxelles
Brussels, Belgium
CHU Liège
Liège, Belgium
CH Agen
Agen, France
CHU Angers
Angers, France
CH Argenteuil
Argenteuil, France
CH Arpajon
Arpajon, France
AP HP Clamart
Clamart, France
CHU Clermont Ferrand
Clermont-Ferrand, France
CHU Grenoble
Grenoble, France
CH La Rochelle
La Rochelle, France
CH Versailles
Le Chesnay, France
CHU Limoges
Limoges, France
CHU Lyon
Lyon, France
CHR Metz Thionville
Metz, France
CHU Nantes
Nantes, France
CHU Nice
Nice, France
GH Paris
Paris, France
CHU Poitiers
Poitiers, France
CH Rochefort
Rochefort, France
CHU Rouen
Rouen, France
CHU Toulouse
Toulouse, France
CHU Tours
Tours, France
CH Troyes
Troyes, France