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Value-based Imaging for Pulmonary Embolism

Learning Objectives:
At the end of this activity, you will be able to:
1. Understand successful communication practices with radiologists/referring physicians related to ordering imaging;
2. Demonstrate understanding of image ordering best practices;
3. Apply evidence-based recommendations into image ordering decision-making.
0.5 Credit CME

R-SCAN Value-based Imaging podcast series features radiologists and referring clinicians discussing strategies for evidence-based image ordering that position your practice for success in the transition to value-based care. Learn more

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Audio Information

Authors:

Carole Dennie, MD, FRCPC, Professor of Radiology and Medicine, University of Ottawa, Section Head, Cardiac and Thoracic Imaging at The Ottawa Hospital, Co-director, Cardiac Radiology and MRI, University of Ottawa Heart Institute

Philip Wells, MD, FRCPC MSc, Professor, Chair and Chief, Department of Medicine, The University of Ottawa, Faculty of Medicine and The Ottawa Hospital, Senior Scientist, Ottawa Hospital Research Institute

Designation Statement: The American College of Radiology designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. You must achieve a minimum score of 80% to receive credit. Estimated time to complete the enduring material is 30 minutes.

Only physicians are eligible to be awarded AMA PRA Category 1 Credit™. The AMA defines physicians as those individuals who have obtained an MD, DO, or equivalent medical degree from another country.

Statement of Competency: This activity is designed to address the following ABMS/ACGME competencies: interpersonal & communication skills and medical knowledge.

Accreditation Statement: The American College of Radiology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Disclosure Statement: In compliance with ACCME requirements and guidelines, the ACR has developed a policy for review and disclosure of potential conflicts of interest, and a method of resolution if a conflict does exist. The ACR maintains a tradition of scientific integrity and objectivity in its educational activities. In order to preserve this integrity and objectivity, all individuals participating as planners, presenters, moderators, and evaluators in an ACR educational activity or an activity jointly sponsored by the ACR must appropriately disclose any financial relationship with a commercial organization that may have an interest in the content of the educational activity.

The following faculty indicated that they have no relevant financial relationships related to the presentation of this material:

Carole Dennie, MD, FRCPC

Philip Wells, MD, FRCPC MSc

ACR staff have indicated that they have no relevant financial relationships related to this educational activity.

Renewal Date: June 1, 2019

References
1.
Fesmire  FM, Brown  MD, Espinosa  JA,  et al.  Critical issues in the evaluation and management of adult patients presenting to the emergency department with suspected pulmonary embolism.  Ann Emerg Med. 2011;57:628–652.Google Scholar
2.
Anderson  DR, Kahn  SR, Rodger  MA,  et al.  Computed tomographic pulmonary angiography vs ventilation/perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial.  Jama. 2007;298(23):2743–2753.Google Scholar
3.
Revel  MP, Cohen  S, Sanchez  O,  et al.  Pulmonary embolism during pregnancy: diagnosis with lung scintigraphy or CT angiography? Radiology. 2011;258(2):590–598.
4.
Shahir  K, Goodman  LR, Tali  A, Thorsen  KM, Hellman  RS.  Pulmonary embolism in pregnancy: CT pulmonary angiography versus perfusion scanning.  AJR Am J Roentgenol. 2010;195(3):W214–220.Google Scholar
5.
Cahill  AG, Stout  MJ, Macones  GA, Bhalla  S.  Diagnosing pulmonary embolism in pregnancy using computed-tomographic angiography or ventilation-perfusion.  Obstet Gynecol. 2009;114(1):124–129.Google Scholar
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Agnelli  G, Becattini  C.  Acute pulmonary embolism.  N Engl J Med. 2010;363(3):266–274.Google Scholar
7.
Gandara  E, Wells  PS.  Diagnosis: use of clinical probability algorithms.  Clin Chest Med. 2010;31(4):629–639.Google Scholar
8.
Gimber  LH, Travis  RI, Takahashi  JM, Goodman  TL, Yoon  HC.  Computed tomography angiography in patients evaluated for acute pulmonary embolism with low serum D-dimer levels: A prospective study.  Perm J. 2009;13(4):4–10.Google Scholar
9.
Gupta  RT, Kakarla  RK, Kirshenbaum  KJ, Tapson  VF.  D-dimers and efficacy of clinical risk estimation algorithms: sensitivity in evaluation of acute pulmonary embolism.  AJR Am J Roentgenol. 2009;193(2):425–430.Google Scholar
10.
Kabrhel  C.  Outcomes of high pretest probability patients undergoing d-dimer testing for pulmonary embolism: a pilot study.  J Emerg Med. 2008;35(4):373–377.Google Scholar

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