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Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 3h
Meta-analysisClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2026

Diagnostic Validation of PERC and Resource Utilization in Suspected Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis.

Xueyan Liu, Hua Fan, Yangyang Hai … Sirui Gu
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Internal MedicineMeta-analysis

PERC use is associated with less CT pulmonary angiography in low-risk emergency patients

Diagnostic Validation of PERC and Resource Utilization in Suspected Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis.

Xueyan Liu … Sirui Gu
Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2026
Background

And Aims Pulmonary embolism (pulmonary embolism) is a frequent and potentially fatal diagnosis in the emergency department (emergency department).

Purpose

This systematic review aimed to evaluate the diagnostic accuracy of PERC and its effect on reducing computed tomography pulmonary angiography (computed tomography pulmonary angiography) use.

Methods

Eligible studies enrolled emergency department patients with suspected pulmonary embolism who were classified as low risk according to the original study-specific approaches, including clinician gestalt, Wells score, revised Geneva score, or YEARS-based assessment.

n = 13,672 patients
Results

Imaging use was 15% lower when PERC applied, without compromising diagnostic safety

RR 0.85 (95% CI 0.80 to 0.91)
null = 10.800.91
CI excludes the null - significant
More results

The pooled pulmonary embolism prevalence was 7%.

The pooled sensitivity, specificity, and negative predictive value of PERC were 95% (95% CI: 89%-98%), 26% (95% CI: 16%-40%), and 98.2% (95% CI: 97.8%-99.0%), respectively.

“
Conclusion

ConclusionsPERC provides a highly sensitive and safe strategy for ruling out pulmonary embolism in low-risk emergency department patients and significantly reduces unnecessary use of advanced imaging without compromising diagnostic safety.

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