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09/01/26

Decision moments and pulmonary embolism diagnostic quality in the emergency department.

Janke, Alexander T.; Fung, Christopher M; Bombard, Matthew C; Krupp, Seth; Oostema, J Adam; Overbeek, Daniel L; Hysell, Matthew; Paxton, James H; Perrotta, Giuseppe; Todd, Brett; Westafer, Lauren M; Barnes, Geoffrey D; Greineder, Colin F; Kocher, Keith E. JAMA Netw Open.

Collection Topics
Cognition and Decision Making Tests, Screening, and Laboratory Processes Business Case for Excellence
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Summary

Emergency clinicians must balance timely pulmonary embolism diagnosis against unnecessary testing. This observational study examines diagnostic decision-making and quality across encounters at 29 emergency departments (ED). By focusing on decision moments, it connects clinical reasoning and testing practices with diagnostic outcomes. The findings have implications for reducing missed diagnoses while avoiding overtesting. Its large clinical setting supports relevance, although results from one state may not generalize to all EDs.
Read the paper
Janke AT, Fung CM, Bombard MC, et al. Decision moments and pulmonary embolism diagnostic quality in the emergency department. JAMA Netw Open. 2026;9(9):e2635312.