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07/12/26

YEARS algorithm for diagnosis of suspected pulmonary embolism in patients with cancer: A randomized clinical trial.

Akerboom, Bram; Martens, Emily S L; Stals, Milou A M; Brouwer, Rolf E; Coppens, Michiel; Costantino, Giorgio; Couturaud, Francis; van Dooren, Yordi P A; van der Griend, René; Hugli, Olivier; Jiménez, David; Kamphuisen, Pieter W; El Kharbouchi, Ouiam; Kroft, Lucia J M; Leentjens, Jenneke; Maas, Martje L; van Mens, Thijs E; Mahé, Isabelle; van Meer, Oene A; Out, Mattijs; Pola, Roberto; Raskin, Jo; Righini, Marc; Sprenger, Reinier A; Kaptein, Fleur H J; Talerico, Rosa; Tritschler, Tobias; Ten Wolde, Marije; Klok, Frederikus A; Huisman, Menno V; Hydra Study Investigators. JAMA.

Collection Topics
Big Three Conditions Cognition and Decision Making Overdiagnosis Equity, Access, and Timeliness
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Summary

Overuse of imaging degrades diagnostic excellence as it results in unnecessary costs, radiation exposure, and patient stress. This randomized trial examines whether the use of a diagnostic rule set could safely reduce CT imaging for patients with active cancer and suspected pulmonary embolism. The results find that the algorithm was as safe in detecting clinically significant clots as routine CT scanning while avoiding unneeded exams. These findings suggest evidence-based diagnostic pathways can reduce unnecessary imaging without compromising patient safety in this high-risk population.

Read the paper
Akerboom B, Martens ESL, Stals MAM, et al. YEARS algorithm for diagnosis of suspected pulmonary embolism in patients with cancer: a randomized clinical trial. JAMA. 2026;336(8):655-663.