Te Haara Sean R, De Rezende Helena, Wang Chao
Specialist Assets and Resilience, London Ambulance Service, London, United Kingdom.
Department of Nursing Science, Bournemouth University, Bournemouth, United Kingdom.
Sultan Qaboos Univ Med J. 2024 Nov;24(4):491-500. doi: 10.18295/squmj.1.2024.007. Epub 2024 Nov 27.
This systematic review and meta-analysis aimed to assess the diagnostic accuracy of the YEARS algorithm in excluding pulmonary embolism, as well as to compare the utilisation of advanced imaging modalities between the YEARS approach and standard clinical practice. Eligible studies were identified from multiple databases spanning July 2017 to September 2022, following the Joanna Briggs Institute methodology for diagnostic accuracy reviews. A total of 10 studies, involving approximately 14,000 participants, were included in the analysis. The YEARS algorithm demonstrated a sensitivity of 96% (95% confidence interval [CI]: 93-98%) and a specificity of 50% (95% CI: 33-67%). Additonally, the risk ratio for advanced imaging utilisation was 0.78 (95% CI: 67-90), indicating a significant reduction in imaging use. These findings suggest that the YEARS is an effective and safe strategy for managing patients with suspected pulmonary embolism.
本系统评价和荟萃分析旨在评估YEARS算法在排除肺栓塞方面的诊断准确性,并比较YEARS方法与标准临床实践中高级成像模式的使用情况。根据乔安娜·布里格斯研究所诊断准确性评价方法,从2017年7月至2022年9月的多个数据库中识别符合条件的研究。共有10项研究(涉及约14000名参与者)纳入分析。YEARS算法的敏感性为96%(95%置信区间[CI]:93-98%),特异性为50%(95%CI:33-67%)。此外,高级成像使用的风险比为0.78(95%CI:67-90),表明成像使用显著减少。这些发现表明,YEARS是管理疑似肺栓塞患者的一种有效且安全的策略。