St James's Hospital uses prediction test to increase PE survival rates

A NEW technique which allows for quicker diagnosis of a potentially deadly lung disease has been pioneered by St James’s Hospital.

Pulmonary embolism (PE) is a blockage of the main artery of the lung which can, if left untreated, have a 30 per cent mortality rate. PEs are usually diagnosed using a CT pulmonary angiogram (CTPA).

Doctors at St James’s are using new technology to more accurately identify those at risk of the condition with a clinical prediction score which will indicate whether a patient requires further diagnostic radiology testing.

The Cerner decision support system helps relieve the demand for this test, reduce unnecessary radiation exposure and free up financial and time resources at the hospital. This means that patients can be treated earlier and so increase their chances of survival.

St James’s carried out an audit of those who had the condition to ascertain the risk factors involved. They found there was an increased risk in pregnancy, in those with deep vein thrombosis (DVT), and also in postoperative and immobile patients. However, only 11 per cent of the 659 patients scanned for PE tested positive for it.

In conjunction with Cerner, a technology company specialising in medical diagnostics, they developed a clinical prediction score to ascertain the probability of a patient getting PE.

Based upon the score, CPTA Advisor indicates whether or not PE is likely and recommends either proceeding with the scan or cancelling the order according to the level of risk.

A second audit carried out at St James’s found an increase in scans that were positive for PE, indicating an increase in diagnostic efficiency over the previous audit.

Additionally, 20 per cent of scans were cancelled because they were deemed to be unnecessary.

Prof Mary Keogan, clinical director of radiology from St James’s Hospital, said the new system was not only saving time and money in relation to the cost of administering CPTA scans, but also increasing the diagnostic accuracy which “ultimately leads to improved health outcomes”.