title: [Spiral CT angiography in diagnosis of acute pulmonary embolism. What factors modify implementation of standard algorithms?].
abstract: OBJECTIVE
  Debate about the potential implementation of Spiral-CT in diagnostic algorithms of pulmonary embolism are often focussed on sensitivity and specificity in the context of comparative methodologic studies. We intend to investigate whether additional factors might influence this debate.
  
  
  METHODS
  On the basis of the current literature and of own experience we study the influence of factors such as availability, acceptance, patient-outcome, and cost effectiveness-studies on the potential implementation of Spiral-CT in diagnostic algorithms of pulmonary embolism. This information is analyzed together with data from comparative methodologic studies.
  
  
  RESULTS
  The factors availability, acceptance, patient-outcome, and cost-effectiveness-studies do have substantial influence on the implementation of Spiral-CT in the diagnostic algorithms of pulmonary embolism. Incorporation of these factors into the discussion might lead to more flexible and more patient-oriented algorithms for the diagnosis of pulmonary embolism.
  
  
  CONCLUSIONS
  Availability of equipment, acceptance among clinicians, patient-outcome, and cost-effectiveness evaluations should be implemented into the debate about potential implementation of Spiral-CT in routine diagnostic imaging algorithms of pulmonary embolism.
authors.affiliation: Universitätsklinik für Radiodiagnostik, L. Boltzman Institut für Radiologische und Physikalische Tumordiagnostik, Wien.
authors.forename: A
authors.initials: A
authors.lastname: Bankier
authors.forename: C J
authors.initials: CJ
authors.lastname: Herold
authors.forename: D
authors.initials: D
authors.lastname: Fleischmann
authors.forename: K
authors.initials: K
authors.lastname: Janata-Schwatczek
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D000792:Angiography / Q000191:economics; D003362:Cost-Benefit Analysis; D006801:Humans; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000191:economics
vernacular_title: Spiral-CT-Angiographie zur Diagnose der akuten Pulmonalembolie. Welche Faktoren beeinflussen die Implementierung in Standardalgorithmen?