title: Knowledge of the diagnostic algorithm for pulmonary embolism in primary care.
abstract: BACKGROUND
  Diagnostic algorithms for pulmonary embolism (PE) have been validated in patients attending hospital emergency departments. However, general practitioners (GPs) are often the professionals of first resort for the majority of non-critical cases of PE.
  
  
  OBJECTIVE
  To evaluate the knowledge of the diagnostic algorithm for PE among GPs in France.
  
  
  METHODS
  Questionnaire-based survey of GPs with a private practice.
  
  
  METHODS
  All GPs in the study area were sent a questionnaire including several questions on the diagnosis of PE and two clinical cases scenario with suspected PE. Factors associated with knowledge of the diagnostic algorithm were analysed by univariate and multivariate analyses.
  
  
  RESULTS
  Five-hundred and eight questionnaires were distributed and 155 (30.5%) were available for analysis. Only 55% of the GPs did know about clinical scores for the assessment of clinical probability of PE and 42% of the GPs were aware that clinical probability is needed to interpret the result of D-dimer testing. Forty GPs (26%) gave valid responses to both clinical cases, 54 GPs (35%) had one valid case out of the two and 61 (39%) gave invalid responses to both clinical cases. Participation in specific training on PE was significantly associated with valid responses to the two clinical cases in multivariate analysis (p<0.017).
  
  
  CONCLUSIONS
  The majority of GPs were unaware of the diagnostic algorithm for PE. Clinical probability was rarely assessed and knowledge about D-dimers was poor. Specific training on PE and greater awareness of clinical probability scores may promote knowledge of PE algorithm diagnosis.
authors.affiliation: Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; ISERM U970-PARCC, Paris, France. Electronic address: benjamin.planquette@egp.aphp.fr.
authors.forename: B
authors.initials: B
authors.lastname: Planquette
authors.affiliation: Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Maurice
authors.affiliation: Hospices Civils de Lyon, Service de Biostatistique, F-69003 Lyon, France; CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France; Université de Lyon, F-69622, Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Peron
authors.affiliation: Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: G
authors.initials: G
authors.lastname: Mourin
authors.affiliation: Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: A
authors.initials: A
authors.lastname: Ferre
authors.affiliation: Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; ISERM U970-PARCC, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Sanchez
authors.affiliation: Service de pneumologie et de soins intensifs, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; ISERM U970-PARCC, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Meyer
mesh_terms: D000465:Algorithms; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000706:statistics & numerical data; D005260:Female; D005602:France; D058005:General Practitioners / Q000592:standards*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000592:standards*; D011655:Pulmonary Embolism / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Algorithms; Differential diagnosis; Disease management; General practice; Primary care physician; Pulmonary embolism