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Respiratory medicine
Protocol
SPECT V/Q for the diagnosis of pulmonary embolism: protocol for a systematic review and meta-analysis of diagnostic accuracy and clinical outcome
  1. Pierre-Yves Le Roux1,
  2. Philippe Robin1,2,
  3. Cécile Tromeur3,
  4. Alexandra Davis4,
  5. Helia Robert-Ebadi5,
  6. Marc Carrier2,
  7. Francis Couturaud3,
  8. Grégoire Le Gal2,3,
  9. Pierre-Yves Salaun1
  1. 1 Service de médecine nucléaire, CHRU de Brest, EA3878 (GETBO), Université de Brest, Brest, France
  2. 2 Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
  3. 3 Département de Médecine Interne et Pneumologie, CHRU de Brest, EA3878 (GETBO), Université de Brest, Brest, France
  4. 4 Library and Learning Centre, The Ottawa Hospital, Ottawa, Ontario, Canada
  5. 5 Division of Angiology and Hemostasis, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
  1. Correspondence to Professor Pierre-Yves Le Roux; pierre-yves.leroux{at}chu-brest.fr

Abstract

Introduction Single photon emission computed tomography ventilation/perfusion (SPECT V/Q) imaging has many proponents within the nuclear medicine community and has already largely replaced planar V/Q scintigraphy in daily practice for the diagnosis of pulmonary embolism (PE). However, the test is still described in clinical guidelines as an experimental test because of insufficient evidence.

Methods and analysis We will conduct a systematic review and a meta-analysis of diagnostic accuracy and management outcome studies involving patients evaluated with V/Q SPECT for suspected acute PE. We will search from inception to 19 December 2017 MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for diagnostic accuracy studies, randomised controlled trials and observational cohort studies. Two reviewers will conduct all screening and data collection independently. The methodological quality and risk of bias of eligible studies will be carefully and rigorously assessed using the Quality Assessment of Diagnostic Accuracy Studies-2, the Cochrane Collaboration’s tool and the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tools. The primary outcomes will be sensitivity, specificity and likelihood ratios of V/Q SPECT for the diagnosis of acute PE. The secondary outcomes will be the rate of venous thromboembolism during a 3-month follow-up period in patients left untreated after a negative diagnostic work-up based on SPECT V/Q.

Ethics and dissemination This study of secondary data does not require ethics approval. It will be presented internationally and published in the peer-reviewed literature.

PROSPERO registration number CRD42018084095.

  • thromboembolism
  • nuclear medicine
  • chest imaging

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2018-022024

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    Footnotes

    • Contributors PYLR, PR, GLG and PYS conceived the idea and design for this systematic review. PYLR, PR, AD, MC, GLG and PYS developed the methodology for the systematic review protocol. The contents of this manuscript were drafted by PYLR, GLG and PYS with input from all members of the authorship team. The manuscript was reviewed by PR, CT, AD, MC, HRE and FC for important intellectual content. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests GLG holds an Early Researcher Award from the Province of Ontario, a CP Has Heart Cardiovascular Clinician Scientist Award from the Heart and Stroke Foundation of Ontario, and the Chair on Diagnosis of Venous Thromboembolism from the Department of Medicine, University of Ottawa.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement There is no additional unpublished data from this study.