Pulmonary vascular disease & thromboembolism
YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism in Patients With Cancer: A Randomized Clinical Trial
Primary resultResult — go to the resultAbsolute risk difference −3.7% 99.9% CI −8.8% to 1.4%Authors' conclusion
In patients with cancer and suspected PE, a diagnostic strategy using the YEARS diagnostic algorithm was as safe as using CTPA only, thus, obviating the need to perform CTPA in 22% of patients.
Study context
- Population
- Patients with active cancer and suspected acute pulmonary embolism (PE), recruited from EDs or medical units in 21 hospitals in the Netherlands, Italy, Switzerland, Belgium, France and Spain
- Participants
- 698 patients
- Comparison
- YEARS algorithm vs computed tomographic pulmonary angiography (CTPA) only
- YEARSn = 352
- CTPA onlyn = 346reference
- Primary endpoint
- Centrally adjudicated symptomatic VTE or (possible) PE-related death after ruling out PE at baseline
- Follow-up
- 90 days
Methodological detailsopen-label, investigator-initiated, noninferiority, blinded central outcome adjudication, multicentre (21 hospitals)
- Open-label
- Investigator-initiated
- Noninferiority
- Blinded central outcome adjudication
- Multicentre (21 hospitals)
Primary result
As reported in the abstract
Absolute risk difference
−3.7%
99.9% CI −8.8% to 1.4%
P = 3.4 × 10-5
Events by treatment group
YEARS vs CTPA only
absolute risk difference −3.7% (99.9% CI −8.8% to 1.4%); P = 3.4 × 10-5
Secondary outcomes
| Outcome | Absolute risk difference (99.9% CI) | P value | |
|---|---|---|---|
| Primary outcome, intention-to-diagnosis analysis · 90 days · noninferiority · intention-to-diagnosis | −2.6% (−7.5% to 2.4%) | P = 5.9 × 10-4 | |
| −10−505Difference (linear scale) |
| Outcome | YEARS | CTPA only | Estimate | P value | |
|---|---|---|---|---|---|
| PE managed without CTPA | 22% | Not reported in the abstract | CTPA only: not reported in the abstract |
Proportion of negative CTPA at baseline (key secondary)
- No difference between groups
- P = 0.93
Original publication
YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism in Patients With Cancer: A Randomized Clinical Trial. JAMA. Published 25 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it