Pulmonary vascular disease & thromboembolismRandomised controlled trial

YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism in Patients With Cancer

JAMAPublished

  • Randomised controlled trial
  • open-label
  • investigator-initiated
  • noninferiority
  • blinded central outcome adjudication
  • multicentre (21 hospitals)

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

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

Outcomeabsolute 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
OutcomeYEARSCTPA onlyEstimateP value
PE managed without CTPA22%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. JAMA. Published 25 August 2026. doi:10.1001/jama.2026.10676

Summarised from the published abstract; every number is checked against it