Availability of diagnostic facilities in the Netherlands for patients withsuspected pulmonary embolism

Pulmonary embolism remains a complex diagnostic problem. Although accurate and cost-effective, the 'Dutch consensus' strategy is not widely applied. W e assessed the availability and investment plans of the different facilitie s used in this strategy. Furthermore, the current and future availability o f new diagnostic modalities was investigated. A questionnaire was sent to a ll Dutch hospitals. The questionnaire contained separate sections with ques tions for the hospital management and the medical practitioners at the depa rtments of radiology, nuclear medicine, internal medicine and pulmonology. Five hundred and eighty-four questionnaires were sent out (response rate 68 %). Forty-three percent of the hospitals had no nuclear medicine facility, 11% had no pulmonary angiography facility, and 59% had no spiral CT scan (S CTA). Forty-six percent of the responding hospitals had a nuclear medicine facility; and 5% used Technegas for ventilation studies. Strategies with SC TA were available in about 27% of the hospitals. Due to future investments this number will increase to approximately 55%. Strategies with Technegas w ere available in 2.4% of the hospitals, this number might increase to 25% i f Technegas is proven accurate. The 'Dutch consensus' strategy is available in two-thirds of the hospitals. All other strategies were less feasible. S everal equivalent strategies for diagnosing pulmonary embolism should be de veloped. These strategies should be accurate, widely available and accepted . (C) 2000 Elsevier Science B.V. All rights reserved.