As we can see from the discussion below, this study does lead to some debate about the true prevalence of PE in patients with syncope. However, I actually think the question might be phrased a bit differently....
I think the most important question is: How many PEs are we missing in syncope patients? In other words, what proportion of the 17% of patients with syncope would have been diagnosed during routine clinical care, and what proportion would we have missed? In this study, all patients with syncope underwent a standardized workup, but I'd like to know how many would have undergone a PE workup had the study not been enrolling.
If we assume that patients with a clinically significant PE, but without any symptoms or signs of PE, would not have been tested, we're left with about 4% of patients. The true number of "missed" or "miss-able" PE may be somewhere between that 4% and the 17% reported.
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